With 8 to 10 percent of Yemen’s population suffering from diabetes – 2 to 3 percent of whom are children – both diabetes patients and health experts say alternate medication provided by the Ministry of Health is ineffective at treating the disease. Wojoud Mujalli reports.



Yemen’s Health Ministry previously purchased diabetes medications such as Actrapid, Insulatrd and Mixtard insulin from a Danish pharmaceutical company and the benefits to diabetes patients were evident. However, the ministry abruptly stopped dealing with the Danish company in early 2006, instead contracting with Egyptian and Indian firms for the same diabetes medication.

According to the ministry, one reason for purchasing the medication from such other sources is that they’re cheaper. However, patients and some health specialists say the alternate medication isn’t as effective as the previous ones, with several patients recently holding sit-ins and marches to protest the medicine.

Diabetes patient Adel Mahyoub of Sana’a agrees that the alternate medicines aren’t as good as the old ones. “Since I started using this medicine, I’ve developed a lot of problems with my liver and kidneys. This is why I sometimes buy the German medicine Lantus, which is the best, but rare to find,” he notes.

Mahyoub further recounts, “I recently went to the Ministry of Health and asked why they contracted with such unqualified firms and why they didn’t purchase [Lantus], at which they replied with satisfaction that the German medicine is too expensive and they can’t afford it.”
 

Yemeni health specialists allege that the medicines from these alternate sources damage the liver and kidneys and may cause patients allergies because they aren’t effective as those from Denmark and Germany.

The Health Ministry offers some 100,000 diabetes patients nationwide free medication via its Central Pharmacy located in each governorate; 30,000 diabetes patients in Sana’a alone receive free medicine this way.

Dr. Abdul-Kafi Al-Haddad, supervisor of the Yemeni Diabetes Center in Sana’a, points out that some diabetes patients get their medicine from other hospitals instead of from the center itself.

However, the center is new and the health minister is attempting to have diabetes patients obtain their medicine from only one source – the Central Pharmacy – so as not to mismanage the filling of prescriptions, as quantities are limited and sometimes don’t cover all patients’ needs.

He adds, “If there are any issues or problems with this alternate medication, doctors must say something about it and take care of their patients.”

Because the health minister controls the Central Pharmacy, hospitals have no control over it; thus, even if hospitals request medication transferred somewhere else, such directive won’t be followed or even considered.



A common disease

According to health workers, diabetes is one of Yemen’s most common diseases, with 8 to 10 percent of the nation’s approximately 21 million population suffering from it.

There are two types of diabetes – type 1 and type 2. The most common is type 2, wherein the B-cells in the pancreas can’t secrete insulin; thus, problems begin. Type 1 mostly is related to genetic factors and is where insulin is secreted but not active.

Dr. Zaid Atef, head of the Yemeni Diabetes Center and deputy manager at Al-Thawra Hospital, explains, “People are becoming lazy, because of which diabetes is increasing more quickly. Not exercising and the increasing rate of obesity in children are also important contributors to diabetes. Additionally, women who give birth many times are more likely to develop the disease, while genetic factors also play an essential role.”

According to him, too much glucose (sugar) in the blood for a long time can cause diabetes, noting that, “This high blood glucose (also called blood sugar) can damage many parts of the body, such as the heart, blood vessels, eyes and kidneys. Heart and blood vessel disease can lead to heart attacks and strokes.”

Atef explains further, “Diabetes slows circulation, which can make body tissues more susceptible to infections and reduce the body’s resistance to infection.”

According to Al-Haddad, diabetes has many effects upon the human body, as well as many causes, one of which he agrees with Atef is the lazy life to which many are becoming accustomed. “People must take more care of their health, paying attention to what they eat and exercising more.”

For this reason and to raise public awareness, he says, “We marched for International Diabetes Day in late November, celebrating it then instead of Nov. 14 for many reasons, one of which was that it was a Thursday and thus would attract larger crowds.”