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Journals from HHPA/HESC 398 Island Health Care: Type 2 Diabetes in the Bahamas January Term 2012

2012-01-09 Day 2: Hospitals and more-part 1

Today was our first full day on the Island of New Providence in the capital city of Nassau. We left our hotel at 8am and headed to their main hospital Princess Margaret. Dr. Dionne Dames gave us a lecture about Type 2 Diabetes specific to the Bahamas. Twenty-five years ago things changed and the prevalence of chronic diseases increased. A lot of American ways were introduced to the islands. “Our trends are your trends,” is the way Dr. Dames put it. The biggest struggle that doctors see today when trying to care for a diabetic patient is the lack of understanding about the disease. Getting patients to buy into the treatment that is being prescribed is also hard. Dr. Dames said that males are more likely to wait until the last minute to receive care: “They wait until their last toenail.” Another struggle that is often seen when treating Type 2 Diabetes is getting patients to change their lifestyle. Even though they are surrounded by beautiful waters, a lot of Bahamian people cannot swim. Doctors are not asking patients to completely eliminate all the unhealthy foods from their diet but little by little making small adjustments to their lifestyle can go a long way. One thing doctors here have used as a catalyst to start treatment and continue treatment is to find something important enough to each patient to motivate them to stay on track. For example, some patients fear they will not be able to play with their grandchildren if their disease continues to get worse. Some patients just appreciate the stairs and don’t want to lose that ability. Dr. Dames always reminds male patients if they aren’t keeping up with their treatment their ability to have an erection significantly decreases, which is very motivating for some. Patients on the family islands or the out islands have an even more difficult time getting treatment. Some people cannot afford a flight to Nassau every 4 months to get their blood work done. Sometimes there is also a language barrier between patient and doctor. Some patients are not able to read as well as understanding some of the terminology that comes along with Type 2 diabetes.

The group appreciated the lecture and the tour of the hospital given by administration and staff. We told one of the nursing educators that we have gotten into the ocean not two hours off the plane and she looked at us like we were insane saying that 72-degree water was cold. As we were driving from the straw market and the fish fry back to the hotel, we drove past Cable Beach, where the first telephone wire connected The Bahamas to America and I couldn’t help but replay in my head what Dr. Dames had said. “Our trends are your trends.” That cable is a symbol for how separate cultures can actually have a huge impact on one another and we might not realize it.

Kelsey

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