Every morning, 65-year-old Shanti sits in her wheelchair at her window, waiting for her daughter’s car. Her daughter has already sent her children off to school and now rushes to her mother’s home to help her shower and get dressed. Shanti was once a businesswoman; she built a successful roti shop after her husband died 15 years ago.
Strong, independent and always on the go, she now uses a wheelchair after losing both legs due to complications from diabetes.
Though the doctors did everything they could, her legs could not be saved. Since then, she has retreated into herself, she has become depressed, weak and refuses to see anyone. He daughter is exhausted, trying to balance two households, care for her children and keep the business running.
Diabetes has quietly become one of T&T’s biggest national health burdens. The statistics are telling us that we have an impending crisis. The International Diabetes Foundation (IDF) notes that between 12 per cent to 15 per cent of the T&T population has diabetes. This is at least 150,000 people. These are the ones who are diagnosed. There may be many others living with diabetes and don’t even know it.
The IDF projections indicate that by 2050, approximately 178,000 Trinbagonians will have diabetes. In 2011, there were 1,350 deaths from diabetes. In 2024, 1,994 people died from diabetes in T&T. Our healthcare system struggles to keep up with the increase in the prevalence of diabetes. In 2024, the total diabetes-related health expenditure was 186 million (USD), and yet many patients complained of inadequate healthcare—shortages of medications, long waits in public clinics and high cost of private ones.
One of the things that we do not speak about is the impact on family members. When someone loses their eyesight, their mobility or their independence, it affects the whole family.
A four-year-old child might not understand why Daddy or grandpa cannot see him anymore. The daughter might spend sleepless nights caring for the father who once cared for her. A wife must now ensure that her husband eats healthier, takes his medications and avoids further complications.
The little changes within the family can be difficult and stressful. It is challenging for a person who lives with diabetes to manage the condition without the support of family members, especially those who belong to the same household.
Just seeing a family member trying to cope with diabetes can be emotionally testing. A blog by Byram Healthcare notes, “Family members may begin to stress over their feelings of powerlessness in a situation. They fear that they have no way of helping you, which can take a toll on everyone’s mental health. This can lead to strain in a relationship and even blame if something bad were to happen.” It is also about how family members must reorganise their lives.
In Shanti’s case, her daughter now has to care for two homes. Her daughter’s children now spend less time with their mother. These may appear as insignificant changes, but they can have lifelong consequences.
The Caribbean Public Health Agency, along with the T&T Ministry of Health, acknowledges this in its “Guidance for Persons with Diabetes (PwD) Caregivers.” It states, “Providing care for persons who have a chronic illness can be a very stressful experience, if it isn’t managed well from the outset. In many instances, caregivers are relatives (children, grandchildren, siblings) living with an elderly family member who needs assistance in caring for themselves with their chronic illness. The stress caregivers experience can be physical, emotional and/or financial.”
The organisations urged caregivers to “ensure that you remain in the best of health” and suggested they seek family support, ask for help, take a break, check on their own physical health and cultivate coping strategies specific to them.
This is sound advice, but often far from reality. Suggestions sound great, but for many caregivers, especially in small families with limited resources, the reality is different. In many households, the caregiver is a single person balancing a job, children and the emotional burden of caring for an ailing parent or spouse. It is also important that we address lifestyle choices that are generally embraced in T&T—Trinbagonians love to eat and drink, that’s a big part of our national “liming culture.” The reality is that healthy food is expensive, exercise is often neglected, and chronic illness is normalised until it reaches a crisis point.
Surely, as individuals and as a nation, we can do more?? We need a proper, structured system in place to help diabetics and their primary caregivers. We urgently need to educate everyone about the disease and how to care for it. As diabetes is hereditary, it is especially important that family members learn early prevention tips. As a community, we need to establish more support systems that will encourage both children and adults who are living with diabetes to eat healthier, exercise and support each other. There is an urgent need for counselling services, peer support groups and outreach programmes which will reach the rural areas as well.
At a national level, we need to invest in healthcare and develop policies which will make healthier food more affordable. Ultimately, we need to change our mindset, so good health is seen as a collective responsibility. As we celebrate World Diabetes Day, let’s look beyond the statistics and see the faces, the caregivers and the families who struggle every single day. If you are not careful, it can very well be you one day.
