Education for indigenous peoples and special situations. Guides in Wichí

Abstract

Diabetes Self-Management Education (DSME) forms the foundation upon which any treatment well planned is built¹. In Argentina, Resolution 2025-2091-APN-MS mandates that all individuals living with diabetes be offered access to DSME by including it in the Compulsory Medical Plan².

While there are structured DSME programs that attempt to standardize the content taught, this becomes challenging when the target audiences consist of vulnerable populations or ethnic minorities.

According to the 2022 national census, 1,306,730 people identified as Indigenous or as descendants of Indigenous or native peoples; of these, 69,080 identified as Wichí, and 9.2% of that group live in Chaco³.

“Dulce MoWiQo” is an outreach project of the National University of the Northeast’s School of Medicine, in collaboration with the Argentine Diabetes Federation and sponsored by Novo Nordisk; the project carries out activities focused on prevention, early detection, healthcare, and diabetes self-management education (DSME) in Castelli and Misión Nueva Pompeya, Chaco. As members of the Diabetic Ophthalmopathy Committee of the Argentine Diabetes Society, and alongside Dr. Claudia Issa and Dr. Carla Mannucci, we were invited to contribute to the initiative.

In these scenarios, while clinical practice aligns with evidence from scientific societies, it is essential for healthcare personnel to develop competencies in contextual adaptability.

The DSME among indigenous peoples requires adaptations that respect the cultural identity, beliefs, and lived experiences of these communities. In this regard, the professional must be aware of the available economic resources and access to potable water and food, among other factors, and must acknowledge the indigenous community's perspective regarding health and illness processes.

Likewise, it is a priority to identify the language barriers that hinder the transfer of knowledge. Under these circumstances, such discrepancies require the participation of a community representative who performs translation duties—a presence that is crucial for legitimizing the role and credibility of healthcare personnel.

As a strategy to facilitate intercultural dialogue, educational material for DSME has been translated into Wichí by Cristian Ledesma, a nurse at the Misión Nueva Pompeya Bicentennial Hospital.

We know that social determinants have a profound impact on the health of vulnerable populations, cooperation is the path to improving accessibility; for when we learn from one another, education becomes a tool for real transformation.