Noah's Publications & Manuscripts

Gringo Loco: Shooting It Up In The South

(Insulin Free Times editorial, Spring 2005)

Nine months ago I was looking down from the high dive, toes hanging off the edge, shaking with disbelief and anticipation. As I launched myself into a freefall cannon ball through the South American diabetes scene, my thoughts revolved around my own exhilarating plunge. My original plan was to inspire diabetic youth upon my return from unknown adventures and to get information to all diabetics living non-complacent lives. A noble goal in the grand scheme of things, but a moderately self-serving vacation in the immediate. The facet of visiting and assisting foreign clinics was added as an afterthought and served to boost the credibility of my mission.

The first phase of my journey was athletically rigorous to a point that even I had not imagined. I probably inspired some vicarious followers by braving rivers, jungles and erratic traveling schedules, but as the swimming pool drew nearer I reassessed the mission checklist. Hitting the placid water below with nothing to show but sapped adrenal glands and a short-lived splash, would be embarrassing and probably score low marks. As soon as the aerial acrobatics began and I twisted and bent to reach foreign diabetes organizations, I remembered that spectators and judges didn't matter. When out of practice, the exhilaration of trying to do good can easily be forgotten.

During my time in South America I've had the privilege to get first-hand knowledge of key diabetes organizations in Ecuador, Peru, Bolivia and Chile. I volunteered in diabetes camps and clinics in exchange for interviews with patients and administrators. This does not make me an expert on the topic of the foreign epidemic by any stretch of the imagination, but it does afford me a perspective that was out of my reach in the U.S. The plot twists in my adventure have come as often as my injections and continue to bring a new understanding of the hurting and hope of our diabetic brothers and sisters down south.

The challenges in the South American diabetes epidemic vary in degrees between countries, but always revolve around the same two elements: money and education. The problem's sinister circular definition makes it difficult to get the right angle for a strait answer. How can education be funded when its would-be targets possess the necessary funds, along with blissful ignorance? The governmental and corporate policies surrounding economic assistance for diabetes are so replete with catch-22's that even Mr. Heller himself would be baffled. The policies' blossoming obscurity stems from the issue of priorities, which is deeply rooted in a progress-oriented mentality.

It's odd that the largest financial aide resource for diabetics is paradoxically the smallest contributor. South American health care is all privatized and the countries' respective governments make no attempt at covering any diabetes costs for the general public. Without medication, costly diabetics die out long before other, patients with cheaper diseases receiving minimal government funds. While a government's attention should be focused on the well-being of its citizens, the priority is the economic grand-slam policy of avoidance. By no means is this problem unique to our Mini-me governments in the South that strive to be like the big Doctor of global economy. Ironically, ignoring the problem now is much more costly in the long-run, both socially and economically, than grabbing the bull by the horns (or the syringe by the needle).

Other large sources of aide are businesses with vested interests in diabetics' health. Unfortunately, the ultimate success of these businesses lies in the priority of turning profits. Factories and company headquarters are not surprisingly based in strong economic areas of the continent where there is revenue to keep the business in the black and darkening. Thus, poorer countries miss out on the same technology and ease of supply acquisition that their more wealthy neighbors possess. Diabetics would not live without the service and aide provided by these companies, but the corporate mentality of personal gain is the same as mine at the initiation of my journey down south. However, minds and their mentalities can be changed at the speed of thought.

Other large monetary contributors are diabetes foundations and organizations with global consciences. The donated money and supplies are imperative in the epic epidemic, but it's like trying to stitch together skin above a severed artery. The wound runs too deep and needs dramatic policy changes to apply the necessary pressure further up the arm. Stitches give the visual appeal of progress and may slow blood-loss, but without a mentality transition in the other sources of aide, the steady whine of a flat-line will signal the end of the epidemic. How long can a Bolivian youth ward off complications by injecting once a day based on a blood test every other day?

After slamming all parties involved (myself included), I probably have either your curiosity or temper piqued. I don't mean to down-play any contributions made to the cause of fighting diabetes, but rather outline the problems undermining a skirmish with an attainable treaty. Although funds and educators are scarce, South American diabetes organizations aren't waiting around for a miracle. Education and action are the battle cries from the charging ranks of all manners of social and political programs.

Social education programs are imperative when some areas think that the most dangerous aspect of diabetes is its contagious quality. I've participated in health fairs for the general and indigenous public, as well as a specialized project for the forgotten population of diabetic prison inmates. The fairs are mostly geared toward an older population of Type-2 diabetics because of the disproportionate patient population between the two types. In Ecuador for example, there are 32 times more Type-2's.

Unlike the Type-2 youth population crisis in the U.S., the South American diabetic youth are almost entirely Type-1. The important social action programs for the Type-1's commonly take two forms: finding empowering examples of outstanding diabetic celebrities and diabetes camps. I can't help but think of a MasterCard commercial when conveying the effectiveness of diabetes camps ...

* Collaboration with medical sponsors: $$$
* Nutritionally balanced meal plan: $$$
* Tuition and copies of the camp photo: $$$
* Empowering a child to take control of his life: Priceless

Diabetes camps are where the stitches and artery compression combine like a smoothly-operating team of EMT's. Company sponsorship of camps for South American diabetes foundations as well as international diabetic youth organizations such as American Youth Understanding Diabetes Abroad (A.Y.U.D.A.), ensures adequate supplies and resources for a high-caliber retreat. This tag-team effort provides an unparalleled experience in education and empowerment for the campers. Even the International Diabetes Federation (IDF) measures advocacy and awareness success in youth populations by the number of established camps.

I took part in the annual summer camp put on by the Fundacion de Diabetes Juvenil (FDJ) in Chile, which can best be described as a traditional American summer camp model spiced up with rump-shaking Chilean culture. Its athletic rigor and sheer number of young diabetics was admirable, but the emphasis on education was even more empowering. The multiple daily doses of diabetic dialogue maintained the attention of my campers with a minimal amount of admonishing glares from the Gringo Loco. Instruction of diabetic self-control is vital when there are precious few supplies with which to practice the teaching.

Now that I've outlined the problems and current tactics, it's time for me to climb even higher up on my soap box. The self-serving profit mentality must be flicked down and extinguished underfoot. Its cancerous odor has drifted far and wide and is choking out even those who experience it second hand. Its addictive quality fortifies a smokescreen preventing a clear view of its negative global ramifications.

Education on a large scale must be directed at governments who have the power to make necessary economic policy changes. Political lobbying efforts do exist, but don't have enough ink to draw attention. This sketch can become a masterpiece with a little shading from another pen. The medical companies already offering support need to team-up with foreign organizations and go after the policy makers. Flexing the big guns of company capital and exemplifying a new level of social consciousness is a large step in the right direction.

Global efforts exist on all sides of the epidemic and are all pulling hard for their own agendas. This multi-lateral attack is precisely why the load is not shifting rapidly. Call it idealistic, but in a war that can easily be ignored by marching past with blinders on our eyes, it is time to unify efforts in the name of progress. Were governments, medical companies and diabetes organizations all to pull in the same direction, the possibility of mutual economic triumph would become obvious. South America is not waiting passively for a cure: it is focused on education and unification.