Hubert Biramahire, a resident of Kigali was diagnosed with type 2 diabetes five years ago. From that time, he has had to endure the stressful and emotionally challenging journey of living with this condition. On top of this however, the 20-year-old says his other challenge has been affording treatment, something he says has caused him bouts of anxiety. Luckily, Rwanda Diabetes Association, a non-governmental organisation with a mission of promoting diabetes care, preventing and curing diabetes came to his aid. Through the association, Biramahire got support psychologically, emotionally as well as physically. But most importantly, he gained access to free treatment; something he says has reduced his worry and has been able to focus on his studies. Treating diabetes can be emotionally and financially draining. Photos: Net Francine Hakuzimana, a mother of two children suffering from diabetes, says dealing with this condition has drained her financially and emotionally. Her children, aged 14 and 18 were diagnosed with type 1 diabetes two years ago. And just like Biramahire, she has faced financial challenges with seeking treatment. Though she has been able to seek treatment using Mutuelle de santé, some of the complications that come as a result of the condition are not always attended to. “When my children get complications related to diabetes, it means that I have to incur extra costs which are not covered by insurance, and this has been a challenge,” she says. At the moment however, things have improved thanks to support from RDA. Treating diabetes There are 3 common types of diabetes including type 1 diabetes (~5%), type 2 diabetes (~>90%) and gestational diabetes (few cases ~3%). Evariste Ntaganda, the director of cardiovascular diseases at Rwanda Biomedical Centre (RBC) says controlling blood sugar (glucose) levels is the major goal when it comes to treatment of diabetes. This is done in order to prevent complications of the disease. For this reason, he says a patient is supposed to take their medication on a daily basis in order to control their blood sugar, and that this comes with a high cost. According to the 2020-2025 National Strategy and Coasted Action Plan for the prevention and control of NCDs in Rwanda, 19.3 percent of households reported a financial shock over a period of 12 months, due to serious illness and accidents among household members. NCDs are the most common cause of morbidity, in addition to high cost of treatment and care. Simon Pierre Niyonsenga, the Diabetes, Renal, Respiratory and Other Metabolic Diseases Programs Director at RBC says most diabetic patients are facing financial constraints despite having Community Based Health Insurance (Mutuelle de sante), due to complications that come with the condition. With the insurance, Niyonsenga says one is supposed to pay from RWF 2,000 to 6,000 per month, depending on the kind of treatment or medication they are getting. “This medication is for life, which means that patients will have to incur such costs forever. This makes it costly and complicated,” he says. Finding solutions In a bid to ease the financial burden for diabetic patients, among other things, RDA is working to offer free treatment for patients, as a way of advocating and improving their wellbeing. Etienne Ingabire, director of RDA says providing insulin only wasn’t enough. For this reason, they resolved building patient’s capacity by creating activities that can generate income for sustainability. They also provide livestock to families as well as education on how patients can learn to live with the condition. “Patients also get to gain skills and education on health in general, and upon completion of these trainings, they are allowed to go to the community to pass the same information to others,” he says. Ingabire adds that because of their limited capacity, they tend to put more focus on young patients, although other groups of people are also considered. At the moment, the organisation pays for the medication and supports around 500 patients countrywide. RBC is also creating awareness on early screening so that those found with the condition in its early stages can minimise the cost of treatment. Normally, the cost of treatment depends on the severity of the condition. Dr Florence Sibomana, a medical doctor and member of Global Youth Leaders for Nutrition, says progress is being made in terms of availing health care services at the community level. “There is decentralised diabetes care at health centres. This is to help people avoid spending too much when it comes to either medication or getting help with diabetes. Before, all of these services were only available at hospitals, which came with expenses.”
