By: Yosuf Abdulhameed,
Aden

Thousands of people in Yemen suffer from diabetes. My wife is one of those who suffers.
My range of information on the above subject is quite limited and I am not a qualified person to discuss it. However, I ventured some personal research about the causes and treatment of diabetes, and narrate my findings for the benefit of our ordinary citizens of Yemen.
I learned that there are many factors influencing the development and progress of diabetes, Hereditary factors play an important part for genetic reasons. Obesity due to excess consumption of carbohydrates and fats induces diabetes. Grief due to loss or sudden illness of a loved and dear one can also be the cause of it. Infection, stress and strain and physical disorders may be reasons for diabetes. Finally, I read that wrong diet is an important factor in the growth and advancement of diabetes.

The symptoms indicating an oncoming attack of diabetes include Polyurea, polydipsia, polyphagia plus headache, weakness, giddiness and body aches. Other symptoms of uncontrolled diabetes are double vision, loss of memory, paralysis, unconsciousness and convulsions. There may be other symptoms of an attack, like trembling of the body, pins and needles and numbness of the hands and feet.
I understand that juvenile-onset diabetes develops in childhood, and is characterized by complete lack of insulin in the body, while maturity-onset diabetes usually appears in middle-aged people or elders who are often obese. I have taken interest in the older group because of my age and the diabetes of my wife. I feel that diabetes of this group can be completely controlled by proper diet. That is how my wife is successfully controlling her diabetes. Thus I stress that diet is the prime element or fundamental source for its control.

Let me first deal with the hereditary factors which cause diabetes. I read that if one of the parent has diabetes, one third of the offspring may develop diabetes in later life. If both parents have diabetes, one-half of the children may develop diabetes later in life. This is not a hard and fast rule, and there are families where no such development has taken place. My personal feeling is that children follow the same pattern of eating and drinking as their parents. They normally prefer the same foods which their parents had taught them to eat. As a result, they inherit some of the rights and wrongs committed by their parents. If we realize these mistakes and correct them, we could then delay the onset or hopefully altogether avoid the "Hereditary Factor." It is sometimes necessary to break with old discredited feeding traditions, and go for modern principles.

My wife didn't inherit diabetes. No one in her family has or had diabetes. Her diabetes was detected when she had repeated toothaches, headaches and giddiness. A lot of tea with sugar, potatoes, rice and other fatty foods were the cause of it. The doctor told her to avoid starchy and oily foods, but she didn't take it seriously at an early stage, and thus developed Diabetes. Her blood sugar reached 300mg%, and sugar appeared in her urine because the kidney's couldn't cope with the high concentration of blood sugar.
I read and consulted some doctors before suggesting to her some curative principles, exercise, etc. which was adopted by her. Her FBS is now between 80-120mg%.

The curative principles are mentioned as follows:
a) Our body needs protein, which is a body builder. High protein products includes meat and most products, fish, eggs, cheese, lentils, etc. We should take a very limited amount of protein, and concentrate more on lentils, which are second class proteins.
b) Carbohydrates found in white bread, sugar, rice, pot toes and other starchy foods are harmful to a diabetic. They are also a necessary part of anyone's diet. I think a diabetic should change over the whole wheat flour products (take khubz bur with little or no oil), vegetables, and plenty of salads. They have a lower carbohydrate content.
c) Exercise plays an important role in controlling diabetes. Regular daily walks up to two and four kilometers or more is necessary for better control. But don't exercise if your diabetes is not under control. Don't lift weights or try to carry heavy objects. They raise blood sugar.
d) A vitamin rich diet is very good for diabetes. Vitamins are available in the foods that we eat. But these are also available in tablet and capsule form. Vitamins A, B, C, D, and E are all essential for the body. A complex is a tablet with many vitamins which should be consumed daily by diabetics.
e) Diabetics should take food punctually at regular times of the day for the proper control of this disease, as the anti-diabetic drug works only for a limited time.
f) Wounds and sores of diabetics, especially on the feet and legs, don't heal and get infected easily, and a little sore can become gangrenous leading to amputation. Diabetics should inspect their feet regularly to check if cuts, swelling, infection and bruises are there. Keep feet always clean and dry, and don't be barefooted. Take Vitamin C, which fights infection and heals wounds.
Science and technology have advanced stupendously during the twentieth century. There has been advancement in the treatment of diabetes. The science of nutrition now believes that diabetes, and for that matter many other diseases, are both preventable and curable provided that the diseases have not reached an incurable or advanced stage.

