By Stephanie Dunn
Vivian Poon is playing with the toes of a flesh-coloured, latex foot that looks eerily real.
To explain the importance of foot care to her class of diabetic and pre-diabetic clients, she twists the sole of a canvas deck shoe to prove the shoes offer little support.
She holds up a picture of a cat licking its paws to emphasize the importance of cleaning your feet and shows a graphic photo of an afflicted foot for every complication she warns against.
For many of the participants in the Centertown Community Health Centre classroom —from the newly diagnosed to those who have been living with the disease for years — this is the first time they have learned how to take care of themselves in a way they can understand.
And it’s not just because of the props. Poon is relying on something more fundamental to get her point across to the Cantonese-speaking group. She’s truly speaking their language.
The culturally specific programming of this diabetes education session goes beyond language and takes into account the lifestyles and beliefs of its clients.
Participants are cautioned about the interaction of traditional Chinese herbs with their medicine. An exercise in reading labels, for example, looks at the nutritional content of seaweed soft flour cakes, a sweet Chinese snack.
The programs, which are run in both Cantonese and Mandarin, are part of the larger Community-based Diabetes Education Program of Ottawa.
Issues such as diet, exercise, stress, avoiding complications and foot care are addressed. The aim is to educate people with type 2 diabetes about self-management and self-care.
The program “has been very positive for my patients,” says Dr. Jeremy Lo.
The Centretown family doctor says the patients he has referred to the program gained a greater understanding of their disease. Chinese language programs are important because many of his elderly Chinese patients “don’t fully understand what is happening to their health,” Lo says.
“Too few people benefit from this,” says Stephen Ng, who is in his sixties and has been identified as at risk for developing the disease.
Ng is fluent in English but he is at the session with his Cantonese-speaking mother who has type 2 diabetes.
An increase in funding from the Ministry of Health means that Poon, who also used to work as a nurse, can put all her efforts into coordinating the Chinese language program.
The number of sessions will increase from four a year to one a month next year.
Pre-diabetes classes focusing on risk factors and prevention strategies will be held for the first time.
This expansion will give Poon more time to promote the program among culturally isolated Chinese-speaking residents.
Chinese seniors have the same health and transportation problems as other seniors but face the added barrier of language, says June Joe. Joe, the chair of the board for the Yet Keen Senior Day Centre, has the same frustrations in accessing this isolated group.
“It is difficult for Chinese seniors to learn English,” Poon says. “It is difficult for any seniors to learn another language.”
“We can’t reach the people who are home bound or the people who have problems with transportation,” Joe says. “We just don’t have the facilities or the people or the money that do that.”
Their children, victims of the high-tech crash, have moved to the United States to find work.
Joe says the response to this program is the same as it is to most health programs. “It’s a great program but it’s not big enough,” Joe says. “And I think you’ll hear that everywhere.”
Whether the planned expansion is enough remains to be seen.