Tackling the country’s health issues

Dr. Behbehani, Kuwait has always had strong democratic roots compared to the other countries in the region. How do you position Kuwait within the Gulf ?

You have to look at the region as six countries; how each is moving forward for its own people. It is not that we are the best, or they are the best. But, for a long time, Kuwait has had a democracy. As a national, you can express whatever you want. Only the Emir of Kuwait is protected and the rest is open for discussion. In the past, we were the only country in the region with a parliament. We are talking about a belief that once you are in the country you have rights, not only as a Kuwaiti, but also as a non-Kuwaiti: you can go wherever you want and you can do whatever you want, as long as you stay within the framework of the country’s rules and regulations.

You have to look at the rights of the people here. Once you are in the country—and you respect the laws and regulations—nobody can touch you, you are free. You really are free to do whatever you want. We don’t have anything to hide. You can discuss anything you want with anybody, no matter what nationality you are.

I don’t think there is anything like this, even in the rest of the world—not only in GCC [Gulf Cooperation Council] countries. In many places, it is not like this. We look at it as a paradise.

Kuwait has one of the best health-care systems in the Gulf: with more than ninety primary health clinics and some of the major hospitals, with significant improvements on the way. What do you believe the health-care sector brings to the success of the development-plan initiative?

There are two things that are important in life, in anybody’s life: health and education. These are the things that we have to look at. And in this country, both of them are free, provided by the government. And that is why we are proud that we have a country where you cannot distinguish between the rights of its citizens; we are equal. And by law, you have to send your child to school to get a degree. Parents are responsible for that. If they don’t, a court case will be brought against them.

Kuwait was the first country in the Gulf to eliminate illiteracy 100 percent. The constitution talks about this in Article 15: education is free, health to be provided (it doesn’t say it is free). We don’t have people who can’t read or write.

The issue in the country today, in terms of health, is chronic diseases like diabetes. Many years ago, this was not a disease here. It was a disease of the north, not the south. We are considered part of the south. Over the past fifteen years though, we have started to have a problem with diabetes because of the change in lifestyles. We are not able to deal with it; we do not have the professional manpower to deal with diabetes.

And that is why this institution was established. We are not primary and we are not secondary; we are tertiary. We are looking at a completely new disease in the country, which is affecting children younger than ten years old—Type 2 diabetes is supposed to be adult onset. But it is not only us. The whole world suddenly changed, even countries that don’t have money. Unfortunately, Kuwait is at the top of the countries in the GCC (with diabetes). Actually, we are now the second (down from being number one). We were globally number three, but now we are number nine. We must make people change their behavior. We are looking to the future and the younger generations, who are the core of the future. We have 365,000 diabetic patients: that is the problem. If you look at the percentage of the whole population, we really have to worry about it. Otherwise, the younger generations will really suffer.

As you just stated, the problem of diabetes in Kuwait is huge. Often it is said that it is easier and cheaper to prevent than to cure. What is your take on this statement?

There are two types of diabetes: Type 1 and Type 2. Type 1 is when you don’t have insulin when you are born and you are not able to produce it. About two hundred people a year are born with Type 1 diabetes in Kuwait. There isn’t much you can do, except provide insulin. We have started to provide an insulin pump as an alternative. People are very happy about this. It is not a large number. But any disease is a large number and that is why we have to deal with it. We are looking at life in the future.

One of the biggest problems of the second type of diabetes is that the age has dropped significantly. The age used to be forty and above; we didn’t even live that long, like we do now. The problem is the change in what we are providing in this country: coffee shops, fast food, etc. The age of those developing Type 2 diabetes has fallen to below ten years—not only here but in other countries too. That is where the problem is: in the young generation. They are the future.

We are dealing with it in a number of ways. We are going into schools. We also bring the children here, where we teach them what diabetes is, how it works, and what can be done to prevent it. They go home and change the views of their parents. They go home and do things differently. We don’t want to be number two for diabetes in the GCC anymore. We will work with them to look at the package for the countries that we are close to.

The Dasman Diabetes Institute was established in 2006 and today is recognized as a flagship entity in the country and region. What is its mission?

We have two departments here: one is for the patients and one is for research. We are concentrating on researching diabetes and its complications. We are looking at discovering new areas of controlling the disease and applying the material to the country. The figures are there, of the number of children we have seen so far—we go into schools or the schools come here.

Fundamentally, we carry out research to understand new ways of dealing with this illness. We are concentrating right now on diabetes and its complications, but it doesn’t have to be diabetes alone. We want to discover what is in the country that leads to diabetes. We look at genetics, but also the social aspect of it. We have 150 staff working on that package of research and our number of publications has risen to 45. We have a new publication showing new approaches to diabetes.

But our publications not only about diabetes. They are also about other things. Diabetes is not about sugar alone; there are other reasons for it. The issue is about how you actually live your life. Once you consume a certain amount of food, it has to enter the cell. But if you have the wrong type of cell and you are taking in a large amount of sugar (on average we take in a lot every day) you will have a problem, because the sugar has to enter the cell. But if it stays in your circulation it will damage the organs in your body. What we eat, how much we eat, and how we should not eat—we have to understand that. When a patient comes to see us, we do a few things: first, we look at the blood function, by looking at the sugar levels; and second, we look at the food intake. The patient has to take a course before he sees a doctor, to understand nutrition. That becomes his gift to his body, in order to prevent diabetes.

You worked at the World Health Organization [WHO] and were on the board of [the University of] Oxford. How does your past experience benefit the Dasman Institute?

Knowledge that you gain, you have to give it back. People who come here have to take a course. We have to make sure they understand, especially the young generation. They have to understand what is going to happen to them if they continue. We concentrate on children in Dasman because they are the future.

When you talk about science and technology, there are no limitations. There are discoveries to be made everywhere. You must learn from others too, if you want to be part of a better world, especially in these six countries. We have the money. We need to use our knowledge to help the other people do things the way that they should be done. Otherwise, they won’t know. Somebody who develops diabetes won’t feel it for years and that’s when complications arise. But these people are the future, and that is the problem. So, I am happy that I have been given the opportunity to do something for my country.

Thank you Dr Behbehani for opening the doors of the Dasman Institute to Peninsula Press.