The facilitation of site visits by diabetes experts to IDF Life for a Child (LFAC) Programme-supported centres has demonstrated numerous benefits for all involved. In some countries, there may be a lack of expertise of diabetes in children and youth as it is an unfamiliar condition. Even in countries where there is considerable knowledge, contact with experts/facilities in other countries is extremely advantageous. Connecting with peers carries particular benefit during difficult clinical cases, where knowledge-sharing could impact health outcomes.
For LFAC specifically, the visits allow a review of progress, an up-to-date needs assessment, and insight into the current national situation for children with diabetes. If a paediatric endocrinolgist visits, the trip can include reviews of specific patients/complicated cases, discussion and teaching of local staff. In addition to their clinical knowledge of diabetes, where possible LFAC facilitates visitors able to speak the native language.
Since January 2014, seven site visits have already been realised, all with highly experienced diabetes health professionals. LFAC's professional collaboration with the International Society for Adolescent and Paediatric Diabetes (ISPAD) has been a key component in the increasing numbers of site visits and establishment of professional relationships between centres in developing and developed countries.
Dr Stuart Brink, an experienced paediatric endocrinologist, spent time in Cochabamba with the Vivir Con Diabetes team. Fluent in Spanish, Dr Brink met with staff at the four Vivir con Diabetes Centers, and spent several sessions with parents, children, adolescents and young adults receiving care, answering questions, discussing ongoing research and their own progress in improved diabetes care throughout Bolivia. "It was quite remarkable and extraordinary to see the results of a programme working so well" commented Dr Brink, "and the resources of LFAC being put to such good use under the supervision of Dr. Elizabeth Duarte and the multidisciplinary team she has created at Vivir con Diabetes in these four cities in Bolivia. Hopefully this will be the beginning of an ongoing mentoring and support relationship as part of the LFAC sustainability path with similar centers". Vivir's Director, Dr Duarte, emailed LFAC following the visit: "I want to thank you so much for all the support you gave to our children and young people with diabetes in Bolivia...the visit of Stuart has been part of this important support."
Dr Patrick Garandeau, a French paediatric endocrinologist previously working in Reunion, visited Burundi’s capital Bujumbura, where LFAC works directly with the Department of Public Health (Programme National Integre de Lutte contre les Maladies Chroniques Non Transmissibles). Here he met key health department staff and visited several diabetes centres within Bujumbura. At the offices of the Diabetes Association FRADMI, Dr Garandeau was able to interact with children, youth and their parents, discussing having diabetes and the challenges it brings.
Dr Audrey Austin, a Guyanese native and prominent US paediatric endocrinologist, was hosted by the Guyana Diabetes Association during her visit to Georgetown and surrounds. “The program is worthwhile” commented Dr Austin, “and I hope we will be able to grow it in Guyana to improve the health of Guyana's children”. As part of the visit she ran a teaching seminar that was attended by some of the country's junior doctors and dieticians. "Audrey did a wonderful job all over" praised Mrs Glynis Beaton, Head of the Association.
Bangalore: Adam Lamendola, Manager of the Paediatric Diabetes Ambulatory Care Service at Monash Children’s Hospital, (Melbourne, Australia) visited the Jnana Sanjeevini Medical and Diabetes Centre in Bangalore in May 2014. During his visit, Adam delivered daily lectures to staff and patients, hosted a paediatric diabetes day course for clinical staff, and worked alongside local diabetes educators to provide care to patients and families in both clinic and home-based environments.
The team at the Jnana Danjeevini Medical and Diabetes Centre were extremely welcoming and generous with their time, escorting Adam to see and experience the sites of Bangalore and surrounding areas including the Royal City of Mysore. Adam was warmly received by clinical staff and patients and thanked for his contribution to the work of the Centre. The opportunity was equally rewarding for Adam who commented, “I have travelled around the world both for work and pleasure, and I can honestly say that my ten days with this beautiful team were some of the most enjoyable times I have had during my travels.” Both professionally and personally, working at the Centre provided a unique and inspiring learning environment for Adam who hopes to apply his expanded knowledge to his future work.
Belgaum: Mr Dan Howarth, previously Education Coordinator for the International Diabetes Federation, was invited to visit the KLES Prabhakar Kore Hospital and Medical Research Centre in Nehru Nagar. As part of a three day visit, he conducted a diabetes education programme with 90 staff from the University Nursing College, made clinical home visits to families of children with type 1 diabetes, and participated in regular clinic of 40 children with type 1 diabetes.
LFAC Education Manager, Angie Middlehurst, participated in the annual camp for children and teenagers with and without diabetes. The camp was conducted by the Kingston Social Development Commission in conjunction with the Diabetes Association of Jamaica.
Along with Sharlene Keens, the Association’s clinic manager, Angie oversaw management of ten children with diabetes, helping them test their blood glucose and providing general assistance throughout camp. She also conducted some informal sessions about diabetes which included all the children and young people.
Visits to Spanish Town and May Pen Hospitals, two of the centres supported by LFAC in Jamaica, were made after the camp. “Congratulations and grateful thanks to Dr Coretta Brown-Johnson (Clinical Psychologist) and Mrs Lurline Less (DAJ CEO) for collaborating and making the camp happen” said Angie. “The children certainly enjoyed the experience and so did I ”.
In March LFAC facilitated a site visit to St Lucia, one of the newest countries to join the Programme, where LFAC partners with the Ministry of Health, Wellness, Human Services and Gender Relations and the St Lucia Diabetes and Hypertension Association. Dr Jadranka Popovic, a paediatric endocrinologist based in the US city of Pittsburgh, had a full five days on the island, meeting representatives of both organisations, families and children receiving LFAC support, and the local diabetes support group. She met and ran clinical sessions for the medical staff at St Jude Hospital and gave two lectures on type 1 diabetes to local health professionals, mainly family practitioners and internal medicine specialists, in St. Jude Hospital and Castries. A meeting with District Medical Officers around the management of diabetes in young people was also part of her visit.
“I had an honor and pleasure of serving as a volunteer for the LFAC and visiting St Lucia”, said Dr Popovic. “I greatly appreciate the warm welcome and support from the Ministry of Health, particularly Mrs. Lydia Atkins. I hope my visit, evaluation and findings provided important initial information that will help LFAC successfully support and run the assistance programme for the children and youth with diabetes in St. Lucia. I hope that our work and efforts will improve the care and quality of life of children with diabetes in that part of the world.”