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A report on the 24th Al-Bawasil International Camp for Children with Diabetes- We Can, We Can!!

2024; Medknow; Volume: 15; Issue: 1 Linguagem: Inglês

10.4103/jod.jod_2_24

2543-3288

Mahira Saiyed, Hana Abdallah Hussein Aweida, Banshi Saboo,

Diabetes and associated disorders

Type 1 diabetes (T1D) is an auto-immune condition that requires insulin and diabetes education (DE), along with some permanent changes to daily routine. DE is the heart of diabetes management. As the saying goes, "Give a man a fish and he will not go hungry that day. Teach him how to fish and he will not be hungry for the rest of his life." In the same way, DE will enhance diabetes self-management skills, build confidence, and improve the quality of life. It is important to give the children the opportunity to learn about diabetes through parents, peers, healthcare professionals, or any other resources. Our goal for Children with Diabetes (CwD) is to make them capable of taking a greater proportion of responsibility for their diabetes. To become friends with diabetes (or at least not to see it as an enemy), as it will probably be easier to manage diabetes well. One such friendly approach to delivering DE in a playful, attractive, child-friendly manner that we came across at the end of December 2023 was at the 24th Al-Bawasil International Camp for Children with Diabetes in Qatar. Al-Bawasil means "the brave ones." It is a 6-day disciplined program organized by the Qatar Diabetes Association (QDA) and supported by the International Diabetes Federation.[1,2] The objectives of the camp were, to teach self-management skills, to allow children to get involved with other children from different regions and build a cooperative environment amongst all of them, give them a chance to express themselves, discover their talent, build teamwork, adopt the principle of equal treatment, teach them healthy eating and importance of adopting a physically active lifestyle. This year the camp was scheduled at Aspire Academy, Doha, Qatar. It is a gigantic sports academy adorned by numerous quotes, which were enough to inspire anyone. There were eight participating countries predominantly from the Middle East and North Africa (MENA) region (Jordan, Iraq, Iran, Bahrain, Kuwait, Libya, Sudan, Syria, Algeria, Tunisia, Turkey, and Qatar) with 66 CwD aged between 7 and 11 years [Figure 1]. The majority of them used insulin pumps and a few used insulin pens with continuous glucose monitors. This was the first time the camp invited countries from the Southeast Asian region namely, India, Pakistan, and Bangladesh. The children from this region were on insulin pens and used glucose monitoring devices. MS was fortunate to supervise two girls with diabetes from India (Dr. Banshi Saboo, Diacare-Ahmedabad, Gujarat, India). HA supervised two girls with diabetes from Qatar.Figure 1:: Bawasil and supervisors from different countries at 24th Al Bawasil International Camp from children with diabetesAll children were divided into four groups and each group had two captains. The groups were named after wild plants found in the barren deserts of Qatar. Plants that grow and thrive in difficult climatic conditions. The significance of such naming is to show CwD that they can live in this world with diabetes, overcome their challenges, and flourish at the same time. They were, Al-Shafalah, Al-Aaqool, Al-Awsaj, and Al-Sidra (our group). Each group had its anthem (With determination and ability, give them greetings, Creative idea, give them greetings) and a common camp anthem as well. (We do not know anything impossible, We can, we can. To remain as light guiding the coming generations, We can We can.) These anthems were the soul and charm of the camp that carried positivity and motivation to overcome the challenges of diabetes. The anthem was pronounced by each group frequently and piercingly and this continued till the last day. Each group made sure they were the loudest than the other. During the entire camp, CwD were always referred to by the name Bawasil (the brave ones). The program encompassed diabetes workshops on injection techniques, insulin, nutrition, and storytelling on diabetes. In addition, it had arts and crafts activities, fashion shows, acts on sustainable living, talent shows, and sports activities. All of these activities were completed in one day of preparation and presentation. Groups were given markings and false Riyals for every activity to motivate participation and earn additional Riyals. The presentation was held every evening, and Dr. Abdulla Al Hamaq (Executive Director of QDA) was there to witness it each day. We were deeply touched by his kind gesture and his approach to CwD. Professor Adel M. El Sayed (Egypt) and Professor Sehnaz Karadeniz (Turkey) were also at the camp. From the third day till the sixth day, there were trips to the Oli Oli Doha's Children Museum, Doha Expo 2023, Heenat Salma Farm, and Souq Waqif. (According to history vendors here used to stand and sell their goods, hence named standing market, Waqif means standing.) The camp concluded