ismail

By ELIZABETH MERAB

@lisamcleans

He keenly watches as geckos scamper around the nearby hedge. It is a sight that amuses him and his eyes gleam with delight.

But the gleam is replaced with a mirthless smile as Ismael Ibrahim turns his attention towards his peers at play.

He would like to join in and play but instead chooses to sit and watch.

“Ensure that you get your insulin injection before eating anything,” the voice of one of the instructors breaks through the noise.

Ismael, who was diagnosed with diabetes last year, is attending his first diabetes youth camp. About 50 children from six coastal counties have been invited to the camp.

But Ismael is different. Not only does he have diabetes, he is also completely deaf. The 16-year-old can only communicate with his hearing friends through a sign language translator.

“It is a bit difficult to pick up every word he is signing because he is mixing the signs taught professionally with what we refer to as ‘local signing’, which children pick up at home,” explains his Ms Fatuma Ngoto, a sign language expert.

Though it would seem as if Ismael is reserved by nature, he has learnt to be keen and uses his eyes to follow conversations.

His parents only found out Ismael was hearing imapired when he was two-and-a-half months old.

“Since childhood, Ismael was a very quiet, peaceful baby even in his sleep. His mother would leave him sleeping to go fetch water and come back to find him still in the same position. I don’t remember hearing my son cry like normal children do,” recalls Ibrahim Chiko, Ismael’s father.

Chiko says that they decided to test their son’s hearing as soon as they suspected something was amiss. They stamped their feet near him. Struck metal rods and played loud music but still got no reaction from him.

“When my wife hinted that our son could be deaf, I did not want to believe it, we decided to try traditional methods first before taking him to hospital for a second and authoritative opinion,” says Chiko.

The diagnosis from Kilifi General Hospital indicated a change of lifestyle for Chiko’s family. Each member of the family had to take care of Ismael due to his disability.

As if this was not enough for the cash-strapped family, rumours that Chiko had used his son in witchcraft spread in the small village.

“Our relatives began to keep off and our neighbours would not even borrow salt from us. Playing with other children became difficult because they believed that our son’s condition was as a result of witchcraft,” explained Chiko.

To avoid dealing with the stigma, Chiko and his wife confined Ismael to their Makuti-thatched house. Eventually, he got admitted to Kilifi School for The Deaf after living at home for 14 years.

“The allegations were were quite hard to deal with. When one doctor suggested the boarding school, we took it up immediately,” he recalls.

A year after his admission to school, Ismael was diagnosed with Type 1 diabetes, a condition that is currently on the rise among children and young people in country.

“One afternoon, his teacher called to say that my son’s health had deteriorated and he needed quick attention. When I went to pick him from school, I could not believe what I saw. He was so thin and weak that even food supplements could not help him gain weight,” says Chiko, adding:

“For a moment I thought he was HIV positive and even tried to probe him so he could tell me if he had shared any sharp objects with other pupils.”

What Chiko did not immediately realise, was that his son was a diabetic. A diagnosis that came a shock to him.

It is this diagnosis that saw him attend last year’s Diabetes Youth Camp organised by Safaricom Foundation. Through it, Chiko was able to come to terms with the condition.

“All this time I was convinced that my son was the only one with diabetes, it is still uncommon to hear that somebody has such a condition. However, today I can breathe easily after seeing all these children, some younger than my son deal with the same,” He says.

According to statistics, at 16 years of age, Ismael’s diabetic case is not unique. Together with the 49 other children who attended the camp, they are just but a fraction of the ominously escalating cases of diabetes in children and teenagers.

A person is said to be a diabetic when their body cannot properly store and use glucose broken down from foods like bread, rice, potatoes and other carbohydrates.

Such patients will present symptoms of frequent urination, increased thirst and hunger, symptoms which Ismael first presented before he was diagnosed.

The International Diabetes Federation Africa (IDF-A) in 2013 documented that 387 million people in the world are living with diabetes. Last year, Kenya recorded 775,200 cases, a marked rise from the previous year.

The sharp increase of diabetes among children and young adults of between 8-18 years has rised concern from the Kenya Diabetes Management and Information Centre (DMI), a registered medical charity.

Mrs Eva Muchemi, the Executive Director of the Centre says that the number of young people being diagnosed with the non-communicable diseases is on the rise with the youngest patient diagnosed with diabetes at their institution being four months old.

“The number of people coming to the centre for diabetes management is quite high. Many of our patients are young people who have been diagnosed with Type II diabetes, which is more common in adults,” says Mrs Muchemi.

Type 1 diabetes occurs when the body of an individual fails to produce enough insulin while Type 2 begins with insulin resistance, where cells fail to respond to insulin properly.

