In Peru, where diabetic retinopathy is worryingly common, José shares his personal experience with accessing diabetes eye care. His story highlights the importance of early detection and proper treatment. His motto? Fear has no place in managing diabetes.
The prevalence of diabetic retinopathy (DR), a leading cause of blindness in the Piura, La Libertad, and Lambayeque regions of Peru, might be as high as 34%. Our WDF colleagues Andrea Beratarrechea and Jakob Sloth Madsen travelled to Northern Peru to meet with our partners, Orbis International, and Peru’s Regional Institute of Ophthalmology, who have been implementing a project expanding a model for integrated DR care to the Piura and Lambayeque regions. The model was successfully piloted between 2014-2017 in La Libertad region.
By supporting the training of healthcare professionals, educating people with diabetes and their caregivers, and integrating technology into eye care services, the risk of avoidable blindness can be reduced by promoting early detection and proper treatment.
Through this scale-up project, more than 2,400 people living with diabetes have been screened for DR, revealing a prevalence higher than in previous Peruvian studies.
One person who has been positively impacted by the project is José Mercedes Marquez Roque.
Our colleagues met José at an NCD office in the primary care centre in the Lambayeque region, where he just attended a medical appointment. Eight years ago, he was diagnosed with diabetes and now takes medication and regularly attends the primary care centre to receive diabetes education and care.
He first found out about his condition when he had to go to the hospital for a medical emergency.
‘I arrived feeling very sick; I couldn't sleep. My stomach hurt, I had a headache, and I was vomiting. Then my daughter said, “let's go to the emergency room.” So I went in the morning, and my daughter assured me they would take care of me. The lady at the door asked, “Sir, what's wrong with you?” I told her, “I'm sick, I don't know if Saint Peter is taking me away, I'm sick.” She held me and said, “We'll cure you now.” They took me to a room, gave me a serum with vials, and after 20 minutes, I was already better."
He was experiencing a severe episode of decompensated diabetes. There, he was advised to have a fundus examination of the back of the eye. This examination is crucial for people with diabetes, as it can reveal changes in the blood vessels that can lead to diabetic retinopathy.
‘The nurse attended to me and explained all about diabetes and asked if they had done a fundoscopic examination. “A diabetic has to have a fundus examination,” the nurse said, and gave my daughter a card for the examination.’
The NCD staff refers patients with diabetes to the regional hospital for diabetic retinopathy screenings, and they also educate patients on diabetes management.
José's experience left a strong impression on him. He was grateful to the advanced services and the quality of care he received. In his own words: ‘I congratulate the staff that attended to me because they have wonderful machines to check the eyes. The doctors are very, very good. In some parts of Peru, it's difficult to find such good people. But here, let me tell you, I found the warmth of home.’
Asked what advice he would give to others, he added, ‘I would advise all my fellow Lambayecanos who might have diabetes – because some say “no, I am not diabetic” - go to the doctor, don't wait for bad news. Get the fundus of the eyes checked, which is not a big deal. Don't suffer from it, because some say, “oh, I can't see,” but they don't know is diabetes.’
Now, he is telling everyone in his close circle to get their eyes checked and get a referral for a fundoscopic examination.
‘Don't be afraid! Why be afraid? Why? Diabetes can be controlled. So, in the end, you won't go off track because you will be fine. Thanks to whom? To you, doctors, I congratulate you. ‘
José has access to integrated diabetic eye care services as part of the WDF18-1653 project, which aims to screen thousands of people for DR and train medical staff, as well as support with diagnostic and treatment equipment for DR in targeted health facilities in the three regions.