Diabetes, hypertension, high cholesterol and obesity are health problems that people from the village “take on their feet” without even knowing about them. The situation will be even more serious in the future, I draw the attention of the specialists.
The caravan of the Association of Chronic Patients in Romania has taken medical services to photo: APCR
A caravan that for four years reaches the communities located relatively far from the urban environment, to give people the chance of medical services, has brought to light this year and hundreds of undiagnosed patients. Many of them have not been to the doctor for years and were surprised to find out that they suffer from diseases for which treatment had to start for a long time. Out of nearly 1,000 investigated patients, 70%, specialists have found, have diabetes, hypertension, high cholesterol or are obese (with all complications arising from here).
The caravan “Health comes to you”, which represented the chance of these patients, is a project of the alliance of chronic patients in Romania (APCR) with focus on cardiovascular disease, diabetes and obesity. It has been held for four years, in communities that are experiencing difficult access to medical services.
The specialists make three visits to the field in the selected localities, in the first week the blood collections and other types of investigations (hemogram, the total cholesterol level testing, but also its fractions – LDL, HDL and triglycerides, serum glucose and hemoglobin, serum, serum, serum, serum, serum, serum, serum and lipid, Instant blood glucose tests, Michigan test for detecting diabetic neuropathy, EKG, blood pressure and pulse measurement, PSA tests, cardiovascular risk calculation and mass index), and a week away medical teams including diabetes and cardiologists offer consultations for the patients.
This year, the caravan reached another eight localities, from six counties: Vedea – Giurgiu, Domnești – Argeș, Unirea and Independence – Călărași, Berzunți – Bacău, Cătina – Buzău, General Scărișoreanu and Țepeș Voda – Constanța.
“It’s an alarm signal that we can’t ignore anymore”
Like the specialists who participated in previous years in the project, and this year the doctors were worried to detect, along with patients with more treatable conditions, and serious cases. The president of the association together against obesity, Lorenzo Radu, revealed, during the recently organized event in which the results of the caravan were disseminated, that the struggle for the health of those with difficult access to medical services starts from the moment when phones are given. Half of the calls initiated by the caravan organizers are encountered with reluctance or refusal, because the local authorities “do not understand what we propose”. There is a lot of health education among the population, there is a place of many prevention activities, but also of education among the local administration, it was the conclusion.
Over 50% of the patients tested, shows the statistics prepared at the end of the visits, have diabetes or prediabet values or glycated hemoglobin. 40% have prediabet or insulin resistance and another 13.6% have untreated diabetes. Of the people with diabetes, 35.4% had average and high risk of diabetic neuropathy (according to the Michigan test).
The caravan of the Association of Chronic Patients in Romania has taken medical services to photo: APCR
Four out of five people are overweight or suffer from obesity (82%), but patients are not aware of this, 83% of those with obesity, declaring that they have never talked to their family doctor about their weight. Only three people said to suffer from obesity.
Total cholesterol higher than normal threshold is a health problem that affects over half of the tested people (60%). People in the 50-65-year-old group predominantly have this problem. Recommendations for additional cardiological consultation received 232 people.
“Behind each case of unbalanced diabetes in our caravan is a lack of access, education and multidisciplinary care. These people do not choose to get sick – but they have nowhere to go and to whom to learn. The caravan shows the clear need for changes in prevention, the treatment of diabetes, but also in terms of accessibility ”, said Dr. Cătălina Lupu, a specialist diabetes who was present in the caravan.
Experiences to remember
Beyond the figures that may seem dry, Lorenzo Radu mentioned only a few cases he remembered, from the caravan: 33-year-old with blood sugar 500; 18 -year -old who at a height of 1.64 m weighs 98 km and, according to investigations, “It didn’t even have a value in the normal range”; 43 -year -old woman with hemoglobin 4 and severe anemia with vital risk etc. “This makes us think that some hard years are waiting for us.”added Lorenzo Radu.
The obstacles to the people of the village are related to both the fact that they do not have access to medical services and costs. A consultation with a cardiologist from an area close to an area included in the caravan costs 750 lei, Lorenzo Radu revealed, and the COSTUL already mentioned is added any other investigations, plus the cost of the road, plus half a lost day. And the truth is that cardiology specialists are increasingly difficult to find, even the caravan organizers are difficult for them to co-opt them in the project.
The prevention should become priority, other guests have also stressed the debate organized by the Alliance of Chronic Patients in Romania. In addition to difficult access to investigations and treatment, another thing should be taken into account, Dr. Anca Hâncu said: it is a myth that in the country he lives healthy. The healthy lifestyle is, or must become, an objective, because the results show that the rural population is ground by diseases even from an early age, and the healthy lifestyle could prevent 70% of the pathology.
Diabetes, among the affections that the people of the village take on their feet without knowing the photo: APCR
“What I discovered in the Romanian villages is an alarm signal that we can no longer ignore. Behind the idyllic image of life in the country are hiding great health risks. People do not reach checks, do not know that they suffer from serious illnesses or receive the correct treatments. The data in our caravan clearly show: the incidence of obesity, diabetes and cardiovascular risk is worrying. It is time to talk more seriously about prevention, real access to medical services and health education. This campaign is a clear call to the authorities for concrete interventions, but also an urge for each of us to actively concern ourselves with our own health and loved ones ”, stressed Cezar Irimia, APCR president.
“It means treating a disease, but not the patient”
Diabetes, the condition so often diagnosed that it has become, unfortunately, not to scare anyone, it could be even harder to treat from now on. These are the cases already diagnosed and included in the national program for the treatment of patients with diabetes. Within this program, both patients insured in the state health system, as well as patients who do not pay the health contribution are included, but they become insured based on the inclusion in the program and have access to treatment for the basic disease, but also for the complications it gives.
The doctor Anca Roman, a participant in a previous edition of the Caravan “Health comes to you”, drew attention, on his Facebook account, that the measure, although he can bring savings to the budget, will be a disastrous one for the uninsured patients.
“I have always advocated for patients and for equal sleds. In recent days, the authorities have announced the intention that, starting August 1, patients included in the national diabetes program will be considered exclusively for services and medication within this program. What would this change mean? That a patient with diabetes will only receive diabetes medication for free, but will lose compensated access to the treatments for the other associated conditions – such as cardiovascular, renal, neurological, which are an integral part of diabetes evolution. In order to receive compensated prescriptions from the family doctor or other specialists, the patient should pay the contribution to health insurance, even if it is already included in a national program.
Diabetes is a chronic systemic condition, which requires multidisciplinary monitoring and complex treatment. To restrict the patient’s access only to blood glucose treatment, but to ignore its major complications-it means treating a disease, but not the patient. What is the purpose of having a “national program” if the patient is, in fact, isolated and penalized because he is sick? Why do we transform medicine into a bureaucratic exclusion system, instead of support? ”was the doctor’s reaction.
