When Priscah Aondo was diagnosed with diabetes, she thought her life was over.
“I lost all my friends. People started talking about me. I was just waiting to die,” the preschool teacher said.
In Kenya, where Aondo lives, the stigma associated with diabetes and hypertension can be crippling.
Often, if someone is diagnosed with diabetes, the entire family is viewed as cursed – leading to isolation, said Newton Ngugi, a capacity building lead for Medtronic LABS’ programs in Kenya. Type 2 diabetes is also often viewed as punishment for a sedentary lifestyle.
In his role, Ngugi has witnessed the stigma firsthand. He has also lived with type 1 diabetes since 2013.
“Having experienced inaccessibility to quality diabetes care and education, I developed a passion for changing the diabetes landscape via undertaking healthcare advocacy training,” he said.
Data-Informed Interventions
That advocacy goes a long way in addressing the isolation caused by stigma. Research shows that loneliness and social isolation can be twice as harmful to physical and mental health as obesity and that a lack of social connection can heighten health risks as much as smoking 15 cigarettes a day.
But it’s not just isolation. People living with diabetes are significantly more likely than those without diabetes to have co-morbid depression or other mental health symptoms.
In Kenya alone, up to 60% of people with chronic physical diseases including diabetes may have clinically significant levels of depressive symptoms – but 85% of the population lacks access to mental health services.
Technology can support integrated services to drive improved outcomes among chronic care patients. That’s why we are running a pilot on early detection, referral and management of depression, anxiety, substance use, and suicide ideation cases among existing and new patients.
Once screened, patients are connected to care based on the decision support in SPICE, our open-source digital health platform.
“There are strong bidirectional links between mental health and other chronic diseases,” said Bonstein Sisa, an innovation and design strategist at Medtronic LABS. “Our innovations and interventions need to shift focus to holistic care for patients through integrated health services.”
‘You Can’t Have Health Without Mental Health’
Just five minutes from Aondo’s house, a group of women began to gather at Bondeni Hospital.
They lined up and waited for a community health worker to arrive and take their blood pressure and blood glucose readings. Now, the assessment also includes a mental health screening.
Clinical psychologist, Vivian Salome was on hand for the assessments. While the women waited, she took the opportunity to educate them on mental health.
“You can’t have health without mental health,” she said, and asked the crowd to share their experiences and questions.
One patient named Florence shared that she has improved so much since coming to the clinic and support groups offered monthly.
‘I’m Here for You’
Salome is one of just two clinical psychologists in the public health sector in Nakuru County – a population of just over 2 million. She helped train a group of community health workers on the mental health workflow.
The care of the community health workers means a lot to Aondo, who is unable to attend the support groups because she is a teacher.
“My health worker Celestine encourages me when she comes,” Aondo said. “She says, ‘I’m here for you.’”
For Aondo, everything changed once she began to accept that she was living with diabetes – and that’s what she wants to share with others living with the condition.
Since being enrolled in the Empower Health program, she has become a peer educator, going door to door to educate others living with diabetes and break down the stigma.
“I’m happy now,” she said. “Now I have hope in life.”
Hear Aondo share some of her story in her own words.
