Jihan Abdalla
“I was always a sickly child,” says twenty-four-year old George Abdalla. Hard to believe, considering that he is now a tall, good-looking young man with a strong built. “Colds, swollen tonsils, fevers - I constantly had them,” he says with raised eyebrows. As a resident of East Jerusalem and with access to the Israeli health-care system, he was able to make the necessary constant trips to the family doctor. “But I was also very active,” he says with a big smile. At age seven, however, George began feeling tired, eating a lot, drinking lots of water and urinating frequently. These mild conditions quickly developed into something worse: vomiting, shakiness and dehydration. “One day, I just passed out,” he says with a hand motion. One emergency trip to the hospital, a blood and urine test confirmed that George was suffering from juvenile, or type I diabetes.
Type I diabetes occurs when the body's immune system attacks and destroys certain cells in the pancreas, an organ about the size of a hand that is located behind the lower part of the stomach. These cells, called beta cells, are contained, along with other types of cells, within small islands of endocrine cells called the pancreatic islets. Beta cells normally produce insulin, a hormone that helps the body move the glucose contained in food into cells throughout the body, which uses it for energy. But when the beta cells are destroyed, no insulin can be produced, and the glucose stays in the blood instead, where it can cause serious damage to all the organ systems of the body.
“I never liked sweets much anyway,” George says. “The doctors and nurses explained to me that I would not be able to eat sweets. They also sat me down and taught me how to use the insulin needles that I would be injecting myself with everyday, after every meal,” George explains. At first, with the help of his mother, he learned how to draw insulin by the syringe from a small bottle then inject himself in the arms, stomach, thighs or lower back. “Technology wasn’t so advanced at the time,” George explains. But he did not use the primitive syringes for very long, soon after that he was using a needle that looks like a pen, and instead of having to draw insulin, an insulin tube can be loaded in the pen. George now uses the latest technology where he does not have to inject himself with a needle at all. He has a long tube attached to his stomach that pumps insulin in his body in very small, regular doses which can be programmed into a machine, very similar-looking to a beeper. George says that having tried all the other methods, the pump is “efficient, practical and accurate.”
For George, living with diabetes required understanding how his body works, how insulin works, and how food works. Maintaining a healthy blood sugar level is vital. In most humans, glucose levels vary from about 80 mg/dl to perhaps 110 mg/dl. For diabetics, it is almost impossible to constantly maintain a blood sugar level within that range using the artificial means that is insulin. “120 mg/dl would be optimal for me,” George explains. “It’s not ideal, but the body can adjust.”
Diabetes is an expensive condition to maintain, insulin and all the other essentials are costly. Yet being medically covered means that George is paying for ten percent only of the actual costs. “I spend over 200 shekels on insulin, needles and tubes every month,” explains George. “This means, that if I had not been covered, I would have had to pay 2,000 a month, which is an unthinkable price.” For diabetics living in the West Bank and Gaza Strip, having no adequate Palestinian medical coverage and no access to Israeli medical facilities, diabetes becomes an extremely complicated and costly condition to maintain. Having a limited access to the variety and improved technology related to diabetes, they contend with using the basic insulin and simple needles, which are not necessarily suitable for everyone.
Diabetes enters the very details of daily life, making these details obvious and more significant. Diabetes is a world where every bite of food, every insulin drop, every physical movement makes a difference. “I have to worry about things that most other people don’t ever have to think about.” Skipping a meal is not an option, skipping an insulin dosage isn’t either, a diabetic has to constantly count calories, hours since they last ate, units of insulin and minutes of activity, “it has made me a meticulous person, knowledgeable about food, and quite good with numbers,” he jokes.
If you have diabetes, or love someone who has diabetes, you know that it comes along on every outing, shows up at every meal, and follows you wherever you go. Yet George maintains that he has not allowed his diabetic condition to negatively affect him or his character, “I have done everything I have sought out to do in life, and from the start I chose not to be a defeatist or become cynical about life,” he says with conviction.
George is open and available to help out youth who have recently or not so recently discovered they have diabetes, and find themselves in distress. With technology always improving, George is open to what awaits in the future for him and his counterparts.
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