Greater Amman, Jordan. In 1989, a four-year-old boy travelled from San Francisco to meet his grandmother for the first and last time in the West Bank. She later died from diabetes complications because she lacked access to health care and education.
01 May 2012 Brit Larsen
“One of the basic ideas behind the GMCP is that people can care for themselves and positively influence the lives of those around them when medical care is lacking and poverty ever-present,” Daniel Zoughbie explains. Patient empowerment is a crucial aspect for how well patients are able to manage their diabetes.
Mr. Sami Ali Harb is 64 years old and was diagnosed with diabetes 12 years ago. He has profited immensely from the information and network which the micro-clinic has provided him. “After attending the sessions, I have no fear anymore because the knowledge we got was more than enough in order to deal with and control my disease. Also, my spirit is so high and diabetes is a friend of mine and not an enemy any more,” he says.
Another micro-clinic member says: “I realized, I was rather ignorant as a person living with diabetes and the programme taught me the things I did not know, and it opened a road for me to deal with myself as a patient. I now feel that I can build a friendly relationship with my disease." According to Nadia El-Kerra, Regional Coordinator for the Jordan Micro-Clinic Project, the micro-clinics reach further than the individual; they also affect the community. ”The micro-clinics empower the patients to face their disease as a community and help overcome stigmas that the community has towards diabetes. It allows for a forum where patients can come together and discuss their struggle with diabetes and it empowers the patients to collectively make lifestyle modifications,” she says.
According to Daniel Zoughbie, the stories shared and the skills learned at the micro-clinics have a much stronger impact on the participants than just walking into an ordinary clinic. “Not only do they learn how to deal with the physical aspects of the disease, but they also learn to deal with the mental and social challenges of diabetes,” he says.
Part of the empowerment is also exchanging experience and dispelling prevailing myths about diabetes. For example, one woman told how she had gone to Syria for a foot operation which would cure her diabetes. It turned out that several others had heard a similar story of a supposed cure for diabetes. Another man stood up and told how he always made sure to put a bit of gasoline in his drinking water to cure his diabetes. In the micro-clinics people have the chance to exchange and have such dangerous myths dispelled.
Programme Coordinator at the World Diabetes Foundation, Ms. Astrid Hasselbalch visited Jordan in May this year. To her, it is beyond doubt that the micro-clinic concept makes a difference for the participants who now test their blood glucose levels once or twice a week, or even once a month, as opposed to never at all. “GMCP has created a momentum in the field of diabetes in Jordan. The project has brought together key national stakeholders and brought diabetes to the national health agenda in Jordan,” she adds.
GMCP Founder, Daniel Zoughbie describes the project as “horizontalising” the relationship between patient and health care system. As he says, “For many, this is the first time they have been provided with a space to ask questions, learn about diabetes, and support members of their community facing common challenges. In this sense, the support - technical, emotional, and financial - that the GMCP has received from the World Diabetes Foundation has had an impact on the lives of many economically disadvantaged diabetic individuals.”
The psycho-social rather than purely medical approach of the GMCP has turned out to be so convincing that the Jordan Ministry of Health has decided to expand and implement the micro-clinic model nationwide. The World Diabetes Foundation will continue its support to specifically train 150 nurses and 54 diabetes doctors from primary health care centres nationwide in order to establish diabetes clinics in all 54 health care centres. Alongside, 1000 micro-clinics are expected to be established. This second phase of the project will be carried out from August 2009 to December 2012.
Back to his source of inspiration, the young entrepreneur can be proud to see the results of his idea materialise into lower HbA1c-levels for the micro-clinic members and better control of the disease which took his grandmother’s life. “As a professional I am of course happy to see the project idea having a positive impact on individuals’ lives. But on a personal level, it is touching to see our micro-clinic participants coming together to support one another. The same spirit of service and compassion that my grandmother was known for, lives through this project,” Daniel Zoughbie concludes.