with the unforgettable closing ceremony, during which Bawasil, the supervisor, and other members wore their traditional attire and recounted their experiences—exchanged traditional gifts from their respective countries, speeches from Dr. Abdulla Al Hamaq and Professor Adel M. El Sayed. The backbone of the camp was its volunteers and supervisors, who were quite enthusiastic and proactive. They were from varied backgrounds medical students, caretakers of T1D, and a few from nonmedical backgrounds. They have been selected intensively from a large pool of people and had received T1D training beforehand. Each supervisor was assigned two CwDs, few of them met for the first time during the camp. The voluntary service did not involve any monetary gain or any other advantage. We were curious to know their reason for participation in the camp. The responses received were, "It is fun to be around children." "It is a service to humanity." "I was on vacation and thought to contribute to some good work." "We cannot expect money in return to every work, the creator bless you in many different ways." Experience as Caretakers There was a feeling of extreme anxiety related to blood glucose values, which may be due to over-concern. Children played all day, went on trips, ate less sometimes more, and took action against hyperglycemia and hypoglycemia or when they looked a bit low. All these instances and more made us apprehensive. Consequently, we gave frequent reminders to test the glucose levels. The sense of discomfort and irritation was visible on the young faces. We realized that continuous glucose monitoring is an integral tool that can help to decrease the burden of diabetes management. Moreover, frequent outings and less food intake due to differences in food choices made us suspicious of hypoglycemia. Next, being a part of a camp made us realize that we need to think of the consequences before engaging in any activity. For instance, on a trip to Heenat Salma Farm, we assumed the blood glucose might drop down as we would have to walk through the farm and the children would be playing all day long. We made sure we had enough supplies to treat hypoglycemia. In other instances, like eating specific food we assume blood glucose will shoot up. To a greater extent, these assumptions prevent us from getting into serious adverse events. Moreover, carbohydrate counting and insulin dose adjustment were the core part of the camp. The QAD Dietician Committee played an active part in helping each child and supervisor to make a healthy choice and inject insulin mindfully. However, children from India had different food choices as compared to children from the MENA region. We were worried, about what food would be there for meals, what a child prefers to eat, or whether he will be able to eat all on the plate. In addition, the insulin dose needs to be adjusted accordingly. At times it has happened that children took insulin, but did not like the food. In such a case, we insisted they eat appropriately to avoid hypoglycemia. Throughout the camp, we were able to maintain blood glucose levels within range without experiencing any severe hypoglycemic events. That brought us a sense of accomplishment. The feelings of anxiety, guilt, and fear are only the tip of the iceberg. There are many such events that parents of T1D come across in this journey. To them, diabetes is a daily battle that they are equipped to win. The camp allowed us to see the strength it takes to manage this condition daily and it is a true test of resilience and courage. Research has proved that parents collaborating with children can be an effective coping strategy for both.[3] In summary, such an educational camp increases self-confidence by establishing friendships with other CwDs who have to abide by the same rules on insulin, diet, and testing. It helps to normalize the condition and live with it. Moreover, it increases diabetes self-management skills. It is more fun to take insulin together and see what your blood glucose levels are and compare it with your fellow diabuddy. It was worth noting that giving child responsibilities away from their parents can help them to gain strength and boost their confidence. Supervising a diabetes camp is a completely different experience than delivering teachings face to face. It allows us to put our feet in others' shoes who are involved in raising T1D kids. Although there were fears, anxiety, and worries, DE and experiences helped to manage diabetes during the camp. Acknowledgements We would like to express our special thanks to Dr. Abdulla Al Hamaq (Executive Director of QDA) and Mr. Ashraf for inviting us to the 24th Al-Bawasil Camp. I (Mahira) am sincerely grateful to Dr. Banshi Saboo for putting his trust and choosing me for this unique opportunity. We extend our gratitude to the Medical Committee and Dietician Committee for looking after us and making us comfortable. Lastly, big thanks to the Communication Committee, Activity Committee, and Control Committee for providing us with all the facilities that were required. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.