Sunday November 14th is World Diabetes Day.
At least 54% of people we work with in The Gambia were amputated due to diabetes; it is by far the main cause of amputation amongst women in the country. Here we talk about how we support these people, with the help of Muhammed Jawla…
“I am Muhammed Jawla – an amputee from The Gambia and an active member of the Gambian Amputee Association (GAA). I had my leg amputated in 2016, but I had been living with the condition since 2008.”
What causes diabetes?
Type 2 diabetes is caused by diet and in The Gambia rice is a staple and affordable dish. According to research, people who eat rice three to four times a day are 1.5 times more likely to have diabetes. There is a lack of knowledge around what causes diabetes, but even for those who know they are living with the condition, limited income means that they often have to continue to eat rice because it’s difficult to afford wider diets.
“In Africa we survive on rice, we eat it for every meal. Everything we consume like baobab juice, wonja, attaya, they all can cause diabetes. We don’t know the risk of diabetes until we have it, until it is too late.
Once you are diagnosed with diabetes your life will change – you must only eat rice once a day and you must eat vegetables at night-time so your blood sugar does not rise, but many people don’t have the money for vegetables. We eat rice for survival, because we don’t want to die, but actually, the rice is killing us too.”
How does diabetes lead to amputation?
In some cases, diabetes can lead to peripheral artery disease (PAD). PAD causes your blood vessels to narrow and reduces blood flow to your legs and feet. It may also cause nerve damage, known as peripheral neuropathy. This could prevent you from feeling pain. If you can’t feel pain, you may not realise you have a wound or ulcer on your feet so you may continue putting pressure on the affected area, which can cause it to grow and become infected.
On top of this, reduced blood flow can slow wound healing and can make your body less effective at fighting infection. This is when gangrene can occur and infection can spread to the bone.
If the infection cannot be stopped or the damage is irreparable, amputation may be necessary. The most common amputations in people with diabetes are the toes, feet, and lower legs. In The Gambia, many people access treatment too late, which goes some way to explaining why the rates of amputation due to diabetes are so high.
“People in The Gambia don’t check their health – I don’t know if it’s because of where they live or lack of education but they don’t go to hospital in time. You only go to the hospital to die. Here, people wait until the sickness is so painful that they have to go. That’s why they are amputated immediately, because the doctor cannot do anything to help. Even me – I did nothing until I collapsed. It was then that I went to hospital and the doctor told me it was diabetes”
What are people’s views towards amputees?
“I say to people, if you aren’t an amputee you don’t know what it’s like to be an amputee. If you were getting 100% respect before you were amputated, once you become an amputee you get 25%, because you can no longer do everything other people can – somebody needs to do things for you. It’s very difficult being an amputee in our society, they do not take you as human”
How do Legs4Africa support people with diabetes in The Gambia?
We support the Gambian Amputee Association (GAA) – an organisation that encourages and provides a space for amputees to come together and share experiences. We also provide counselling to those newly amputated to give them some emotional support and connection following a life changing experience. This year, 82% of the newly amputated patients we’ve met while counselling on surgical wards were amputated as a result of diabetes.
“Legs4Africa are very useful; they provide us with prosthetic legs and they support our amputee association (GAA). Thanks to them our office is improving and they are doing a good job at the mobility centre. We now have 432 GAA members and we are having very good meetings”
How can Leg Up improve services for people with diabetes?
Through Leg Up, we hope to start working with disabled organisations and health providers to increase awareness of the importance of early interventions to deal with the risks associated with diabetes. This will involve sensitisation campaigns on local radio and across social media.
As well as focusing on prevention, we want to do more to support those already amputated as a result of diabetes. In Ghana, we have diabetic amputee counsellors who advise others on the importance of healthy living while promoting the notion that diabetes is a manageable medical condition rather than a curse disconnected from lifestyle as it’s sometimes perceived. The plan is to mirror this successful programme in The Gambia.
How can YOU support people in The Gambia this World Diabetes Day?
Donate to our Leg Up campaign before December 24th 2021 and have your contribution doubled, just click here.
All money raised will go specifically towards our work in The Gambia over the next two years.