Project Krishna is a joint initiative by Swasthya Diabetes Care and All India Institute of Diabetes and Research that aims to provide better care and resources to children with Type 1 diabetes in Gujarat and nearby states. The project intends to establish a resource center with facilities ranging from basic care to modern treatment methods, available to financially weaker populations at subsidised or no cost.
Dr Mayur Patel, the Chairman of Swasthya Diabetes Care, is the force behind this initiative and believes that corporates should extend their CSR activities to non-communicable diseases like diabetes.
In this interview with TheCSRUniverse, Dr Patel shares his journey, vision, and goals for raising awareness about Type 1 diabetes and related interventions to help marginalized communities. He also shares his experiences on how to make a difference in the lives of children affected by Type 1 diabetes and help them lead a better life.
Scroll down to read the interview:
Q: What circumstances and findings led you to start Swasthya Diabetes Care? What is your mission and goal?
A: I strongly believe that service to mankind is service to God. I have been serving society as NSS leader to the chairman of community projects and other roles since 1977. I started practising exclusive diabetes care immediately after my post-graduation. I realised that diabetes management requires proper counselling and support. Moreover, many complications of diabetes are potentially preventable if diabetes patients manage their disease carefully and undergo screening for complications regularly. To provide all kinds of speciality services under one roof and holistic management of diabetes, I established Swasthya Diabetes Care in 2003. Swasthya Diabetes Care treats patients from all sections of society from rich to poor, urban to rural. Our mission is to ensure affordable and accessible diabetes care to everyone.
Q: Please elaborate on the current challenges that female patients of Type 1 diabetes, especially adolescent girls, face in rural households.
A: The first and foremost challenge faced by female patients of Type 1 diabetes is lack of awareness about the ailment among family members. In some societies, girls are seen as a burden to the family and having Type 1 diabetes is an additional burden. They do not get enough medical attention due to their parents’ ignorance or financial situation. Difficulty in purchasing insulin and other essentials and lack of access to treatment worsen their situation.
To get the services of a diabetes specialist, the patient and one or both parents need to travel to the nearest town or city, resulting in a loss of daily wages. This is especially a challenge for those belonging to the economically weaker sections.
Unfortunately, insulin injection is still stigma in our society for Type 2 diabetes patients, and finding a match for a girl with Type 1 diabetes, who has to inject insulin four times a day, is difficult. Even after marriage, the females face difficulties in conceiving and there is also a lack of medical support for diabetes management during pregnancy. Data suggests that after 5 years of diagnosis, a majority of such children are non-traceable. The reason could be death due to a lack of insulin therapy.
Q: What is your approach and methods towards raising awareness and sensitizing rural households?
A: As a part of the Conquer Diabetes Project, an innovative Public Private Partnership Project with the Health Department of the Government of Gujarat, we have trained ASHA workers to sensitise rural families about Diabetes in general and Type 1 Diabetes specifically. They counsel and motivate such families about the importance of regular medical visits and insulin injections. ASHA workers also get incentives from the government for this work.
Moreover, we have recently launched Project Krishna, for handholding of all Type 1 diabetes children. Under this programme, we have trained medical students, interns and postgraduate medical students in managing Type 1 Diabetes. These students have been assigned one Type 1 diabetes child each. These students are in regular touch with the Type 1 child. If possible, they also undertake home visits, and counsel patients and family members.
Q: How difficult is it for you to break orthodox mind-sets? What are the challenges?
A: Breaking the stigma attached to insulin is very challenging. Convincing a family or parents about the importance of insulin injection in the management of Type 1 Diabetes is the most difficult task. They see this as the end of life for their children.
Even if the child is taking insulin regularly, he or she still needs to check blood sugar at home regularly with the help of a glucometer device. This is another big challenge as the majority of the children or their parents are not willing to do that. Because of the stigma, they feel awkward when they have to take insulin at school or a social function in front of friends /relatives. In many cases, children not taking insulin at such times leads to uncontrolled blood sugar.
Q: Please share your geographical reach and impact in terms of number of beneficiaries reached.
A: We are covering the whole state of Gujarat as well as the border districts of Madhya Pradesh, Maharashtra and Rajasthan. We have been able to provide free treatment to more than 1,000 Type 1 diabetes children along with all forms of counselling services and other support.
Q: Are you collaborating with other social sector stakeholders or like-minded individuals? Are local government bodies assisting you with this? What is your approach in this regard?
A: We are collaborating with various NGOs working in the field of Type 1 Diabetes. We are also having collaborations with various national-level medical student networks, to engage them in Project Krishna. As mentioned earlier, we have undertaken the Conquer Diabetes Project with the government of Gujarat, where the government has started incentivising ASHA workers to mobilise diabetes patients to medical facilities.
Q: A major chunk of Corporate CSR funds goes into healthcare but the nitty gritty of ground-level problems are known to NGOs and social activists like you who work closely with the communities. So, according to you what kind of support and interventions can Corporates make to help expedite the efforts of social activists like you?
A: We respect and appreciate all corporates that are helping people through various CSR activities. But, what we have noticed is that most of the CSR activities in healthcare are focused on the nutrition of children, cataract operations, distribution of free glasses, supporting an NGO’s hospitals, etc. Also, most of these activities are carried out in the surrounding areas of corporate houses, and hence do not reach the people who are actually in need. There are many government-run programs already in existence for above-mentioned projects.
We are working in different areas like spreading awareness about diabetes, helping Type 1 diabetes children, saving legs from amputation because of diabetic foot problems, preventing blindness from diabetic retinopathy, etc.
When we approach corporates for support under CSR for our activities, their typical response is that everyone knows about diabetes and hence there is no need to spread awareness. In most cases, they are not aware of Type 1 diabetes. Corporates are willing to support a patient who has lost a limb by providing prosthesis/wheelchair but not so much for treatment to prevent leg surgery. Corporates also say that they can support blind people but cannot support surgery for the prevention of blindness due to diabetic retinopathy. This is the true picture we have seen.
We expect corporates to expand their horizon of CSR activities to non-communicable diseases like diabetes. They can help in providing free treatment to Type 1 diabetes children. They can also support the treatment of poor people with a diabetic foot or diabetic retinopathy.
Q: Your recommendations for any policy-level changes to make efforts in this particular domain more meaningful and sustainable.
A: The government should provide free insulin, free glucometer and other supplies to all type 1 diabetic children. The government must also give special consideration to Type 1 diabetes patients in education and jobs in the same way that specially-abled individuals are given.
