Fighting diabetes disinformation
Dr Olubiyi Adesina is a busy man. A Consultant Endocrinologist with the Federal Medical Centre, Abeokuta, the capital of Ogun State (Nigeria), he is also the Coordinator at the Talabi Diabetes Centre, a not-for-profit facility focusing on diabetes awareness and education in Ogun State. We caught up with him remotely a few months into the COVID-19 pandemic. Social distancing and travel restrictions were casting uncertainty on another one of his initiatives -the first camp for young people with type-1 diabetes organised in the state.
Originally from Osun State, Dr Adesina moved to Ogun State, at the doorstep of the tentacular city of Lagos, twelve years ago. His interest in diabetes and endocrinology finds its origins in the impact that diabetes had on his own family. He realised early on that the lack of information on the disease was killing people, and that awareness was the first line of defence to slow the spread of the disease. This cemented his belief in the power of education and fuelled his combat against misinformation -what we would now call ‘fake news’.
If there is such a thing as a health influencer, Dr Adesina was one ahead of his time. Before social media exploded, the diabetes expert offered to volunteer a weekly column in the Sunday Sun, a popular newspaper with a nation-wide distribution. “People were promising all sorts of cure against diabetes, and there was an absence of true information” he explains. ‘Diabetes Corner’ was launched in 2009 and became one of the readers’ most sought-after columns in the newspaper.
For nine years, alongside his professional responsibilities, Dr Adesina would be a voice for diabetes education in the media, addressing topics ranging from early signs of diabetes to nutrition and myths-busting “I wrote that column in simple, everyday language.” A sign of his approachable nature, Dr Adesina left his email and phone number in the newspaper and allowed readers to ask him questions directly. Eventually, as the Sun expanded its audience, the demands of the column and its readership were no longer sustainable and Dr Adesina relinquished his stint in journalism.
From this experience, he developed a strong conviction that healthcare professionals and experts had a responsibility to educate and reach out to a wider audience, particularly through traditional and non-traditional media. “We need to engage with the media and media practitioners.” he believes. “They need to understand what diabetes is about, because access to accurate information is a major problem. Traditional media and social media can help convey this information.
Primary care diabetes education
Alongside media outreach, Dr Adesina opened another battlefront against diabetes in Ogun State: primary care education and screening. As the main coordinator of the Talabi Diabetes Centre, he has been designing and implementing campaigns to inform and screen populations by segment: for example teachers, women attending the market etc.
In 2016, Dr Adesina and Talabi Diabetes Centre received a grant from the World Diabetes Foundation (WDF) to train a thousand primary healthcare workers on diabetes care and provide basic equipment to a hundred primary health care centres: glucometers and strips to test blood sugar levels and monofilaments to identify diabetes foot complications. “This was significant”, Dr Adesina explains, “because in the structure of health care in Nigeria, diabetes is normally treated at the secondary and tertiary levels. The paradox is that the majority of patients access care at the primary healthcare level”. Initially targeting a hundred primary healthcare centres, the project team managed to provide equipment to three hundred centres, taking advantage of favourable currency conversion rate. Over a 2-year period, the project team screened 13,000 people, 900 (7%) of whom were diagnosed with diabetes.
An important aspect of the project was to ensure its sustainability beyond the initial support provided by the grant. “Getting the money to buy test strips is a challenge across the country” Dr Adesina explains, “and the government lacks the resources to fund a sufficient amount of them”. Financial sustainability was built into the project by charging a small fee for the test. Outside of the primary care centres, a test strip can cost up to NGN 400 (USD 1). The centres supplied the test at a fourth of this cost (NGN 100), so that future supply could be secured. The project team distributed five boxes of strips (250 strips) to each centre and gave directions on the cost and mechanics of establishing a revolving fund to purchase future supply.
Planned in the design of the project are two more critical elements: training of future workforce and upskilling of the original cohort. The Talabi Centre will undertake this aspect of the work every three to four years, to ensure that the knowledge of the healthcare professionals is passed on and remains relevant and up-to-date.
To scale up this type of initiative, other stakeholders will have to come into the picture. As the head of the Ogun State Diabetes Association, Dr Adesina acknowledges the leadership role that non-profit associations can play. “Small groups are doing similar work in Lagos State and Abuja, but there is a need to coalesce for optimal impact” Dr Adesina believes.