Living with a chronic disease often requires care over several years, sometimes for a lifetime. Treatment, therefore, is not limited to a single doctor’s visit or a prescription for medication. It is also necessary to regularly monitor the progression of the disease, recognize the signs of complications, understand the role of treatment, and know how to adapt certain daily habits.
At the Thomonde Health Center, the chronic noncommunicable diseases program provides support to patients living with hypertension, type 1 and type 2 diabetes, asthma, sickle cell disease, and heart failure.
These consultations allow healthcare providers to assess patients’ conditions, monitor their progress, renew or adjust certain treatments based on clinical indications, and enroll newly diagnosed individuals in the program. Education is also an integral part of care, particularly regarding treatment, diet, and the prevention of complications.
This follow-up sometimes requires addressing issues that go beyond the medical prescription itself.
Dieumentha François, the nurse in charge of NCDs at Thomonde since May 2021, notes, for example, that some patients arrive with concerns, misunderstandings, or misconceptions about the disease that can influence how they adhere to their treatment.
Her work includes nursing consultations, patient follow-up, therapeutic education, support groups, and phone calls designed to maintain contact with those under her care. She also collaborates with other members of the healthcare team when more comprehensive care is needed.
A recent situation reminded her of the importance of this aspect of her work. A young woman who had been under care for diabetes for several years had gradually stopped taking her medication. Some of her close relatives had begun to question the diagnosis and attribute her condition to another cause. She then stopped going to the hospital and sought other forms of care.
When the team reestablished contact with her and she returned to the center, her condition had deteriorated significantly. She was weak, pale, and had lost a great deal of weight. She was treated immediately and kept under observation.
But resuming care also meant understanding why she had stopped her treatment. Therefore, the team went over the basics of diabetes, insulin, and the possible consequences of stopping treatment with her again. Her grandmother, with whom she lives, was also involved in these discussions.
This step was important because managing a chronic condition continues long after discharge from the health center. Decisions made at home, support from loved ones, and understanding the treatment can directly influence a patient’s ability to remain in care.
Today, according to the Thomonde team, the young woman is continuing her insulin therapy and follow-up care.
Situations like this are among the reasons why education plays a key role in the NCD program. A patient must be able to understand why a medication is prescribed, why they need to return for follow-up visits even when they feel better, and what changes should prompt them to seek help.
Support groups also allow patients to share their experiences and ask questions. François sometimes notices that people who themselves needed a lot of explanation when they first arrived begin, over time, to encourage other patients to stick with their treatment or to explain to them what they have learned during their appointments.
This development does not replace the role of healthcare professionals. Rather, it shows what can change when a patient better understands their condition and becomes more comfortable taking an active role in their own care.
For teams working with chronic conditions, maintaining this continuity remains essential. A patient may need medication for years, but they may also need repeated information, regular appointments, and sometimes a follow-up call when they stop coming to the clinic.
It is this combination that François considers one of the most important aspects of his work.
“ My source of motivation is knowing that every day, through the work I do, I change a life, I bring back a smile, I teach someone how to protect their health and their life in the face of a disease that frightens them, and how to balance managing their condition with pursuing their dreams. ”