Befriending an Enemy: Dealing with Type 1 Diabetes in Gaza

Living with your enemy since tender childhood, with no way to keep him away but death: this is the feeling that people diagnosed with diabetes feel every moment, especially those with Type 1 or “insulin-dependent” diabetes. Type 1 diabetics have a permanent requirement for insulin resources, in order to maintain a healthy blood sugar level.

For Palestinian diabetics living in Gaza, there’s no exceptions made. The blockade imposed on the Strip makes it complicated to access a safe supply of vital medication. Moreover, the dramatic rate of poverty (nearly 64%) guarantees that an adequate supply of healthy food products is rare.

Ahmed, a 20-year-old Palestinian who has lived in the besieged Gaza Strip all his life, was diagnosed with Type 1 diabetes 14 years ago.

“This disease has its own chapter in thousands of people’s lives, it’s obvious that each person’s reaction and adaptation will differ, my reaction was to face it,” said Ahmad, describing the journey with his unshakeable shadow.

“I was diagnosed with diabetes at the age of 6, I didn't know anything about it at that age, but my parents’ reaction was clear evidence that it’s not ‘pleasant’ news.”

Coping with chronic diseases means having special requirements just in order to live normally. The feeling of comparing the life of a diabetic with what “normal life” would be is one of the main factors contributing to anxiety and lack of self-esteem.

“At school my parents informed all teachers about my situation, hoping not to restrict me in a way that would be harmful for my body: allowing me to go to the restroom whenever I wanted, or to eat candy whenever I felt my blood sugar level drops. Some of the teachers were respectful, but many were not. Some even bullied me: ‘Don’t think because you have diabetes you’ll get special treatment’. Those words made me believe that I’m a cursed child, hating my body for not working properly.”

Statistically, people with diabetes are 2-3 times more likely to have depression than people without diabetes. From a physiological perspective, the reason is a combination of the way erratic blood sugar and insulin levels affect the brain as well as the psychological stressors associated with having a serious chronic disease, not to mention the societal way of thinking about a diabetic, and the restrictions in academic streams and occupational opportunities. All these factors increase the probability of having depression, anxiety and eating disorders.

But in the Gaza Strip, where 2.2 million Palestinians here already endure a man-made mental health crisis as a result of Israel’s crippling and suffocating blockade, means the situation is even more complicated.

“Two years ago, alongside the 2021 Israeli aggression, there was a blockade against insulin pens, and crops spoiled faster due to chemicals thrown on farms. I had difficulty finding proper food to consume, and the lack of insulin pens left me living harsh days with unstable blood sugar levels.” Ahmed is not alone in his suffering, there are over 63,000 Palestinians in Gaza with diabetes, according to a 2018 Palestinian Ministry of Health report.

“I realised that I can never escape this nightmare, punishing my body by not eating well or by not taking medication will hurt no one but me. I started accepting it, learned about it more, tamed it. I hid the fact that I'm diabetic from everyone, so I could live the dream of being normal. Sometimes living normally is the dream of special people,” Ahmed told me.

“I’ve always dreamt of studying at police college, so I trained myself and my body to cope with police life, and studied hard at high school to get the accepted average. Once I got my results I prepared all the documents and applied to the college. I passed the physical exam and the written one as well, but I got rejected, because of diabetes. The dream I devoted myself to for most of my life is shattered because of a disease I didn’t choose to have. I became deeply depressed. With no plan B to proceed to, I felt hand-cuffed.”

Ahmad has been my friend for nearly eight years. In those years I’ve seen his ups and downs, lived with him, his suffering whenever a sudden drop in his blood sugar level at night inhibits his sleep. But now, he has befriended his inevitable enemy, accepting it deeply in his heart.

“Now, after almost 14 years of coping with diabetes, after infinite numbers of mental breakdowns and attempts to maintain a healthy sugar level, this enemy is no longer an enemy, it became a blessing, a reminder to me of how precious my body is, not to ruin it with wrong habits. Although I have suffered from it, diabetes has taught me how to treat my body well, to always appreciate it.”