For the past several years, Wuqu’ Kawoq has been providing diabetics with free consultations, medications, and nutritional advice. As the number of diabetics we encounter has been growing rapidly, this summer, the directors of ACOTCHI approached us about the possibility of holding nutritional classes and forming support groups for diabetics in the highlands. In order to plan for these endeavors, as well as to evaluate and improve our ongoing diabetes programs, we have been conducting preliminary research with our diabetic patients.
Using a survey put together by our team of nutritionists (Nicole Henretty, a registered dietician, and Sarah Messmer, medical student) as well as ethnographic interviews, we have been assessing patients’ knowledge, attitudes, and practices concerning diabetes. One of Wuqu’ Kawoq’s new interns, Miranda Greiner, recently worked with me and several midwives and collaborators in Comalapa to perform interviews and 24-hour food recalls in Kaqchikel, as well as a focus group. Additionally, for the last several weeks, I have been working with Wicha Ixtajop, who coordinates care for diabetics in Santiago, to better understand our patients’ experiences with diabetes and health care in general.
We have gained many insights from this research so far. First, the family plays a significant role in patients’ abilities to follow a diet, and few patients are aware that diabetes is often a hereditary condition. Therefore, nutritional education targeted at the families of diabetics will be beneficial. Second, many diabetics feel isolated and would like to hear about others’ experiences with the disease. Furthermore, every single patient we have talked to has interpreted the onset of the disease as the result of stress, poverty, and poor mental health. We hope to coordinate support groups about these themes, as well as diet and exercise, in the near future. Third, due to the variety of medical services available in Guatemala, many of which are poor quality, patients often receive contradictory and confusing information about the disease from doctors, pharmacists, herbalists, family members, and friends. We are hoping that our educational classes will be able to address some of these issues.
We will be continuing our research with diabetics in our other clinical sites for the rest of the summer, and hope to sponsor classes taught by midwives and health promoters over the next six months. As I continue to coordinate ethnographic efforts, Sarah and Nicole are developing posters and a curriculum, while Miranda has been working on a Kaqchikel pamphlet defining diabetes, common symptoms, and treatments for patients.