Namma Clinics are of no use to us, say diabetes patients

Patients are forced to visit pvt pharmacies

By Arsha BS

It was only after having a numb foot for weeks that Raj Kumar, a resident of Attiguppe, was diagnosed with diabetes. His life changed after the diagnosis. As his blood sugar levels were very high, he was asked to take insulin shots before every meal.

tection, according to the WJCO paper. Women in rural areas ignore lumps, a main physical symptom of breast cancer, when they are painless. About 50-70 per cent of these women seek treatment very late. Additionally, the absence of medical facilities close by, a lack of trust in healthcare providers and weak financial condition prevent people from getting early treatment.

Women hesitate to discuss changes in their breasts with their family members.

“Women feel uncomfortable talking about any changes that take place in their private parts. The problem is that people in rural areas are embarrassed to discuss things that have to do with private parts. This needs to be addressed. Initially, my aunt felt very conscious when she wanted to see a doctor when noticed a lump in her breast,” Swathi shared.

Women with breast cancer are reluctant to say they have the disease. They felt uncomfortable speaking out about their experience with the disease. The Observer noticed that rural women were more reluctant to talk about breast cancer than women living in urban areas.

Some factors contribute to an increase in breast cancer — genetics, lifestyle changes and lack of awareness. But most women still aren’t aware of these.

A study conducted by the Indian Journal of Cancer in Ramanagara district showed that rural women have low awareness, with 81.2 per cent of them not able to state even a single symptom of breast cancer. Eighty-seven per cent were unable to identify even a single risk factor for breast cancer. A majority of them have little knowledge of self-examination of the breasts, a feasible screening method for women.

The month of October is designated as Breast Cancer Awareness Month. In order to spread awareness, the state and central governments take various initiatives and organize programmes. Various NGOs participate in programmes like bike rides, talks, and poster displays to raise awareness about breast cancer among women.

Kalyan, a resident of the Chikkaballapura district, lost his paternal uncle to cancer because of a lack of awareness. “In rural areas, people are still not aware of cancer. A majority of women are unaware of breast cancer. I have seen a few women in my village getting late treatment for breast cancer. Awareness should increase as breast cancer is curable if diagnosed in its early stages.”

The WJCO paper highlights the importance of adopting a holistic approach, utilizing the Web, involving community health workers, early detection, and reaching out to the poor to reduce the growing number of breast cancer cases.

Swathi stressed the importance of taking care of women’s mental health during treatment.

“My aunt had a black mark near the lump. People who saw the mark started asking about it. She felt uncomfortable answering them. In fact, she has stopped talking to a lot of people as she doesn’t want anyone to know that she is suffering from breast cancer. The patient’s mental health can have an impact on the treatment she is undergoing. The add-on mental suffering along with cancer pain is hard to handle.”

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Raj Kumar makes handicrafts, earning Rs 10,000 a month. Over the past eight months, he has spent one-third of his earnings to buy insulin vials. Unable to bear the financial burden, he visited a Namma Clinic in Bengaluru, only to find that there is no testing facility available there. This is the experience of many others like Raj Kumar.

Namma Clinics, an initiative of the Karnataka government, were inaugurated on December 14, 2022. Each covers a minimum of 5,000 people. The government has made diabetes screening mandatory for all above the age of 30. But Namma Clinics in Bengaluru lack adequate laboratory facilities.

Diabetes is one of the most prevalent diseases in the state.

“I have never come across a government campaign about the disease. The government must make people aware of the consequences of diabetes. In my family, after I was diagnosed, everyone in the family underwent the HbA1c test. We went to a private lab to get tested. It was expensive,” Raj Kumar said. He was advised by the doctor to take insulin. As it is expensive, he could take only short-acting insulin.

Raj Kumar says awareness programmes must be conducted not only for adults but for school children as well so that the latter become aware of the disease. He wishes he had known about it before so that he could have led a healthier lifestyle. “It would have been so helpful if people like us could get free treatment for diabetes from Namma Clinics. They function quite well otherwise, but when it comes to expensive treatments, they can’t help us. I will have to arrange money to get insulin no matter what, because health is more important than anything else.”

A doctor at one of the Namma Clinics in Bengaluru who did not want to be named informed The Observer: “The government’s work stops in the documentation process. They do not move ahead. The more important things they should do come after this process. They need to create awareness among people. Only then can we do something to control diabetes. None of the PHCs I know has a proper screening facility. Some of them have glucometers. The HbA1c test, which gives accurate results, is not available in PHCs. It is quite costly. If a diabetes patient comes to us for insulin, we are helpless. We neither have insulin nor proper storage facilities. No awareness campaigns are happening…. We are trying our best to help these people out. Whenever we don’t have any facilities, we suffer loss.

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When we talk about diabetes patients, we must not ignore pre-diabetes. Diabetes is a serious condition that should not be taken lightly. The rate of growth of diabetic patients is alarming. If a parent has diabetes, the chances of the children being diabetic is 50 per cent. If diagnosed early, it is possible to control it.

- Dr Nirmal Kumar, diabetologist

“The sufferers are poor people who cannot buy insulin from private clinics and pharmacies. These people have no idea about the disease and do not consult a doctor until they become weak. By that time, they will need insulin, which we don’t have here. I had a patient who came to me for insulin, and because we did not have it, he had to go to a private pharmacy. He was almost broke. The government has to come up with awareness campaigns every six months. We are ready to help to make diagnosis and treatment accessible to all.”

However, authorities have a different view.

Naveen Bhat Y, Mission Director of the National Health Mission, said: “Namma Clinics are given glucometers and strips. If they do not receive any, they can report it to the department. Insulin is available in PHCs, and we also have awareness campaigns happening on the 14th of every month, with a specific theme each month. Diabetes awareness has been a theme.”

According to an Indian Express report, “a door-to-door health survey by BBMP revealed that among all the people living with comorbidities, 50.44% suffer from diabetes in the city.”

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