Wednesday, December 22, 2004

Why an Indian regional language website for diabetes?

Why an Indian regional language website for diabetes?

I 2003 while reading up on some journal articles I came across the following article reference in Diabetes Care Journal

“McCabe, M., Morgan, F., Smith, M., and others (2003, June).”Challenges in interpreting diabetes concepts in the Navajo language." (AHRQ grant HS10637). Diabetes Care 26(6), pp. 1913-1914.

During development of a pamphlet on diabetes for Navajo Indians, these researchers found that they had to pay attention to cultural factors, regional language differences, and the possibility of a lack of word-for-word translation. Translators initially recorded an oral Navajo translation of the Michigan Diabetes Knowledge Test. A Navajo language expert translated the taped version back into written English and then prepared another Navajo version. The revised translation was verified with selected elderly community members, health care professionals, and others. By probing the linguistic, cultural, and regional language issues in translating an apparently simple questionnaire from English into Navajo, the translators were able to articulate approaches that can be used in explaining diabetes management in an appropriate cultural context. “

Then realized how much little education material exists in the Indian regional languages and decided I should make a web site.

For about 2 years I have been collecting material and learning about web sites HTML etc.

There were many issues about fonts, Unicode .what kind of language to use.

and terminology problems.

“literal translations, while accurate linguistically, could be sufficiently inappropriate culturally to prevent accurate communication between provider and patient.” (Melvina Macbe et al)

In order to keep things simple and also scientifically accurate

Day to day language in a conversation type format was retained for most of the web content.

Unicode was chosen for regional language content so search capability can be included in the regional content also.

Transliteration of English technical equivalents was decided upon to reduce much confusion.

Everybody knows “DIABETISU” but few people know what "Madumeha" is though that is the Sanskrit name for this disease.

In 2004 during my biannual trip to India I noticed the very lax guidelines for Diabetes control even among medical professionals.

One of my own classmates had let his diabetes go out of control and had become very thin from loss of muscle mass. During our college time he was a good body builder with a physique we all envied.

I was able to convince him through much persuasion from his wife who was another classmate of mine to start LANTUS and get good control.

This incident increased my determination to start this website even more

If this is the situation among educated medical professionals what is it like among the general public.

Being an internist dealing with a patient population in which almost 50 % are diabetics .I have realized that I can divide the diabetic population in to 3 kinds.

The Ignorant

The Misinformed and Unmotivated

The Informed and Motivated

The 3rd category are the best those patients who understand their disease process, take charge and follow all the guidelines and live a long and complication free life.

The first category is large and the levels of ignorance can vary and there is lots of disinformation all over.

Some of them may be turned off to learn by the language barrier and also the technical jargon.

The second category are the real dangerous kind, they are the know alls who tell people around that eating methi(__fenugreek____)will cure Diabetes .Ignore all the warning signs and then end up with complications for which they do doctor shopping and blame everyone including God but themselves.

There are 2 words in English “Tough love”, “Enable” tough love

NOUN: The use of strict disciplinary measures and limitations on freedoms or privileges, as by a parent or guardian, as a means of fostering responsibility and expressing care or concern.

Enable

VERB: To supply with the means, knowledge, or opportunity; make able: a hole in the fence that enabled us to watch; techniques that enable surgeons to open and repair the heart. b. To make feasible or possible

Lots of time people who want to help the diabetic try and adopt tough love but usually this backfires.

I find enabling is much more useful and helpful.

I hope this website will be kept as up-to-date as possible and if it helps even a small Miniscule proportion of Diabetics in India, I will consider my effort worthwhile.

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