Addressing non-communicable diseases in Suriname: The Diabetes Challenge

PARAMARIBO–World Diabetes Day is near and non-profit organizations in Suriname are encouraging people to get their “numbers.” Foundation Diabetes Education Suriname (SDES) staffers encourage Suriname citizens to take advantage of the free prick points such as the one set up at the Tourtonne Market, this past Saturday. The organization feels the urgency, as Diabetes, a non-communicable disease, continues to rise worldwide. The prick point was strategically placed at the market, which is heavily attended all morning long as families, young and old, come there to buy their produce every week to prepare their diverse cuisine that proudly originated among the various ethnic groups inhabiting the country. Like many other cultures where Diabetes is on the rise, Surinamers face the challenge of adapting their preparation of foods and still come up with the fine cuisines they are known for.

Although it is not clear how many cases of Diabetes Suriname has, more and more cases arise, particularly among people in the interior. Often this population finds itself diagnosed at the point where Diabetes has led to kidney disease and in some cases end stage renal failure. At that point, it is no longer a matter of simple treatment, but patients now require dialysis, a very expensive treatment to take over the work that kidneys can no longer do. Suriname is not foreign to this treatment and several dialysis centers have sprung up in Paramaribo.

Dialysis is offered as close as the National Kidney Center at the Academic Hospital and as far as Diapura, a state of the art dialysis center, located in District Commewijne, close enough to the capitol yet far often too far for most. Patients often cannot afford the transportation for the frequent treatments necessary to improve their condition and sometimes to keep them from dying unnecessarily. Therefore Diapura provides transportation for most of its patients in order to assure compliance with treatment procedures, a schedule of 2-3 times a week for most.

Demand is so high, Diapura runs three shifts even on Saturdays, due to the increasing number of dialysis patients in the region. With little to no kidney specialists and nurses trained in nephrology, the center has its own challenges but they stay motivated with the knowledge that they can save and increase quality of life where previously hope was lost. The cost of treatment sometimes poses a greater challenge to address Diabetes in Suriname as patients may receive subsidized treatment only for part of the dialysis process but still have to come out of pocket for simple things such as a shunt, necessary for transporting the patient’s blood in and out of the body: if infected the outcome is potentially fatal.

Diabetes presents a burden that is not only related to the cost of treatment and care, but also to in-direct costs which are presented when the patient loses his or her productivity from disability and premature mortality. According to the Journal of Clinical Endocrinology and Metabolism, medical expenditures for people with diabetes are 2–3 times higher than for those not affected by diabetes.

 In order to meet the Millennium Development Goals and combat non-communicable diseases, it will be important for Suriname to join other countries and intensively monitoring the prevalence of Diabetes in the various ethnic groups. SDES reported 209 amputations between 2000-2003 and 123 amputations due to complications with Diabetes. Multiple pilot projects have been under way, supported by the Ministry of Health, to provide answers to the rise of non-communicable diseases such as Diabetes and Cardiovascular diseases which often go hand in hand. The challenge is great but the solutions are in our reach. Suriname can indeed prevent another epidemic; the choice is ours.