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Pediatric endocrinologist takes her work to island of Mauritius
Mauritius ranks among countries with the highest prevalence of diabetes in the world.
With only one endocrinologist on the entire island and no pediatric endocrinologists, Carol Singer-Granick, MD, jumped on the opportunity to utilize her skills in Mauritius, an island about 900 miles off the coast of Madagascar.
Singer-Granick is associate professor of pediatrics at University Hospital, University of Medicine and Dentistry in Newark, N.J. She specializes in congenital adrenal hyperplasia, growth disorders, pubertal disorders, thyroid disease and type 1 and 2 diabetes.
Two years ago, Singer-Granick’s husband Mark Granick, MD, a plastic surgeon, went to the island after his advance practice nurse, a native to Mauritius, suggested they help the country.
“That’s how it started,” Singer-Granick told Endocrine Today. “It took about a year and a half for the initial organization, and I went along as the pediatric endocrinologist.”
“The island has a mixed population of roughly 1.5 million people. They have reasonably [fair] primary care that the government subsidizes, and most of the population has the basics, but they have no more than that,” she said.
 Carol Singer-Granick |
Island epidemic
Mauritius has a prevalence of diabetes at almost 20%, placing it among countries with the highest prevalence of diabetes in the world. Twenty percent of individuals older than 30 have diabetes and after age 50, 50% of the population will have developed diabetes.
In March 2007, the government published a manual called the National Service Framework for Diabetes: A 10-year Program because there are so many people with diabetes, according to Singer-Granick.
“The population is actually not obese compared with the United States, so it may be genetics,” she suggested.
The majority of the population depends on the government.
“The government issues about two syringes a month. Nongovernmental organizations give a few more, so children have about five syringes a month, and they reuse them multiple times,” she said.
The syringes are typically wiped with a tissue. When Singer-Granick inquired about infection, she was told infection is not the main problem; rather, it is the pain experienced when children inject themselves with dull syringes.
Diabetes programs
The University of Mauritius Medical School is on the island, and there is a small neonatal intensive care unit, according to Singer-Granick.
“They do the best with what they have, and they address many patient issues,” she said. “They do an admirable job in basic care; they just need more in higher specialties.”
Singer-Granick worked with pediatricians at Victoria Hospital, one of the main hospitals in the country, and helped in several clinics while she was there. On November 14, World Diabetes Day, the government organized a diabetes residential camp for children for the first time, she said.
Her overall experience with the children, parents and medical staff in Mauritius was positive.
“In endocrinology, you do not have dramatic or drastic things happening in a short time. Everybody was so happy with every little thing I did, even though I could not do all that much,” Singer-Granick said. “I feel very refreshed because all of the families [and hospital staff] were so grateful.”
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Moving in the right direction
The Mauritius government had ordered glucose meters from China that were substandard and essentially unusable, so the nongovernmental organization obtained funding and supplied each family with a meter and strips so that they could test once or twice a day for that month, according to Singer-Granick.
“I brought some meters and educational books for the children, and I actually learned more about what they can use there because they only have access to certain kinds of strips,” she said.
She hopes to return on a yearly basis if possible, and hopes to bring syringes from companies and also give them some equipment.
“My nurse contact in the nongovernmental organization manages the education of the children for almost the whole island, and she was very impressive,” she said. They need as many donations and as much funding as possible, and I would like to help as much as I can.” – by Christen Haigh