Type 2 Diabetes & why Nicaraguans don't eat better

Type 2 Diabetes is a growing concern for the poor in Nicaragua: it is now the fourth leading cause of death of Nicaraguan women…mainly because of lack of medical attention.  It either goes undiagnosed, or women do not have access to needed medications.  

One in ten adults has type 2 diabetes in Nicaragua.   

Within ten years, it is estimated that 4 out of 10 adults will have type 2 diabetes…40% of the adult population.  

Why?

40% of Nicaraguan children are malnourished

There are multiple causes.  The first cause is that poverty leads to malnourishment as children.* When children do not get enough calories or the proper nutrition, then their bodies develop in such a way to horde what nutrition they do get.  When they become adults their bodies are still hording…which makes fat.  Most of the fat settles around their torsos because Nicaraguans use their legs to walk everywhere, they use their arms for washing clothes, chopping wood, carrying heavy loads, etc.  The fat settles in the worst place: around the middle, which increases the chances of type 2 diabetes.  


Secondly Nicaraguans put on weight because of what they eat.
 

Plantains...all cooked with oil and salt

What do they eat?  Rice, lots of rice.  Corn tortillas, lots of tortillas.  Some beans.  Plantains.  Little chicken.  Some eggs and farmer’s cheese…all cooked with oil and salt.  Sometimes soup with little meat but lots of yucca or potatoes.  Maybe cabbage and tomato salad.  They drink coffee with sugar, sodas, and refresco (watered down fruit pulp and juice with lots of sugar)  Notice anything?  Oil and carbohydrates and sugars.
 
Why don’t they eat better?  Well let’s compare prices: 

• A pound of rice costs $0.48 while a pound of chicken costs $1.36 
• A pound of beans cost $0.52 to a pound of fish $0.70 (this is cheap fish with the head and all) 
• 4 plantains cost $0.96 to 4 small heads of broccoli $4.00   
• 12 tortillas cost $0.96 to 12 eggs $1.92 
• 1 liter of regular oil is $1.40 while olive oil is $9.35

This is what they eat…what they drink is loaded with sugar.
 

Sugar is a cheap source of calories

Soda is $0.32 (diet soda is $1.00/can) and bottled clean water is at least $0.80…Coke is literally cheaper than water.  In the rural areas many grow enough coffee for themselves and in cities instant coffee is cheap, always drunk with lots of sugar...and most importantly sugar is only $0.36 a pound.  36.  Cents.  A.  Pound. Sugar is a cheap source of calories to keep going with all the hard labor.
 

And when your life is spent in a one room house with a dirt floor, 2 light bulbs, maybe a radio or TV, and life is one struggle after another, then adding some sweetness…or a lot of sweetness because sugar is so very cheap…well it makes life a little more tolerable.
 
In other words…why is type 2 diabetes growing so rapidly in Nicaragua?
 
Poverty.
 
*World Vision says 40% of Nicaraguan children are malnourished.     
                                                       -Kathleen

Anatomy of a Speaking Tour

They say it takes a village to raise a child…well, it certainly takes one to get ready for a speaking tour!  

Becca is getting ready to go on a three week speaking tour in Washington State and Oregon.  She leaves Thursday the 19th of September.  About two weeks later Pat and Kathy leave on their two month speaking tour in southern parts of Ohio, Indiana, Illinois, and Missouri.  
 

They are adapting the slide script that Sarah, Becca, and I put together for Sarah’s spring tour.  They are taking brochures that the three of us put together at the start of each year.  They are taking Nicaraguan crafts and art from artists that Sarah has cultivated.  For each trip Sarah buys and packs all of the items and delegations lovingly haul trunks back to the States and store them until we come pick them up.
 
While they are gone speaking, the people behind in Nicaragua receive documents called “so and so’s brain” in order that the work does not falter.

The ones doing the speaking have spent months setting up speaking events poring over our database and maps, writing emails and letters, and figuring out how to make the most of the trip. 
 
Many of you play an important role in this.  You host events, open your homes for our folks to sleep, feed them, help them when problems arise, and take care of them.  All of the work of folks here and up there means that last year we raised close to $55,000!  We're hoping that with all your help, this year we may be able to even top that!  Thank you!      -Kathleen

How the *heck* did we get an ultrasound donated?!

We are getting an ultrasound machine donated, and you would not believe how it came about!

Sarah was in the States on her speaking tour when we started looking for funds to hire Dr. Jorge Flores –  a radiologist who had worked with us for 10 years until 2009 – and funds for an ultrasound machine.  We have a retired friend, A.B., who started an organization that refurbished medical machinery and shipped it to non-profits around the world.  I wrote Sarah and asked her to track down A.B. and see what he could do.

MobiSante Tablet Ultrasound Machine

A.B. referred Sarah to his contact who said that he could probably not help but recommended working towards a mobile ultrasound machine from MobiSante.  Sarah ended up in California speaking at an event with Jane, who volunteered as a nurse at our clinic, and they looked at this machine online and got really excited…It was portable…Sarah called the company to see if one could be donated to “this wonderful clinic”…but they did not do donations.  So we started looking for more funds.

Meanwhile Jorge had contacts with someone with a used machine here in Nicaragua at a lower cost.  Sarah had returned from her speaking tour and she is really good with machines.  Sarah agreed to go with Jorge to look at it and thank goodness she did!  She insisted that they give us more information and while all that was happening a transformer blew in that part of Managua and they lost several machines.  This made us think about our vulnerability to unstable power, dust, etc.  Soooo Sarah called the MobiSante representative again.  

Jorge trying out MobiSante ultrasound machine

“What about a non-profit discount?”  That they could do and later the rep called Sarah back and gave Sarah the name of an organization in Nicaragua that had just purchased the same machine.  Sarah called…yes, Jorge could come try out the machine.

Amanecer Mobile Health Clinic has clinics in rural areas, and while Jorge tried out the MobiSante ultrasound machine, the nurses and doctors at the clinic started asking questions.  They knew how to use it, but not how to interpret what they were seeing.  Would Jorge be willing to train their staff?  They had money for training.  Sarah called me to ask if Jorge could have time off to train them, and then she plugged the idea of in exchange for his teaching they might get our machine in lieu of paying Jorge for the trainings.

Jorge's impromtu training with the Amanecer Clinic staff

They had to get back to their sponsors to see what could be done.  A week later, we got an email…their sponsor would like to buy us the ultrasound machine in exchange for Jorge training the Amanecer Clinic staff.  This way the poor everywhere benefit…their doctors and nurses receive the needed training from our wonderful teacher and doctor, Jorge, and our patients receive ultrasounds.

In the same speaking tour, in Texas Sarah talked with another long-term donor and friend, Marty, who has been helping us look for funds.  She was excited to hear that we have a machine donated and she went further and secured the funds in order to get us the pediatric wand...so now we have it all!

Sarah is dogged in her attempts to get donations for the work of the CDCA.  She will not settle for lousy excuses that mean the poor suffer because of faulty machinery.  We laugh and say, “Doña Sarah is fearless and shameless.”  She is.  All for the poor. – Kathleen