More than 3 million people in Thailand are suffering from diabetes.Around two-thirds of Thailand's diabetes population live in rural areas where access to health care often is limited. Not surprisingly, many of them develop complications as a consequence of unmanaged and undetected diabetes.According to the Thai Ministry of Public Health approximately 500,000 people are currently suffering from diabetic retinopathy and are at high risk of visual impairment.The Ministry of Public Health has commenced this project in order to improve access to diabetes care with the aim of preventing complications like diabetic retinopathy as well as preventing blindness in those already suffering from diabetic retinopathy.The objective of this project is to provide treatment and raise awareness about diabetes and diabetic retinopathy among rural communities.
The project is headed by the Ministry of Public Health, however, the approach will be cross sectional and the project will be implemented in collaboration with authorities under the Ministry at both central and local level. The project is being co-funded by the Danish Embassy in Thailand with funds raised at a charity dinner on World Diabetes Day 2008.The project will initially be implemented in 11 provinces in the northern and north-eastern part of Thailand. With time, the plan is to expand the project to cover the entire country.People living in rural areas often face difficulties in accessing health care; they often have to travel long distances and the transportation costs can be unaffordable to many. One way of alleviating this is the use of mobile clinics which travel to remote areas and provide health care to where people live.In this project, two mobile eye clinics will be established and equipped with standard equipment for detection and treatment of diabetes and diabetic retinopathy. To run the mobile clinics, a number of eye care teams will be created and trained. Each team will consist of one ophthalmologist, one ophthalmic nurse, 1-2 technicians and a number of community health volunteers. The members of the teams will all be local staff and the teams will run the mobile clinics in their local area. Hence, the team operating the clinics will shift according to the area so that local health care personnel will always serve their own community.A total of 600 health care personnel will receive training on various aspects related to diabetes and diabetic retinopathy including detection, use of equipment and proper management.Moreover, a number of community health volunteers will be trained. Groups of unpaid volunteers are currently collaborating with the health facilities on monitoring and treating sick people in the local community. Hence, these volunteers are already familiar with their role and are well-known in their community. The community health volunteers will be trained in diabetes prevention and management and will promote healthy diet and exercise to avoid diabetes or related complications. They will also learn how to conduct blood glucose testing and monitor patients.Raising awareness about diabetes is another important component of this project. Therefore, activities such as games and workshops will be organised in relation to the visit of the mobile clinic. Written information about healthy lifestyles will be disseminated to the people attending the clinics and the local radio will broadcast information about diabetes as well as announce the date of the next visit of the mobile clinic.Those who have diabetes or diabetic retinopathy will receive treatment in the mobile clinic. It is expected that between 8,000 and 12,000 diabetes patients will receive laser treatment. In case of severe complications the patients will be referred to a higher level hospital for proper treatment. Those who need treatment will receive this free of charge. The community health volunteers will carry out follow-up on the patients to monitor their condition.
• 2 mobile eye clinics established and equipped • 1,578 health care personnel trained • A number of community health volunteers trained • 14,943 diabetes patients with diabetic retinopathy will receive free laser treatment