It’s shortly before midday on a hot Thursday. The termerature is rising above 30°C. There are not a lot of patients today, as usual on the day before the full moon. Balinese people are busy preparing offerings for their ceremonies on this day. Normally, they only go for emergencies to the doctor on a day before a ceremony.

But there is one patient in the waiting area, a man around 50 years old. When he humbly enters the consultation room I notice that he is limping. He says his name is Ketut and that he has walked from a village close to the Lempuyang area, which is some 4 or 5 kilometers from our clinic. Then he shows me the reason why he had to come so urgently, an open wound on his foot. My next question confirms my suspicion: Yes, he has diabetis since more than 5 years.

Unfortunately, diabetis is a very common condition in Bali and it is a disease of the poor. The wealthier people can afford a healthy mixture of fish, meat, vegetables, fruit and rice. The poor people eat only rice and get diabetis at an early age. If they don’t have regular access to medicine, like Ketut until now, the disease progresses and causes these typical, badly healing wounds at the feet.

I clean up his wound, give him medicines, instructions how to use them and what he should eat or not eat, despite knowing quite well that the bad eating habits are often not a question of choice but of poverty. It saddens me that I can’t do much more for him so I ask our ambulance driver to give him a ride back home to at least spare him the painful journey on foot.



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