In all respondents, irrespective of gender, help with health problems was solely sought from the professional sector primarily, mainly from health care staff in public hospital or private for-profit clinics, and in some cases private for-profit nursing homes.
Secondarily predominantly health professionals in the professional sector was consulted for health problems, in females mainly from hospitals, health centres free of charge or private for-profit nursing homes, in contrast to males who mainly turned to private for-profit clinics or private for-profit nursing homes. In a few cases in both groups practitioners in the folk sector were consulted, to obtain herbs or certain fruit for treatment, or food supplement distributors in the folk sector.
I go to X main hospital...Then, I go to Dr [NAME] in the private nursing home. (F (= female) 7)
X hospital...private (for-profit) clinic (M (= male) 2)
I used herbs. Food nutrient distributors. I started DNLD products and then Tiansh (F 5).
When needing help with different health problems, the respondents, irrespective of gender, in all but two cases consulted health professionals, mainly doctors and nurses. The exceptions were persons who turned to friends in the popular sector:
Doctors and nurses in the clinic and the hospital (M3)
I get help from the doctors and nurses in the hospital. People have told me to use herbs like rukaka, omubirizi, omujuma, neem tree, avocado powder as tea. (F7)
Reasons for seeking help
For the respondents, irrespective of gender, the main reason for seeking healthcare/help was symptoms related to DM or control of DM. Many described severe patterns of symptoms causing fainting or collapse. A few in each group had come to refill or buy medications.
Vaginal itching. Dizziness, dry tongue that I even fail to talk, severe thirst. (F 15)
General weakness, fall down and collapse, sometimes I find myself in the hospital, I don't know exactly what happens, I just fall and sleep. (F 8)
I go there to refill medicine when it is finished. I always get abdominal muscle pain, general weakness sometimes failing to carry myself, I also feel pins and needles in my feet. (M 4)
Females often sought help with reviews of the disease and for control of blood glucose. Many of the women described having 'joint pains', some had sought for symptoms related to infections such as 'cough', 'fever', and 'malaria', and a few had 'problems with breathing'. Also vaginal itching and high blood pressure were exemplified as reasons for seeking help. Among males, one told he had sought help with 'joint pains', another for 'abdominal muscle pain', and one for 'dysfunctional sex'.
From whom was help sought?
Respondents, irrespective of gender, said that they had predominantly sought help in the professional sector from doctors or nurses in the hospital. Some had turned to private for-profit clinics. One man told he had sought help from a private pharmacy and another claimed he relied on self-care measures, e.g. drinking soft drinks to treat low blood glucose.
Doctors and nurses in the hospital (M1)
Private (for-profit) clinic I go to, it is owned by a midwife. I go there because it is near and I use it as first aid facility. (F8)
I always go to get other drugs or to write for me and buy medicine from the private pharmacy because drugs at the hospital they are always out of stock. (M5)
Unable to stand up...Dizziness and falling down. I know what to buy and usually carry sweets, water, or a bottle of soda. Pepsi Cola or Coca. (M3)
Healthcare seeking in case of failed healthcare
In cases of failed healthcare all males, except one, had sought help from the folk sector, to obtain local herbs or Chinese medicine from traditional healers or food supplements from food nutrient distributors. One man wished to use food supplements but didn't have money to buy them, and another had been advised to use bitter herbs (omubirizi ngaroitan) but feared complications and thus hesitated:
I was convinced to take Chinese medicine but stopped it when I developed high blood sugar because I stopped the medicine for diabetes. I took it for one month (M4)
People talk about food supplements like Tiansh but I can't buy them because I don't have money. (M5)
Among women, those who experienced failed healthcare most had also used help from the folk sector, such as local herbs from traditional healers or food supplements (e.g. Omega 3, zinc) from food nutrient distributors in the folk sector. In some cases only the professional sector (hospital or eye clinic at the hospital) or the professional sector in combination with family and friends in the popular sector were sought for help. In one case the folk sector and the popular sector were combined, as the person got food supplements from food nutrients distributors and local herbs from friends.
I have much pain in my legs so I go to Kazaire (herbalist) for extracted local medicine in bottles but it is very expensive. For eye problems I go to R eye clinic. (F 3)
I get help from my daughter-in-law who takes me to another private (for-profit) clinic, Dyapharm, that provides Chinese medicine. (F 1)
I go to the hospital and R eye clinic. Food nutrient distributors for Golden Neo-Life Diamitte (DNLD). I tried Omega 3 to cure diabetes (F4).
However, in both groups there were some who had not experienced failed healthcare.
Healthcare seeking from traditional healers
The number of females who had also sought help from traditional healers was roughly the same as those who had not, and one stated she had done it before but stopped because of the expenses and because it had deteriorated her condition.
Yes. Extracted herbal medicine...Kazaire gives medicine in powder form. Aloe Vera powder, when I use it I get some relief. (F4)
No, I have not tried elsewhere. (F2)
I get local herbs. Severe urination. If it is not Thursday for the diabetes clinic I use herbs or if I don't have money to buy the tablets I take bitter herbs. (F 5)
Before coming to X hospital, I used herbal medicine...failed to raise money and the condition worsened. (F 15)
With a few exceptions males had not sought additional help from traditional healers. Most had used herbs to treat DM and lower blood glucose but also for pain relief or treatment of high blood pressure. The reasons stated for not seeking help from traditional healers in the folk sector were mainly that they didn't believe in it or only tested it. Others said it was 'expensive' and one person stated that the 'money instead was needed to buy life-saving medications'. Fear of changes in blood glucose control was also evident.
For me, I don't believe in going to visit traditional healers. From health education by our doctor in the hospital we were advised not to leave diabetes medicine. There is no cure for diabetes and if you stop diabetes drugs you will go into coma and die. So I fear going into coma (F 10).
About half of the females had sought help from traditional folk healers, mainly to treat their diabetes or hypertension and in a few cases for treatment of pain. One had used it before but had stopped because of expense and being weakened by the treatment.
Only two of the males stated seeking help from traditional healers in the folk sector; both received herbs, one to lower blood pressure, the other to cure the diabetic disease. However, two of the men had not sought help from traditional healers but had got advice from friends in the popular sector to go there and used herbal medications.
The reasons a couple of females stated for not seeking help from traditional healers were that they 'don't believe in it', while a few men and women 'feared the use because of the risk of worsening' the diabetic disease and blood glucose control; one in each group could not afford it.