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Dear Friends

I want to create a group which shall share information on Diabetes through memoirs. Please join and send your own memoirs. Find below an interesting story, titled "An Adventerous Lover-" and "He amputated his leg himself..."

It was during my stay at Republic Square at Paris, while I was attending 18th Congress of International Diabetes Federation (IDF) in 2003 that I happened to go through an anecdote published in a health magazine, provided in the kit of the congress, titled "Equilebre." This anecdote is very inspiring and needs profuse readership. 13 years old Eve, a Jewish teenager from Parguay, fell in love with Victor, a 16 year old neighbour and a family friend. After 6 year, when Eve was 19 years old, the wedding bells rang. In 1939 Nazis from Germany attacked the country and occupied it, threatening existence of Jewish community. With 20 Marks and a few clothes, the couple escaped through the next available ship, which deported them at Shanghai.
Victor soon found a job in a reputed woolen mill while Eve became an English teacher in a neighboring school and the couple started their life from scratch in a new country. But the destiny had something else for them.....Noticing intense thirst and weight loss in Eve, Victor consulted a Chinese Physician who diagnosed her to suffer from Type 1 Diabetes. By this time Insulin was easily available in Shanghai, so Eve soon recovered her lost health and went back to job. When Japanese invaded Shanghai and cut off its connections with rest of the world, severe scarcity of Insulin ensued and Insulin became costlier than gold. The occupying forces took away forcibly, all important medicines, including Insulin, from the drug shops for their personal usage and the shop keepers closed down the shutters. Seeing Eve's health, deteriorating day by day, Victor requested several Chinese doctors to try making Insulin, but they refused. So he put his head into the books and read the original account, narrating the way Banting extracted Insulin from Dogs' Pancreas. Next he had to search a place, which could serve as Laboratory. This need was fulfilled by his Chinese friend Wong, who was a food Inspector and used to test food prepared by small vendors. One fine morning Victor hunted a kabaus (a kind of Buffalo), separated pancreas from it and made a determined effort to make Insulin, as per procedure, described by Banting. Some how he prepared an extract of Insulin but could not dare to inject it into his wife. He first injected a shot in a rabbit and when the rabbit fell unconscious, Victor became sure of its efficacy. Next he injected that Insulin in Eve who soon picked up health and returned to her work. This inspired Victor to undertake social work and help other patients of Diabetes, who were in crisis due to non-availability of Insulin. Soon he discovered that some 200 Insulin dependant Diabetics were there in the city, so he formed a club of relatives, came out early in the morning to hunt the animals and prepared Insulin in his way through out the day to provide adequate quantity to these patients. This he continued till the end of the world war and because of his humane effort, no patient died due to lack of Insulin. This anecdote reaffirms truthfulness of a common saying-"where there is will, there is a way."

Second Memoir:-

It was a pleasant morning of Jan, 2001. I had gone to Chennai (previously called Madras) city to present a paper in an International conference, called Diabetes In Asia. One speaker from Manchester, Prof. Rhys Willium, while presenting his paper on economics of Diabetes, stunned the audience, by showing news clipping from our own leading news paper-the Indian Express. Storey in nut shell was to emphasize that foot care in Diabetes was damn costly and storey could be summarized as follows:-

There used to be an old diabetic patient, named X. He was a plumber by profession and had Diabetes for last 15 years or so. Some how he developed an ulcer over one of his soles but since his feet were insensate, he did not pay much attention to it until he developed much swelling on the foot progressing to leg, which gradually hindered his routine. As per common practice in our part, he visited an old poorly qualified dispensing family physician who just got him dressed by his helper and did not even bother to see his sole and arranged some medicines, presumably some cheap antibiotic and fillers (vit etc.). With a heavy leg Mr. X was finding difficult to paddle his old bicycle and attend to plumbering job from one house to another, so responding to advice of one of his friends, he turned groccer and started selling vegetables, since this job required him to keep sitting. He used to spend some 2 USD per day on dressing and medicines and was earning some 4 USD from his current job, thus he was bale to push the cart of life and family somehow. But not for very long….as his foot wound deteriorated and smelled badly customers avoided the corner of the road, where Mr. X was sitting, which lead to wrath of his neighboring grocers who abused him and threatened to leave the place or face the consequences.

Frustated Mr. X had no one in the world to help. Relatives and friends used to close the door as he approached for help since their patience had already exhausted. In the meantime the family physician surrendered and referred him to a surgeon for below knee amputation. The surgeon demanded some 400 USD for the procedure and alerted him for additional 400 USD on medicine etc.

Some times situation emboldens a person and Mr X had a “nobel idea” to get rid of that weeping, foul smelling anti social leg. He sat on the rail track and advanced his leg below the wheels. In a few minutes he was free from the problem and just tied a long piece of cloth himself to stop the bleeding, dressed himself for a few months and was mobile on crutches which too were improvized and designed by himself. Now he is back on his job of plumbering and can even paddle his bicycle.

Through this memoir I want to point out following pieces of information related to Diabetes-

1. In Diabetes feet are most problematic part and its problems extremely costly.

2. Because of Neuropathy feet become insensate and hence an ignorant patient is liable to ignore and postpone visit to physician until it is too late.

3. In developing world plight of Diabetes care is horrible and that of subspecialties like Podiatry still more of concern.

4. In Diabetes, Education is the most important pillar of management for which no infra structure exists is developing countries.

Dr. L.K. Shankhdhar