The following article appears in its original unedited version in the February 2008 edition of the Boston Haitian Reporter [1], a monthly newspaper.

Diabetes is the sixth leading cause of death in the United States and a difficult diagnosis for thousands of Massachusetts residents.

Diabetes, a chief health disparity amongst the Haitian community, is the latest target for the Center for Community Health, Education and Research, Inc. (CCHER).

During a round-table discussion last month, the organization announced plans to launch a REACH US initiative in an effort to educate the community on health and prevention.

With the support of neighborhood activists, the Boston Public Health Commission and a grant awarded by the Centers for Disease Control, CCHER has scheduled a series of community forums to address issues of diabetes, nutrition, fitness and obesity.

Eustache Jean-Louis, executive director of CCHER, says their goal is to coordinate a steering committee to help develop an assessment plan.

"We are designing local-level interventions geared at reducing health disparities. What's next is to implement a diabetes prevention campaign with the help of our neighbors, the media and medical institutes that can offer aide. It is also about increasing community knowledge and influencing mental beliefs," Jean-Louis said.

At the kickoff meeting at the CCHER headquarters in Dorchester, dozens of supporters, diabetes patients and medical professionals came together to find a solution.

Fifty-one year old Rhoda Johnson-Tuckett, diagnosed with diabetes 10 years ago, says there is a lack of education about what it means to have diabetes.

"People equate diabetes with feeling sick, but that is a serious and, many times, deadly mistake," Johnson-Tuckett warned. "When I was first diagnosed, I was in denial-that is the story of many diabetics. You tell yourself you feel fine and that kind of thinking leads you to not take care of yourself. My first resolve was to ignore it [diabetes], but when I learned of the consequences- losing limbs, kidney failure or death- I learned to educate myself."

"For people of certain cultures it's harder for them to grasp the concept of a healthier lifestyle," continued the Honduras native. "The changes you need to make go from your diet to your mindset. You have to make a switch from your cultural food such as rice, meat and fried everything to healthier choices like exercising. I had to change what I'd known my whole life and take the necessary steps to improve. I could still enjoy the meals of my culture, but I learned how to do it in smaller portions. You [diabetics] can still live a rich and fruitful life."

In addressing the behavioral and psychosocial aspects of diabetes, experts such as Michelle Matin, a nurse practitioner at Boston Medical Center, stated that behaviors of various diabetics correlate with anxiety, depression, poor self-esteem and high levels of stress.

"Depression often occurs with diabetic patients and that has a lot to do with their belief system," said Matin, who is also the vice chair of CCHER.

"Weight gained is seen as a healthy sign of strength within the Haitian culture, so when you tell them they have to diet and exercise, they get discouraged quickly, especially when they learn that they can't eat so much of their cultural food. We have to help them change their attitudes."

At the meeting, many expressed that diabetics, especially those of the Haitian or Hispanic cultures, do not seek help right away. Instead they seek alternatives. This, Matin says, is a major issue when it comes to early detection.

"Frequent check-ups will help primary care doctors detect the disease early. But the hesitance varies from low income and not being able to afford treatment or feelings of anger or isolation due to lack of support from peers."

Johnson-Tuckett, who has worked with the Boston Public Health Commission for over 20 years - she is the manager of HIV/AIDS Prevention and Education program- says our community needs to get into a deeper conversation about diabetes.

"We need to explain what diet means because it has a great impact on increasing our health, but we need someone to deliver the message in our language," Johnson-Tuckett said.

"The message will be better received if delivered by someone who looks like us, sounds like us, speaks our native tongue. Someone we can relate to, someone who has been there and can relate and can provide support. The cultural barriers have to be broken down and we have to train the community to go out and speak to the community."

Noted at the meeting were services such as the Boston Steps program, which offers various activities such as neighborhood walks and steps to wellness program and nutrition classes.

A representative of the program, Kathy Cunningham stated that some of the members had knowledge about diabetes but didn't know how to take care of themselves.

A key element that helped the group improve was the ability to adapt to their two cultures by bringing traditional recipes, but learning to make it healthier.

On March 4, Boston Steps will host a wellness summit from 9a.m. to 2p.m. at the Behrakis Health Science Building at Northeastern University.

Source: BostonHaitian.com [2]

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