Empowering Rural Health: Diabetes Care at FAME
Ensiankik
Esiankik* is a charming young Maasai girl. She exudes a vibrant charm that conceals her challenges. She doesn't know her age and her mother doesn't either. “Mayelo!” she giggles when we ask. In the Maasai language, "Mayelo" translates to "I don't know,". FAME's social worker, Kitashu, estimates her age to be around 13-15.
For the past five years, Esiankik has been battling illness. It all started when she suddenly lost a lot of weight and became weak. Most days she had leg pain, which got so bad that she couldn't walk to school anymore, so she stopped attending. House chores that had always been easy and fun for her, such as fetching water from the river, where she would spend hours with her friends telling stories, became impossible for her to do. She often just wanted to lie down because she was tired, despite not having done anything. Then on one rainy morning, Esiankik fainted and was unconscious for hours.
“We rushed her to the local dispensary after trying everything to wake her up and nothing worked. The doctor at the dispensary told us that her case was very serious. He recommended that we take her to one of two hospitals, FAME Hospital or Kilimanjaro Christian Medical Centre (KCMC), a zonal referral hospital located in the Kilimanjaro Region, as he only trusted one of the two to figure out what was wrong with her.”
Both hospitals were many miles away. Esiankik and her family live in a small secluded village 150 miles from FAME and 220 miles from KCMC.
“Both options left me heartbroken as they were very far from home and I did not have money to afford such a long journey. But Esiankik was critically ill, so I sold the two cows I had left after the drought and got some money. We took a bodaboda (motorcycle), two buses and a bajaji (autorickshaw) to get to FAME from our village.”
Esiankik (right) poses with her mother (left) and her little brother (center) in FAME’s Ward 1.
Once at FAME, Esiankik was diagnosed with Diabetes Type 1, a chronic autoimmune condition requiring consistent insulin therapy. Insulin injections are administered to keep blood sugar levels within a specific range to prevent complications. She also suffered from diabetic ketoacidosis (DKA), a serious and potentially life-threatening complication of diabetes caused by a severe shortage of insulin. She was immediately started on insulin therapy.
“I was very scared when we got to FAME as I thought Esiankik was already dead. I was happy after a few hours when she opened her eyes. The doctors explained her disease to me and since I don’t speak Swahili, they brought in a translator [Social Worker Kitashu] who spoke my language. Once I understood the lifelong nature of the disease, my heart broke for my daughter. She is so young! How can I care for her when we live so far away and don’t have enough money?”
Esiankik (middle) is flanked by Nurse Moinan Letion (left) in FAME’s Ward 1. With her discharge scheduled, Esiankik was moments away from having her cannula gently removed, marking the end of her hospital stay as she prepared to return home.
This would signal the start of Esiankik's journey with diabetes. The compassionate nurses at FAME taught her mother how to handle the insulin, give injections and properly store it. Although terrified, her mother was determined to learn and asked many questions to ensure she understood everything.
It's been five years since and yet diabetes continues to be a challenge for Esiankik and her family. This time, she has been admitted to FAME’s inpatient ward for five days. Accompanied by her mother and little brother, she had come to pick up her insulin which FAME generously provides without charge to help subsidize their costs and ease their financial burden. However, since she had missed a week of insulin shots, her sugar was dangerously high and she had to be admitted
“I do everything I can to take care of her. This time, we were late picking up the insulin because I didn’t have enough money for the transport to get here, so she missed a couple of days. I feel terrible! I try so hard to make sure we pick up the medication on time and give her the injections twice a day without fail. But sadly, I have let her down.”
Esiankik’s mother explains that she tries to follow all the advice that the doctors have given her.
“I follow the diet advice provided by the doctors. However, sometimes we don’t have enough food, so she eats what the rest of us eat. Still, I always try to put her recommended food aside when I can. As for the insulin, I store the vials in a clay pot in the corner of our hut; the pot has soil that keeps the insulin cold. This has worked well. When I run errands in the local market, our elderly neighbor helps me give her insulin injections as he is a nurse and knows how to do it.”
“Esiankik is my second child. I am thankful that her five siblings are healthy; none have this illness. While I can leave three of the children at home alone when I bring Esiankik to FAME, my youngest son comes with us since he is so small. For some reason, he enjoys our FAME visits very much and I know he will be sad when he’s older and I must leave him home when I come here!”
“Before Esiankik’s diagnosis, I knew nothing about this disease. I also didn’t know anybody who had ever had it. She was the first. I am so thankful to FAME, who continue to support me in this journey; for over five years now. Without their help, I would not be able to handle this situation. They have taken great care of us. Ashe Oleng [Thank You]!”
Asked about FAME, Esiankik giggles, smiles and covers her mouth shyly. Her giggles and smiles say more than words ever could.
*The patient’s name has been changed to protect her privacy and permission was secured to share her story. The quotes from this interview have been translated from Maasai to English.
