Belize's Healthcare: Insulin Production And Accessibility

Belize has the highest national prevalence of type 2 diabetes (T2D) in Central and South America and the fifth highest in the world. T2D is the leading cause of death in Belize, a low-income country where many people cannot consistently access biomedical treatment. As a result, plant medicine usage is estimated to have increased in recent years.

While there is no mention of insulin specifically, it is likely that insulin is one of the prescription medications that some Belizeans use to manage their T2D. Insulin is a hormone produced by the pancreas that manages glucose in the bloodstream. When the pancreas does not produce enough insulin, or the body resists insulin, blood sugar levels become dangerously high.

The internal medicine staff at Belize Healthcare Partners Ltd are experts in dealing with the prevention, diagnosis, and treatment of a broad range of adult diseases, including diabetes. They are trained to handle severe chronic illnesses and can prescribe daily insulin injections or drugs to increase insulin production, as well as recommending lifestyle changes such as weight loss, exercise, and dietary adjustments.

Diabetes management in Belize

Belize has the highest national prevalence of type 2 diabetes (T2D) in Central and South America and is the fifth highest globally. T2D is the leading cause of death in Belize, a low-income country with a population of over 300,000. The Belize healthcare system is two-tiered, comprising publicly and privately run healthcare facilities. While the public system provides free or low-cost healthcare services, it is underfunded, understaffed, and undersupplied, and patients often face long waiting times. On the other hand, the private system is expensive and offers limited medical procedures.

Belize's health sector faces challenges such as corruption, mismanagement, and lack of resources, resulting in restricted coverage and accessibility. However, the government is working to improve the situation through various reform initiatives and investments in an e-health platform to centralise health information and empower individuals to take control of their health.

Challenges in Diabetes Management

People living with T2D in Belize face several barriers to care and self-management, exacerbated by the COVID-19 pandemic. The tiered healthcare system has significant gaps in coverage, and there is a lack of accurate health information and innovative dissemination methods. The pandemic further compounded these issues by disrupting community support networks, physical exercise routines, and access to health services and nutritious food.

Plant Medicine Usage

Due to inconsistent access to biomedical treatment, particularly during the COVID-19 pandemic, plant medicine usage among people with T2D in Belize has increased. A study revealed that 85.7% of participants used plants in their T2D self-management, with three main usage patterns: exclusive plant use (31.4%), complementary plant use (42.9%), and minimal plant use (11.4%). However, almost none of the participants disclosed their plant medicine usage to their healthcare providers.

Recommendations for Improvement

• Extending public healthcare coverage: Ensure that all Belizeans have access to public healthcare services, especially in areas currently lacking coverage, such as Cayo, Orange Walk, and parts of Corozal and Belize City districts.
• Enhancing health education: Develop and implement a comprehensive, nationwide diabetes prevention and education program to address the lack of knowledge about T2D causation, management, and strategies for prevention.
• Promoting innovative opportunities: Encourage physical activity, nutritious food access, economic stability, and psychosocial support through activities like informational and motivational text messages, a Belizean T2D cookbook, televised educational workshops, and mobilisation of community support networks.

Insulin alternatives in Belize

Belize has the highest prevalence of type 2 diabetes in Central and South America, and it is the leading cause of death in the country. Insulin is a hormone that plays a central role in controlling blood sugar levels in the body. While insulin injections are the primary treatment for type 1 diabetes, they are also used to manage high blood glucose levels in type 2 diabetes if other treatments are unsuccessful.

In Belize, plant medicine is a common alternative to insulin for treating type 2 diabetes. A 2023 study found that 85.7% of participants used plants in their type 2 diabetes self-management. There were three main usage patterns: exclusive plant use (31.4%), complementary plant use (42.9%), and minimal plant use (11.4%).

• Cinnamomum zeylanicum
• Cymbopogon densiflorus
• Abelmoschus esculentus
• Stachytarpheta jamaicensis
• Moringa
• Turmeric
• Ginger
• Cinnamon
• Noni
• Gumbolimbo bark
• Aloe vera
• Fenugreek seeds

While plant medicines are widely used, there is limited research on their efficacy and safety. Some people with type 2 diabetes in Belize also use non-insulin drugs to lower blood glucose levels, such as metformin, which is the most common medication for the condition.

Overall, there are a variety of alternatives to insulin used in Belize for treating type 2 diabetes, including plant medicines, non-insulin drugs, and lifestyle changes such as improved diet and exercise.

Belize's healthcare system

The MoH offers affordable care to the majority of Belizeans, with a strong focus on providing quality healthcare through a range of public programs and institutions. While the private health sector provides care to a smaller portion of the population, it shares an emphasis on quality care and quality improvement. However, the standard of healthcare across the country is generally considered low, with public hospitals and clinics remaining underfunded, understaffed, and undersupplied.

