Our story begins in December 2012, when a group of eight medical professionals was selected and sponsored by Project C.U.R.E. to participate in a secular medical mission at Holy Cross Hospital (HCH) in Nagercoil, a small city located in the state of Tamil Nadu in Southern India. Both the American and the HCH teams formed a cohesive unit to provide medical care to the rural, underserved families of fishermen and farmers living in this region. In two weeks, we saw over 1,000 patients with a variety of medical problems. At that time, we provided general medical care and obtained random blood glucose levels on patients who had been previously diagnosed with Type II diabetes or presented with the late complications of the disease, such as non-healing ulcers, numbness in the feet, increased thirst, and increased urination, to name a few. We soon discovered a preponderance of one chronic disease in particular: Type II diabetes, with random blood glucoses ranging from 200 to 450. Compared with the 9.3% prevalence rate in the U.S., we diagnosed or confirmed that over 10% of our patients in the camps surrounding Nagercoil had uncontrolled Type II diabetes. From that moment on, our immediate destiny was clear:

We would tackle this disease head-on.

A Starfish is Born.
From this general medical mission, Project Starfish was born — with the focus of providing large-scale diabetic screening and treatment for the underserved people in the Nagercoil catchment area as well as continuing our general medical clinics. In January 2014, with the endorsement and support of Sister Atmaja, the administrator of Holy Cross Hospital, and support from Project C.U.R.E., we conducted a second medical mission to HCH to initiate, organize, and formalize a treatment program. We saw over 2,600 patients, obtained random blood glucose levels on nearly all patients over 18 years old and performed HbA1c diagnostic tests on those patients whose random blood glucose levels were over 140. Project Starfish provided the funds to purchase the portable HbA1c analyzer as well as the kits to perform the tests. To the best of our knowledge, the use of HbA1c tests in following diabetic patients is not routinely utilized in India. This test gives us a look at blood glucose control over a three-month period compared to a “random” glucose, which can be affected by many external factors depending on when the test was drawn.
We found that most patients in the camps were already known diabetics. Only 11% were actually diagnosed by our screening. Of the 482 patients whose random blood glucose levels exceeded 140, we reviewed their charts and determined that 62% of those known diabetics were uncontrolled (HbA1c>7). We presented our findings to the faculty and medical students of Kanyakumari Government Medical College in September.

Another important aspect of the project was to use social epidemiological methods to determine what factors contributed to, or were associated with, the high prevalence rates and poor management in patients with uncontrolled diabetes. With the collaboration of the University of South Florida, questionnaires were given to 152 of the known diabetics. We discovered that there was a definite correlation of Type II diabetes, obesity, and hypertension.

We Unite.
Ours is a community project. Today, Project Starfish’s goal is to work with local health care providers to determine how, together, we can ultimately diagnose and control this disease. Through the generous support of our sponsors, donors, and volunteers, we continue to provide diagnostic and treatment services to the surrounding communities of Nagercoil, Tamil Nadu, and we endeavor to continue our work to ensure that the people in this region receive the best possible sustainable health care.

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