Sucre Blue

The Challenge: 

The Question: 

How do we best solve access to chronic disease treatment?

The Problem: 

Access to care

The Solution: 

CHW Support Models

Channels: 

Sucre Blue is a program that strives to create a chronic disease health care model to bring affordable access to medical treatment to people with diabetes, hypertension and cardiovascular disease in Bangalore. It’s a challenging setting to work in. One has to think that in these communities there is no doctors, hospitals or medical treatment in place. Access to treatment is  extremely limited (for diabetics as well - many forms are absent, some not always available, most of them too expensive anyway) and families earn 2 dollars per day. Many patients’ diabetes is caused by malnutrition, despite the common conception that it is a rich people’s condition. I often see blind children who lost their sight because their families lacked access to medication or means to purchase them. And all that in India, with the second fastest growth of diabetes in the world, and 70 percent of the population living in rural areas. Which makes it extremely difficult to identify those in need and ensure they’re given help.

For the past years, I have lived in India - partly in a hospital, without being paid, and I had a chance to see how the system works. As a diabetic myself, I’ve experienced the hardships of managing my own illness and needed to adapt to available solutions.

As an answer to this challenge, we are building a sustainable, and affordable model that could be replicated in other communities, across India and beyond. The service is based on dozens of patients and caregivers, who are being trained to provide other members of the community with door-to-door assistance. Our Community Health Workers in the pilot area conduct free screenings (sugar level, BMI, pressure monitoring) and check for diabetes and other health problems  - which they can later address according to the needs of each of the patients. An important component of this work is building relationships between the patients and the leaders - and help to establish links between those in needs and institutions that could provide them with further help. We also provide patients with free medicine. On top of that, we educate, bring awareness and help with early detection of potential issues. Many pre-diabetics in India could avoid becoming ill by changes in their dietary habits - and the diet is large to blame here.

Such screenings would not only help to support those who suffer from diabetes but extend preventive care and potentially save millions of dollars in treating more complex effects of diabetes, such as dialysis and other complications. Beyond that, we’re helping some of the diabetics to overcome their poverty, as managing their problems costs ¼ of their income, pushing them to extreme poverty. Providing free treatment and medication is essential for them to improve their quality of life.

On top of that, we equip our workers with SMS technology that allows them to collect the daily logs and patient's’ history - which will be stored in an open source database available to any researcher in the world. Otherwise, such information about chronically sick citizens of rural India is basically impossible to acquire.

We plan to transform Sucre Blue into a model that could be replicated by communities all over the world - with a peer-based approach, designed to deal with chronic diseases. In India, we engage women in our work - mostly those who suffer from diabetes themselves. It is a way to change a bit disproportionate representation of men in healthcare - and it empowers women in the society.  Having their personal approach to diabetes allows us to change the opinion around the disease, often perceived as a curse, for example forbidding some of the ill to get married.

Comments

Can you clarify?

Noemi's picture

@sucreblue it is lovely to read you, welcome to the community, and to OPENandChange bid - I saw you are formally onboard.

From the description of the service being peer-led I understand that the people doing the screenings, the caregivers are trained citizens? Or do they have medical background? I'm asking because the first makes for a model we keep seeing and others are advocating for similar ones - where building alternatives to systems means training ourselves into becoming carers. Because the systems are understaffed or too rigid to provide low cost access to treatments with low overhead.

You should definitely go in and meet the people at @concrn training community dispatchers for the homeless, or at @MAZI fighiting depression together. Or closer to home - how building cheap eco-coolers from plastic bottles helps people cope with heat. They are all community led solutions.

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