Overview 
The Ministry of Public Health in Cameroon is responsible for the maintenance of all public health services. Common diseases still affect the population, and some of these ailments are due to poor environmental living conditions, which could be improved with proper hygiene and sanitation. The demand for all types of health services and equipment is high and constant, and the need for modern equipment is especially urgent. Staff are poorly paid and overworked, which makes it difficult to treat patients adequately. Many doctors and nurses who were trained in Cameroon emigrate to Europe, South Africa or Asia.

There are still a lot of areas with limited or no health care facilities. Lack of good and portable water is also a major contributing factor to poor health in villages and some health care units. Typhoid fever, cholera and even malaria remain common. Some areas lack electricity, which means no sophisticated equipment needing electricity to operate can be used there. Even where equipment is available, it is often not working or there is no one to operate it. Some of the services are even more expensive and difficult for the people to access. Sometimes people lose their lives because their health becomes too expensive for them. While trying to get the money to pay for healthcare, patients either die or the situation gets more complicated and becomes worse.

What happens if you need to see a doctor?
It all depends on what you are suffering from. Based on the preliminary questions the nurses will ask you, you might be booked to see a doctor. The waiting time ranges from weeks to months, up to a maximum of 6 months. Otherwise, when you need to see a doctor in other cases, you to go to the hospital and pay your consultation fees, and you are sent to see the doctor. There are some bigger general hospitals, especially the private ones, which have doctors that stay on call so that you can reach a doctor in case of emergency.

Who decides what doctors can prescribe?
The Pharmacists associations decide which drugs are available to the pharmacies and the drug supply agencies. Doctors prescribe to patients based on their ailment. Depending on the area where the doctor is working, they might try to prescribe drugs that are more easily affordable.

What about getting admitted to hospital?
The same principle as above applies here. Doctors decide whether you are admitted based on your condition. In some other cases, some people prefer to be admitted so that they can be followed up properly and also so that they can actually take their drugs as prescribed. In general, when you are sick in most cases the doctors decide whether to admit you in hospital or not.

Practically, what is it like to live with type 1 diabetes in Cameroon?
The cost of living with type one diabetes in Cameroon is very expensive. To see a doctor, you must pay for your consultation fees, your lab tests and any drugs prescribed. For diabetes supplies, everything must be paid out of your pocket. Insulin costs approximately $10 USD per vial, which might last a month depending on your dose. For syringes, it costs $2 for 10. The blood glucose machines for testing can cost as much as $40 USD. Nobody, not even the government, helps you with anything as far as diabetes care is concerned.

There is a program started by Novo Nordisk that offers support for children below the age of 14 years. It was run well for about five years, then the Cameroon government took over. Now, the program is not effective because the supplies are limited and always going out of stock. Children come for help but do not find drugs. Therefore, they are left to find and try to buy what they need.

The challenges are enormous. However, it is better when there is an opportunity to meet other people that understand what you are going through. A positive outlook is to use diabetes to reach out to others, and to study hard to become an advocate for diabetes.

How does diabetes care vary throughout in Cameroon?
Healthcare really depends on the different geographical locations and the different family backgrounds at different locations. There are some areas where health care is very difficult to access and this is due to poor road infrastructure and network linking the town and the villages. On the other hand, in most of the urban areas where the roads are better, there is electricity, quality water, and all the sophisticated equipment and the trained technicians to operate them. Generally, the quality of health care services is much better in cities.

Thanks to Deric Formbuh for providing the type 1 perspective from Cameroon.