angie middlehurst type 1 diabetes trainier

Angie Middlehurst, diabetes educator, visits A4D sites in Laos and Myanmar

Action4Diabetics (A4D) welcomed volunteer diabetes educator, Angie Middlehurst, to visit clinics in Myanmar and Laos at the end of April 2019. 

Angie has over 21 years of experience with childhood and adolescents diabetes. Most recently, she was the Educational Director at Life For A Child (LFCA), a global organisation focused on developing Type 1 Diabetes (T1D) care around the world.

Before sharing the details of the trip, we would like to thank Angie for giving so much of her time towards the A4D cause. She is a truly passionate diabetes healthcare advocate; having people like Angie involved with the charity makes a massive difference!

With Angie’s expert observations and training, we had a few key objectives from the visit: 

  • Review problem cases and provide hands-on T1D support.
  • Conduct lectures and workshops related to T1D management for hospital staffs.
  • Provide one-on-one coaching for healthcare professionals.
  • Enhance psychosocial support through patient home visits.
Fiona Ooi and Angie Middluehurst with a family A4D support in Myanmar. Type 1 Diabetes.
Fiona Ooi, regional manager at A4D, and Angie Middlehurst with a family in Myanmar.

Diabetes Training in Mandalay, Myanmar

Angie arrived in Mandalay and joined Fiona Ooi, regional manager at A4D, to visit 550 Bedded Mandalay Children’s Hospital. Here Angie met with Dr Myint Nilar, who runs the diabetes clinic, to discuss the current situation of diabetes care in the upper region of Myanmar. 

Over the following days, Angie held a workshop on nutrition and carb counting for post-graduate junior doctors and nurses and reviewed problematic cases. These lessons were followed up with a lecture on insulin injection and then a sick day management class.

The week finished with some more practical activities: a diabetes clinic and patient home visits. 

Angie made some observations on how to encourage families to share experiences of living with T1D at the clinics and then traveled out to see families A4D support in rural areas.

Joined by the specialist care teams, Angie felt the home visits were particularly useful for the families living in more remote areas. Some of the families we support can live hundreds of kilometres from the clinic, and their interaction with health professionals is irregular. They can often become isloated and feel alientanted due to the condition.

a girl has her blood tested by an A4D sponsored doctor in Mandalay.

A4D Home Visit: Strengthening Relationships and Improving Care

By visiting a patient at home, healthcare teams get a clearer understanding of the challenges that a young person with T1D faces. Can they keep their insulin chilled? Who is their principal carer? What are the family dynamics?  

Answering these questions is easier once the healthcare professionals have built trust with the patient. Relationships are strengthened through home visits and they contribute towards care plans that are holistic and sensitive in approach.

We encourage health professionals to see people in villages. Across the region, we have seen visits have a positive impact on the quality of care when resources have permitted.

family with type 1 diabetes Myanmar A4D

Next stop, Laos! 

Fiona and Angie then travelled to Vientiane, Laos. Here they met with Dr Amphayvanh, who heads up the paediatric clinic at Mahosot Hospital. Similar to Myanmar, this initial conversation helped Angie understand the complexities that condition poses in Laos. 

For the rest of the week, Angie held lectures and workshops in Vientiane for healthcare professionals. Covering many of the same topics that she did in Myanmar, Angie also rana group patient education session. Seven patients, including one newly diagnosed who was still in the hospital ward, joined in.

Towards the end of the week, Angie visited some of the young people with T1D that we support. Fiona and Angie really enjoyed meeting the families!

Angie Middlehurst trains people with Type 1 Diabetes in Laos for A4D

After her trip, Angie had this to say about the work of A4D: 

“A4D has been able to offer support for children and young people with Type 1 Diabetes and their families. They do this via supplies, conducting camps and encouraging older children to mentor younger ones. All of this has been achieved while championing local sustainability.

This work needs to continue. A4D bring children and young people together at clinics and camps to lessen their feelings of isolation and encourage self-management and confidence for their future. 

Importantly, the efforts of A4D go towards saving lives, preventing complications and ensuring children with Type 1 Diabetes don’t just survive but thrive and lead fruitful lives”

Angie Middlehurst, Diabetes Educator.

Overall, it was a successful trip, and we look forward to hopefully working with Angie again in the future. A big thank you to Angie and thank you to our partners in Mandalay and Vientiane for being so welcoming.

Interested in helping? Contact us!

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