Belize has a network of approximately 60 public health clinics, with a total of 700 public hospital beds, providing primary medical and dental care to rural areas. Most of these health clinics suffer from inadequate staffing, a lack of financial resources, and a lack of equipment and medicine, resulting in reduced access to quality care. There is also a shortage of medical professionals in Belize, with many doctors and medical professionals being foreign nationals who often work as volunteers.

The country has eight major public hospitals, with the majority located in Belize City, including the Karl Heusner Memorial Hospital, the national and regional referral hospital. Outside of Belize City, there are seven additional hospitals located within the capitals of each of the seven other districts, including three regional hospitals: the Southern Regional Hospital in Dangriga, the Northern Regional Hospital in Orange Walk Town, and the Western Regional Hospital in Belmopan.

The Belize Health Information System (BHIS) is an integrated comprehensive health information system introduced in 2008 to improve health outcomes and performance. It allows for the collection and dissemination of population-based and record-based health data.

While public healthcare in Belize is available to all citizens and residents at no direct cost, a large portion of funding has been allocated to Belize City. As a result, those living outside the city often need to travel to seek treatment, and many expats leave the country for more complicated medical treatments.

The private health sector in Belize has grown in recent years, especially in urban areas, offering comprehensive coverage and a range of secondary and tertiary healthcare facilities. However, private healthcare facilities are expensive, and medical procedures remain limited.

Diabetes and COVID-19 in Belize

Belize has the highest national prevalence of type 2 diabetes (T2D) in Central and South America, and the fifth highest in the world. T2D is the leading cause of death in Belize, a country facing increasing prevalence with few resources. The COVID-19 pandemic has exacerbated the difficulties of those living with T2D in Belize.

A Tiered Health Care System

Many places in Belize do not have public clinics, and where they exist, there are long waiting lists. Those who can afford it often pay for private health services, while those who cannot suffer more long-term, drawn-out complications. This can be linked to similar findings from a 2019 study in Peru, which demonstrated that socio-economic and structural factors act as barriers to individuals' capacity for T2D self-management.

The Need for Nationwide Education

When asked what they wanted, participants in a study on T2D and COVID-19 in Belize consistently said they wanted prevention and education programs. Belizeans wanted to be able to access more information on nutrition and nutritious food production. Belize has a dietary culture that includes many starchy and sugary foods, and doctors say that one of the top contributing factors to diabetes in the country is diet.

The Impact of COVID-19 Restrictions

The COVID-19 pandemic has had a detrimental effect on T2D self-management practices in Belize, constricting access to physical exercise, quality nutrition, glucose monitoring, medication, and social supports. Belizeans with T2D have been experiencing increased anxiety, depression, and stress from COVID-19.

Diabetes prevention in Belize

Belize has the highest prevalence of type 2 diabetes in Central and South America, and it is the leading cause of death in the country. The condition is responsible for early mortality and increased morbidity, with associated complications including cardiac arrests, cerebral vascular accidents, renal failures, lower limb amputations, and vision damage.

Belize's health sector provides essential healthcare services for residents, but coverage and accessibility are severely restricted due to corruption, mismanagement, and a lack of resources. However, the government is working to improve this situation through various reform initiatives and investments in an e-health platform.

• Improving access to healthcare: Belize's public hospitals lack adequate medical supplies and specialised care, which can lead to complications and low antenatal attendance rates. The government's efforts to improve the healthcare system and increase accessibility will play a crucial role in diabetes prevention.
• Addressing food insecurity: Food insecurity in Belize, often resulting from deep poverty and the adoption of a Western diet, has contributed to the high prevalence of type 2 diabetes. Improving access to nutritious food and addressing unhealthy relationships with food can help prevent the disease.
• Promoting physical activity: Encouraging physical activity and exercise programmes can help Belizeans manage their weight and lower their risk of developing type 2 diabetes.
• Health education and awareness: Belizeans have expressed a need for nationwide education on diabetes prevention and management, particularly in rural and remote areas. Educational programmes can empower individuals to make informed choices about their health and reduce the prevalence of the disease.
• Integrating traditional and Western medicine: Traditional plant-based medicines used by Indigenous communities in Belize have been found to be effective in managing type 2 diabetes. Integrating these practices with Western medicine can improve diabetes prevention and management, especially in underserved communities.
• Addressing socioeconomic factors: Type 2 diabetes disproportionately affects disadvantaged racialised groups. Addressing socioeconomic inequalities and providing support for small businesses, such as food vendors and childcare providers, can improve health equity and reduce the burden of diabetes.

Frequently asked questions