In late August of 2019, Partners In Health in Malawi, known locally as Abwenzi Pa Za Umoyo (APZU) had the unique opportunity to co-host a camp for children and young adults living with type 1 diabetes (T1D) throughout the country. Camp Tikhoza, meaning “Yes we can” in Chichewa, was co-hosted by the Sonia Nabeta Foundation, a partner organization based in Uganda that works to improve care for children with T1D throughout Africa and the Non Communicable Disease (NCD) Unit of the Malawi Ministry of Health.
Over 60 children, varying in age from 9 to 22 years old, attended the weeklong camp in the capital city of Lilongwe. The camp welcomed children and young adults receiving treatment at the country’s four central hospitals (Lilongwe, Blantyre, Mzuzu, and Zomba).
Divided into six different teams, each led by a counselor from Uganda also living with T1D, the children participated in a variety of interactive activities throughout the week. Teams also heard from several Malawian NCD leaders – including Dr. Jones Masiye, Director of Clinical Services for the Malawi Ministry of Health and a representative from the Diabetes Association of Malawi – while Dr. Cissy Nalunkuma, a pediatric endocrinologist from Uganda, taught sessions in managing and controlling their condition.
The camp was joined by nurses and doctors from Malawi and Uganda, with workshops on insulin injecting techniques, the importance of checking blood sugars, appropriate diet for someone living with diabetes, and psycho-social support. The Malawian nurses who attended the camp also received training on diabetes care, adjusting and managing insulin, and diet counseling for people living with diabetes. The children also participated in lively social activities including a Sports Day and a talent show, providing an opportunity to get to know each other and build community among peers living with the same condition.
Unlike higher income countries, most children in Malawi only have their insulin checked once per month – the day they visit the clinic. Fifty-five percent of the children who attended the camp did not have home glucometer machines, making insulin adjustments very difficult. In order to improve this reality, every child attending the camp who did not have a home glucometer was given one, along with a five-month supply of lancets and test strips. They were taught how to use the glucometers to monitor their blood sugars appropriately, while also each receiving a hemoglobin A1C (HbA1C) test that will be passed on to their clinicians to improve long term blood sugar control. Although supplying the children with a few months of supplies is a short term solution, APZU is working with the Ministry of Health and the Sonia Nabeta Foundation to develop national strategies to provide ongoing supply of diabetic equipment.
Although Camp Tikhoza offered the opportunity to bring children from across Malawi together, the reality is that many children with T1D cannot make it to a clinic to obtain an acceptable standard of care, as transportation is largely inaccessible for many Malawians and only four hospitals have dedicated type 1 diabetes clinics. Through continued activities such as Camp Tikhoza, PIH/APZU and the Ministry of Health will continue to collaborate with national stakeholders to improve the availability of care for severe NCDs such as type 1 diabetes around the country, bringing care closer to patients and their families.