Chimwemwe Chipenge easily remembers the date of the diagnosis that saved her daughter’s life: June 31, 2014.
That was the day Chimwemwe told clinicians with Abwenzi Pa Za Umoyo, as Partners In Health (PIH) is known in Malawi, that her young daughter, Sheila, “was getting smaller, losing loads of weight,” and experiencing dizziness, headaches and frequent urination. The clinicians diagnosed Sheila, now 14, with type 1 diabetes.
Sheila had been losing weight and not feeling well for weeks, but she had tested negative for malaria and other routine infections. While diabetes was a shock, and new to the Chipenge family, they were relieved to finally learn what had been causing Sheila’s symptoms. In the months that followed, Chimwemwe and Sheila learned that type 1 diabetes often affects young children, and that Sheila would need insulin twice a day. They also learned that, unlike malaria or other curable infections, type 1 diabetes was an ongoing, incurable condition that would require regular attention.
In the years since, though, the Chipenge family has discovered that through steady access to care and a supportive community, Sheila is able to thrive.
Her story is an inspiration as the international community recognizes World Diabetes Day—an important moment to advocate and raise awareness for diabetes globally. Staff at PIH organizations around the world, from Malawi to Navajo Nation, are marking the occasion with many diabetes-related events, including patient education sessions in Haiti and a screening campaign in Rwanda.
The care that Sheila receives is part of PIH’s integrated chronic care clinic, a model developed in partnership with Malawi’s Ministry of Health. The model’s goal is to increase access to care for people with non-communicable diseases in rural areas.
PIH’s integrated care model began as an HIV program. Clinicians now are building on that success to offer community-level care and screening for several chronic diseases—such as HIV, type 1 diabetes, rheumatic heart disease, and cervical cancer—under one umbrella. Providing integrated care enables PIH to reach many more patients like Sheila, and to link them to health services and social support.
That support often starts at home. Over the past three years, Chimwemwe has played a critical role in managing her daughter’s condition. She gives Sheila her insulin injections twice a day, at 6 a.m. and 6 p.m., and cooks healthy, hearty food, such as brown bread and whole-grain porridge, to support the injections.
Chimwemwe also is ready to recognize and respond when Sheila’s blood sugar drops unexpectedly.
When Sheila “gets a fever and sweats a lot, I know that she is dizzy,” Chimwemwe said. “So, I take a little sugar and give it to her.”
Although managing Sheila’s type 1 diabetes is a challenging new reality for her and her family, they continue to receive significant help from the community. Health workers from Neno District Hospital have coached Sheila on how to manage her diabetes at home. PIH helps operate the local hospital in rural southwestern Malawi, where the Chipenge family lives. A community health worker checks in regularly with Sheila and her mother, monitors Sheila’s health, and accompanies Sheila when she needs to visit the clinic.
PIH’s integrated chronic care clinic is a unique program in Malawi and an important model for the region. The clinic shows how complex, non-communicable diseases can be effectively managed in rural settings by investing in strong health systems and providing regular access to screening services, patient education, follow-up care, and life-saving medicines.
Over the next three years and beyond, PIH will continue supporting local communities and patients like Sheila while working with Malawi’s Ministry of Health to strengthen and expand services at district hospitals.
For her part, Sheila is focused on things close to home—like being a teenager and growing up. She’s now in eighth grade and enjoys spending time with her friends after school.
Sheila said she plans to study hard, so one day she can become a nurse and “save sick people’s lives,” as the PIH team in Malawi helped save hers.