Providing education and supplies to reduce risks of infections among diabetics in Rwanda

Similar to other countries worldwide, in Rwanda, diabetes constitutes a drastic and costly disease for families and communities. Diabetes can lead to complications such as amputation, blindness, kidney failure, and liver malfunction. Because of its chronic nature and the severity of its complications, continuous safe medication and patient education are crucial if acute and long-term complications are to be prevented.

However, in many sub-Saharan African countries (including Rwanda), insulin-dependent patients face difficulties in getting the drugs, single-use syringes, and safe disposal boxes they need for their daily medication. The reuse of syringes and poor disposal of used syringes (often thrown in latrines or openly dumped in the environment) are commonly practiced by insulin-dependent patients and constitute a potential source of infections.

In response to this challenge, the Rwanda Injection Safety Project (RISP) worked with the Ministry of Health, through the Environmental Health Desk and the Non-Communicable Diseases Department, and the Rwandan Diabetics Association to train peer educators on safe injection practices and provided commodities to enhance best practices. RISP is a funded through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention, and is implemented by JSI R&T. The project is a follow-on to the Making Medical Injections Safer project, which started in 2004.

“I am very happy and confident that the JSI support will help us in addressing many of the challenges faced by our association members.” -Francois Gishoma, President of the Rwanda Diabetics Association.
Working with the Rwanda Diabetics Associations in sites countrywide, 35 peer educators, including nurses and representatives of diabetic patients, were trained on the risks of unsafe injections and poor management of used syringes at home in order to promote and sustain best practices among patients. Additionally, RISP conducted joint supervision visits to further strengthen and sustain injection practices and the management of used syringes among insulin-dependent patients. The supervision visits targeted trained persons in charge of diabetic patients at the health facility the day of the visit. The site visits enabled the joint team to address several problems related to unsafe practices.

Following the training, the project provided 500,000 single use insulin syringes and 6,675 safety boxes to supplement available supplies and enable patients to reduce the risk of infections resulting from poor injection practices and the management of used syringes.

In remarks during the receipt of the commodities, Francois Gishoma, President of the Rwanda Diabetics Association said, “I am very happy and confident that the JSI support will help us in addressing many of the challenges faced by our association members.”

The strong partnership between the Ministry of Health, the Rwanda Diabetics Association, and RISP has strengthened the prevention of the transmission of infections among the majority of vulnerable insulin-dependent patients through the improvement of injection practices and management of used syringes. The partnership has also successfully linked insulin-dependent patients with health facilities that received the supplies so that patients know where they can get new single-use syringes and safety boxes for preventing infections.