ACCESS TO DIABETES TREATMENT IN NORTHERN ETHIOPIA

Treatments for diabetes in Ethiopia are at present only available in h ospitals so many patients must travel great distances to obtain insuli n, tablets, and diabetes education. We reviewed all 496 people with di abetes attending the diabetic clinic at Gondar Hospital (281 with Type 1 (insulin-dependent) diabetes mellitus (DM) and 215 with Type 2 (non insulin-dependent) DM. Half of the patients came from rural areas, all but 3 of them travelling more than 20 km, one-quarter of them more th an 100 km and 33 patients (13 %) more than 180 km. It is likely that m any patients who fail to attend from the more distant areas have died. We are developing a scheme which would enable diabetic patients to be treated at rural health centres by nurses trained in the principles o f diabetes care which could greatly improve the outlook for diabetic p atients in Ethiopia. (C) 1998 John Wiley & Sons, Ltd.