My advice to diabetics who have not been able to control their trouble is that they should consult their medical specialists early and consistently. They should know the drugs that they are taking, their effects and side effects, when to adjust the doses, what other drugs to take or not to take in order to avoid hyperglycemia and hypoglycemia attacks.
In conclusion, I can say that diet control can reach a stage when a diabetic will feel that there is no need for drugs anymore. He should consult a Medical Specialist, and should not go off the drugs on his own.
Diabetics can live the rest of their normal lives without any further attacks.

Psychological diseases have become more and more common in developing countries. The doctors have pointed out that the spread of psychological diseases are mainly due to health, economic, and social conditions, and the spread of infectious diseases, malnutrition and accidents. They have also stated that the situation may become worse if we take into consideration the lack of psychiatric services; the number of doctors specialized in this field is very small and psychiatric centers are rare in towns, let alone in the country. Yemen is one of these developing countries that suffers very much from this problem. The number of governmental and non-governmental centers for psuchological treatment doesn't exceed the number of fingers on a hand. There are a very limited number of psychiatrists, but they are practically helpless with the number of cases they must deal with.
To learn more about this subject, Ahlam Al-Ghawlanee of the Yemen Times paid a visit to the Psychiatric Hospital in Sanaa and had the following interview with the manager of the hospital, Dr. Mohammed Hizam Al-Makramee.
Excerpts:

Q: When was the center established?
A: It was established in July of 1991. It was called the psychiatric care house at that time. It was very limited in its services and specialists, for it started with only one department and one psychiatrist and some nurses. The purpose of the house at that time was to take care of the psychiatric diseases in the women's cases in the central prison. In course of time it was expanded, until it developed into this large center, and was renamed the Psychiatric Hospital.

Q: What are the services introduced in the hospital?
A: As I said, it was restricted to psychiatric women's cases in the central prison, but after various development projects were inaugurated in the hospital, it started working on a large scale and has become a center for receiving all sorts of psychiatric cases.

Q: Who is supporting the center?
A: The center was established by the Islah Charity Society, which has been supporting it up to now, with the help of some government organizations and some business men; governmental organizations such as the health Ministry and Military Financing, business men such as Hail Saeed Companies and Al-Gharasee Companies who provide the hospital with food. There is also some support from some non-governmental organizations such as the British Council and the British Assembly, as well as some organizations which help in supplying the hospital with different necessities.

Q: How many sick cases existed in the hospital?
A: It varies, but it normally is 30-40 cases, and sometimes it increases and sometimes it decreases.

Q: How many cases does the hospital receive every day?
A: There is a separate section in the external clinic in which psychiatrists receive sick cases of different ages and from both sexes. The number of cases that come to the hospital every day are around seven to eight, sometimes they reach as high as ten.

Q: How many cases have been treated, and what is your success rate?
A: Generally speaking, the success rate in psychiatric treatment is very low, but we have some cases in which we have succeeded in treating our patients. There is no specific success ratio for every patient, and there are some complex cases in which the international success ratio is very limited. It is very difficult to judge, because there is a specific treatment fro every case.

Q: What are the means of treatment in the hospital?
There are drugs, therapy sessions, and various types of psychotherapy.

Q: What are the reasons for psychiatric diseases?
A: Generally speaking, the environment and the people surrounding you have a strong influence, besides the circumstances of the person himself.

Q: Are there any newly developed techniques in treatment of psychiatric diseases that have been implemented here in the hospital?
A: We have newly developed apparatus and techniques, and we are going to receive a new one soon which will help us a lot and is considered to be the latest technology worldwide.

Q: Can we specify the ages that are more liable to be affected by psychiatric diseases?
A: We can not specify the ages which are more liable to be affected by these disease, for psychiatric diseases have no specific time, but can come anywhere from the age of 15-50 years. Youth in our country are also liable to psychiatric diseases, which is mainly because of the deplorable and miserable situation they are in. Children are the least subjected to these diseases.

Q: Are there any activities that are used to pass the time of the sick people?
A: The hospital provides the patients with food, clothes, medicine and residence which are the basic needs. There are other activities such as reading, writing, sewing and drawing. We also have a table tennis, videos, football etc.

Q: Do you charge any fees in order to get into the hospital?
A: For examining patients have only to pay 100 and if they are coming to stay in the hospital they have to pay 1000. All the other expenses we do our best to cover ourselves.

Q: What are the main obstacles that you face?
A: The difficulties are large, for example we lack the different kinds of medicine and have limited supplies of what is available, the limited amount of equipment, and not enough complete qualified workers. There is also no contact between us and the outside world, and some other difficulties as well such as the non-existence of a library.

Q: What do you aim to achieve in the future?
A: We are planning to establish a new section for men. We also hope to get new equipment and to open a pharmacy.

Q: Any last comment?
A: We would like to express our thanks and gratefulness to the Yemen Times, which is always looking out for the afflicted and trying to comfort them.

Ahlam Al-Ghawlanee
Yemen Times