Diabetes Mellitus (DM) is a leading cause of heart failure, stroke, visual impairment and blindness. Diabetic retinopathy (DR) is a major complication of diabetes, and is one of the leading causes of vision loss worldwide. Both DM and DR are preventable or can be managed with timely diagnosis, referral and treatment. Undiagnosed diabetes and delay in retinal examination and treatment results in more serious and disabling DR.
The project, in a rural area of Bangladesh, the Narail District, is designed to address the causes of diabetes and its complications. A randomised study of adults in the Narail district conducted by the Organisation of Community Development ORCD, a registered NGO in Bangladesh, revealed a high incidence of undiagnosed diabetes, hypertension, pre-diabetes and poor vision. Hence, the emphasis needs to be on early diagnosis of DM, timely referral of DR and treatment of both. With treatment options generally being more readily available in the cities, a major hurdle for rural people is the difficulty they have travelling to the cities due to financial hardship, distance, poor transport, time constraints and lack of awareness of the importance of treatment. Rural areas lack basic health care, let alone access to specialist services for diabetes and eye care. The clinical presentation of DR is often more severe in low resourced rural settings because of the high proportion of undiagnosed diabetes and delay in retinal examination.
The ORCD has established a centre and currently provides basic assessment and management of people with diabetes and its complications, however, the centre lacks equipment and skilled health workers.
The project is designed to strengthen the services of the ORCD centre over a two year period and has the following components:
Supply medical equipment for the ORCD facility for the diagnosis and treatment of patients
The training of laboratory technicians and medical assistants to provide appropriate services
The Establishment of tele-medicine services to provide improved and specialised eye care management and treatment
The project committee will directly supervise the implementation of the project. Ten Rotarians will be involved in developing and promoting a diabetes awareness and health education program in the communities of the Narail district.