As the disease progresses a lack of insulin may also develop. Insulin is a hormone produced in the pancreas to regulate the amount of glucose in the blood.

Mrs Muchemi explains that when a child is diagnosed with diabetes, their survival rate is usually between seven months and one year due to lack of appropriate medication and avenues for monitoring and information.

“Many medical practitioners tend to overlook this important aspect when carrying out a diagnosis and therefore, these children end up not being managed early enough,” she says.

However, the director’s major concern is the increase of diabetes Type 2 among children.

“Type 2 diabetes is mainly caused by sedentary lifestyle and we are seeing a sharp increase of the condition in young people, which is a worrying trend,” she says.

Mrs Muchemi points out that medical records only reflect those who have gone to hospital for diagnosis and therefore, may not clearly indicate the situation on the ground.

“When many people are diagnosed with a disease, there is always a high chance that the number of those undiagnosed is even higher. For every one person diagnosed, there are two others undiagnosed. This means that a third of people living in the developing countries will be diagnosed after their death,” she explains.

She adds that early diagnosis is the key to survival and a healthier life. However, Mrs Muchemi acknowledges that the treatment comes at a price.

“Insulin and the testing kits are not cheap and many cannot afford it yet diabetes affects patients of all social classes nowadays. The cost therefore stands in the way of these patients well-being.”

Poor families, for example, may be unable to raise the Sh1,800 required for a pack of insulin testing strips needed per month.

She concludes by advising that anybody above 25 years should have a blood sugar test.

“Diabetes is manageable and not a death sentence. You only need to get tested to know whether you have it or not. There is need for more awareness especially among the young since it is a group that is usually neglected.”

As he takes the syringe to draw insulin, Ismael can breathe with ease knowing that he is not alone in his predicament.

“Does he know how to go about his medication and meals?” I ask. With the help of Ms Ngoto, he quickly responds:

“The doctor wrote down how and when I should take my insulin. He also said that I can only have ugali that is equal to the size of my two fists, eat a lot of vegetables and drink enough water. He cautioned me against staying hungry for too long and this is advice I follow keenly.”

His new friends beckon him to join them in playing beach football and he happily obliges.

Early start in American football linked to brain problems

A new study of NFL retirees found that those who began playing tackle football when they were younger than 12 years old had a higher risk of developing memory and thinking problems later in life.

The study, published in the medical journal Neurology by researchers at the Boston University School of Medicine, was based on tests given to 42 former NFL players ages 41 to 65 who had experienced cognitive problems for at least six months.

Half the players started playing tackle football before age 12 and the other half began at 12 or older.

Those former NFL players who started playing before 12 years old performed “significantly worse” on every test measure after accounting for the total number of years played and the age of the players when they took the tests.

Those players recalled fewer words from a list they had learned 15 minutes earlier, and their mental flexibility was diminished compared with players who began playing tackle football at 12 or older.

While both groups scored below average on many tests, there was a roughly 20 per cent difference between the two groups on several measures.

The age of 12 was chosen as a benchmark because it is roughly the point by which brains in young boys are thought to have already undergone key periods of development.

Research has shown that boys younger than 12 who injure their brains can take longer to recover and have poor cognition in childhood.

The findings are likely to fuel an already fierce debate about when it is safe to allow children to begin playing tackle football and other contact sports.

Youth leagues are under scrutiny for putting children at risk with head injuries.

Pop Warner and many other youth leagues have added training protocols, have limited contact in practice, and have adjusted weight and age limits to try to reduce head injuries and the risks associated with them.

But some leagues continue to allow children as young as 5 to play tackle football.

“Being hit in the head repeatedly through tackle football during a critical time in brain development may be associated with later life cognitive difficulties,” said Robert Stern, the senior author of the study, who teaches at the Boston University School of Medicine. “The take home message is, the earlier you start, the more issues you may have.”

The findings came out of a larger multiyear study financed by the National Institutes of Health with the goal of finding a way to diagnose chronic traumatic encephalopathy in living people.

Stern warned that the results were applicable only to NFL players, and that more studies would be needed to determine the impact on a wider population, like players who stopped playing in college or high school.

The findings also should not be used to dictate rule changes, he said.

But “it makes logical sense that kids during a time of rapid brain development should not be exposed to hit after hit after hit to their head,” Stern said.

“To me, it is logical. The brain is our most important organ. The idea of dropping kids off at a field during a very important period of maturation and fostering hit after hit after hit, it doesn’t make sense to me personally.”

First Published in DN2, A weekly magazine found inside the Daily Nation http://bit.ly/1HQufBQ

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