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Diabetes micro-clinics in conflict-ridden West Bank

The Diabetes Micro-Clinic Project: On a mission to stop one of the most relentless killers in the West Bank


My diabetic grandmother died trying to get from Bethlehem to the hospital; there were no ambulances, and she had developed fatal complications due to poor diabetes education, restrictions on movement, and the stressful political situation.

Diabetes is one of the leading contributors to disability and death in Palestine. I am intent on doing something about this. During my recent visit to the West Bank, I identified the staggering dimensions of the problem and some key difficulties in treatment delivery and education. My purpose is to narrow the gap between the established clinics' effectiveness in providing care and information, and the community's need for health services. Consequently, I am proposing to establish "micro-clinics" composed of small groups of diabetic patients meeting in designated houses or businesses for the purpose of diabetes monitoring and education. The micro-clinics will be vehicles of empowerment that utilize community support and create public ownership, so that the affected population can move toward improving health care in their communities, despite unfavorable circumstances. To encourage participation, the micro-clinics will form a partnership between diabetic patients, university students, academics, medical practitioners and members of the community.

The Palestinian population is plagued by diabetes and uneducated as to its real causes, effects and proper treatment. The tense political situation only serves to exacerbate the problem. These observations are supported by the World Health Organization's assertion that the diabetes epidemic causes greater mortality in the world each year than the 3 million annual deaths caused by AIDS. According to the WHO, the per capita death toll from the disease is highest in the Middle East and parts of the Pacific, with "more than one in four deaths in the 35-64 age range attributed to diabetes." The World Diabetes Foundation reported that 7 to 10 percent of the population in Palestine is affected by the disease; another 40 percent of women and 20 percent of men are obese and at high risk. Furthermore, those who can afford health care have become dependent on medication rather than addressing the fundamental issues: a healthy diet, sufficient exercise and regular monitoring of blood sugar levels.

My desire to start this project is based upon my observation that many Palestinians do not have the resources or education to purchase personal glucose monitoring systems like those widely used in America and Europe. The importance of these machines cannot be overestimated; they are the diabetic's first line of defense against the noxious effects of elevated blood sugar levels on virtually every organ and bodily function. In addition to lectures and workshops, The Diabetes Micro-Clinic Project will provide shared access to these monitors - in essence, creating mini-labs in diabetics' homes and businesses. The intention of my project is to show that innovative community development projects like the establishment of micro-clinics in economically depressed Palestinian cities can help the affected population to transcend the barriers of poverty and facilitate the prevention and control of deadly diseases. The clinics will create a public domain whereby people can obtain education and treatment for a basic life and death issue. If successful, The Diabetes Micro-Clinic Project could become a model for future health care delivery systems in underdeveloped, conflict-ridden areas - vehicles for screening and disseminating health care information to the population and for monitoring blood pressure, cholesterol levels and other health indicators using new technologies.

— Daniel