Young Leaders with Diabetes (YLD) Advocacy Camp, IDF Africa

Under the directive Prof. Naby Balde (Regional Chair, IDF Africa), Prof. Abdurazak (President,
Ethiopia Diabetes Association), DR Joel Dipesalema (President, Diabetes Association of
Botswana) the YLD Advocacy Camp on the fight against Diabetes in Africa was held at
Magnolia Hotel & Conference Centre, Addis Ababa from 28th September 2019 to 2nd October 2019. The meeting was attended by 36 participants from the Anglophone countries which are (Gambia, Botswana, Nigeria, Ghana, Rwanda, Lesotho, South Africa, Swaziland, Kenya, Ethiopia, Uganda, Sudan, Tanzania, Zambia & Zimbabwe). This was in line with the International Diabetes Federation (IDF)'s vision of living in a world without diabetes. For many years now, the IDF has held several congress meetings bringing together the global diabetes community. The congress tackles a broad range of diabetic issues, from latest scientific advances to cutting-edge information on education, diabetes care, advocacy and awareness. Diabetes has become a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation worldwide. According to the World Health Organization (2018), the number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014. WHO projects that global prevalence of diabetes among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014. About 2.2 million deaths were attributable to high blood glucose in 2012.

An estimated 1.6 million deaths were reported to have been directly caused by diabetes in 2016. Proportion (%) of people who died from diabetes in 2017 before the age of 60 in IDF regions Africa has the highest range of around (75-78%) as compared to other regions in the world, with European region ranging below 40%. Thus diabetes is a major cause for concern. According to the World Bank, in 2015, the global prevalence of diabetes rose by 2.7%, ranking number 8 and it is projected to rise to 3.5% by 2030, ranking number 5. According to the IDF, the objectives of the World Diabetic Day (14 November) aims to: be the platform to promote advocacy efforts; be the global driver to promote actions to confront diabetes as a critical global health issue.

The management of hypoglycemia is the most crucial element in the life of a person living with diabetes. Hypo is a very critical condition and diabetic patients need to know preventive
measures and ways to treat it. This can be done through eating well, maintaining a healthy weight, getting active through exercises, management of blood sugar at a target range of 4.0-7.0mmol/L or (80-130mg/dl) before meals and less than (7.0mmol/L or 180mg/dl) 2hrs after. Additionally, a diabetic patient should practice self-management that is to make better decisions, getting into support groups for health care advices. Proper execution of such measures helps prevent diabetic related complications such as kidney failure, blindness, and heart attacks. More so, there are a number of steps taken during sick days i.e. 1) continuous administration of medications (insulin) strictly as prescribed (2) testing blood sugars accordingly (3) drinking extra (calorie-free) liquids (4) weighing yourself regularly (5) checking your temperatures regularly. This will help the patient when to consult a doctor especially when there is excessive vomiting, signs of depression, when the ketone levels are moderate-high, failing to keep the liquids for more than 4hrs and when sugar level is remaining too low (3.0mmol/L) or too high (14.0mmol/L) over regular 2 checks.

Furthermore, it is very crucial for a diabetic patient to always have their hypo kit, insulin & testing equipment. This helps especially in instances where complications are caused by natural disasters such as the Cyclone idai that hit Zimbabwe in 2019. In addition, there is also a need to acknowledge the issue of mental health related to diabetes. Its effects may interfere with diabetic patients' ability to stick to their medication. Therefore, should the need arise, such mental health issues should be tacked by professional experts. Diabetic stress is another aspect that should be seriously taken into consideration. For instance, if a diabetic patient is feeling overwhelmed as a result of daily care of his/her diabetes, the patient is advised to see either endocrinologist or a mental health counselor who specializes in chronic health conditions with immediate effect.

Additionally, for leaders, the most important skills one should possess are: followership (adherence to) and the leader has to understand his/her follower in every aspect; management (use of limited resources combined with forecasting, planning, control and execution skills to achieve predetermined specific goals), involving the creation of organizations that are adaptable, resilient, focused and efficient, being able to innovate quickly and bold enough to stay relevant, profitable and being able to inspire others to bring the gifts of initiative, imagination & passion to work; governance (the process of making and administering public policy affairs or toexercise sovereign authority), through cultivating accountability, setting of shared direction, engaging stakeholders and steward resources.

In addition, to make sure that the information is spread at a larger scale, we venture into
communication through social media. Gladly, Africa internet penetration is at its rising (39.8% as per 30th June 2019 record). Social media plays a pivotal role in diabetes awareness campaign because of its wide coverage within a short period of time, it is easy to deal with anonymous complex issues, people can share their individual experiences with diabetes, blogs or podcasts and also sharing statistics & policy implications involved. Awareness campaigns could also be
done through creating authentic dialogues, mass customization, and horizontal communication (tagging of people/organizations such as the IDF Africa, member associations, the Ministry of Health (MoH). However, such efforts are in some cases hindered by peoples' diverse opinions and interest in the matter. As such, those who dislike the program might deliberately distract the flow of awareness while some goes to the extent of attacking the sender.

However, as a leader, one should know how to respond and always be sensitive about the
authenticity of the information being disseminated/shared. A leader should always be polite when addressing raised issues regarding his/her posts on social media and give credit to authors and those who comment positively. This will promote excellent citizen engagement and patient support in the fight against diabetes both at community level, country level, continental level, and also at the international level. In line with the WDD objectives, the IDF encourages young leaders with diabetes to act as role models to fellow diabetic patients. Thus, this calls for us the youth leaders to be extra good in everything we do while encouraging others to do the same as we fight against diabetes. I wish to encourage everyone to answer to this call as we fight existing diabetic challenges so we can live in a world free of diabetes. We could also study the lives of iconic people such as Theresa May, Prime Minister of the United Kingdom and Leader of the Conservative Party (2016-2019) who suffered from Type 1 diabetes in a bid to learn how she handles the situation.

Lastly, advocacy is one of the crucial elements in the fight against diabetes. In this case, I wish to recommend government ministries such as the Ministry of Health (MoH), together with our Associations to create new policies, laws & regulations, programs, procedures, processes ormodify existing ones so we can always be ahead of any challenge that might arise. Some of the stages involved in the advocacy process incudes: defining the decisions, setting of goals & objectives, selecting the targeted group, knowing the political landscape and those who make diabetic related decisions such as the Ministry of Health and any other related organization.

In conclusion, the YLD camp held in Addis Ababa from 28th September to 2nd October 2019, was categorically amazing, very informative and a real life changing moment. Diabetic related issues were heavily discussed even more than we anticipated. We learnt many things including management of hypoglycemia, steps to be taken when one falls sick, how to get our proposals accepted, not just diabetic proposals but business proposals as well. My desire as thd Ambassador for Zimbabwe Diabetes Association (ZDA) is to advocate in the best way i know how to help in the fight against Diabetes as is the initiative by the International Diabetes Federation (IDF).

Motto: #ONE DISEASE, #ONE WORLD, #ONE SYMBOL #UNITE FOR DIABETES👌