Living with Diabetes in Lebanon with Cyrine Farhat – Dia-Logue Podcast Episode 08

Pam Durant speaks with Cyrine Farhat, the Founder of Positive On Glucose. We discuss her work in this non-government organization, and the challenges of living in a country where access to diabetes medication and supplies is difficult.

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Cyrine Farhat is a T1D, a Certified Life Coach, a Global Diabetes Advocate, and the Founder of Positive on Glucose.

Find Positive On Glucose on Facebook @positiveonglucose

Find Positive On Glucose on Instagram @positiveonglucose_diabetes

Episode 08: Living with Diabetes in Lebanon with Cyrine Farhat

Pam 0:02

Hello and welcome to Dia-Logue, the Diapoint podcast. I’m your host, Pam Durant. Today on the podcast, I will be speaking with Cyrine Farhat. She has been living with Type 1 Diabetes for several years since she was a teenager. She’s a certified life coach. And she’s also a global diabetes advocate. And she is the founder of an organization called Positive on Glucose. She is based in Lebanon, and I met Cyrine a few years ago. So I’m very familiar with her amazing advocacy work, and what she’s been doing. We know and we read about the stories where it’s challenging for people to access insulin, and other supplies if they have diabetes. But for many of us, it’s not often that we get to hear it firsthand. So I want to again, thank Cyrine for joining me for this episode. Welcome to the podcast.

Cyrine 1:02

Thank you so much for having me, it’s a great honor.

Pam 1:06

I’m really excited that you’re here. And I know we’ve known each other for a few years now, through the network of people living with diabetes here in the region. And your story is always very inspiring, as well as the work you do. So why don’t we start with you, if you don’t mind sharing your story? How did diabetes come into your life?

Cyrine 1:32

Um, so again, thank you so much, Pam. So I was diagnosed with diabetes when I was 15 years old. I remember it so clearly, I was sick. And everyone thought, like, I have, like, urinary tract infection or something. And I surprised my family and my doctor with having Type 1 Diabetes. And it was a real shock for everyone. And they kind of, you know, like for them, it felt like, oh, now she can’t be who she always wanted to be. And now she can do all the things normal teenagers do. And like, I didn’t believe that I don’t feel like diabetes made me any different. If anything, it made me kind of more in control, because I was in charge of keeping myself alive. And that’s very empowering. And from them, it kind of went like I wanted to prove I’m just as able as anyone else to do anything I put my heart and mind into. And kind of created this drive around doing more, being more, putting efforts more than anyone else, proving that diabetes is an obstacle. And I think that’s where the spirit of advocacy, you know, like, that’s how it grew. It came from a place where I didn’t feel supported, and I wanted to in turn to like support and enable and empower other people living with this condition, to be anything or any anyone they want to be.

Pam 3:06

That’s amazing, because at 15 years old, there is no good age to get a diabetes diagnosis, but 15, the teen years it’s so challenging and to be so driven from that time is truly inspiring. Was there a particular, one incident, where you just said, okay, this is my way forward? Or were you always just a really driven person before diabetes?

Cyrine 3:33

I’m an only child so like, my parents were always like, very overprotective over like a girl and, you know, like how the Arab community is. So they always wanted to protect me from the world. And then diabetes came. And I remember the day I was diagnosed, all my family members came over, they were like, they were kind of everyone was kind of grieving. You know, I was looking at them, like I’m here, I’m alive, I’m breathing, I’m okay. I’m just gonna take insulin and like, that’s it, I’m gonna be fine. And of course, it’s kind of, it’s both this rebellious for it’s, you know, like, no, like, you won’t grieve like, this isn’t a challenge. This is something I’m gonna take, I’m gonna make it like, amazing, it’s gonna be like, my point of value is going to be like my superpower. And I’ve just been there, you know, ever since. And, you know, as a diabetic, as a girl, you always encounter things. I think every single thing I ever encountered, made me more adherent to like, this notion of diabetes is a superpower. I’m gonna make something wonderful out of this, like, remember my name. I’m gonna do amazing things. Like, it’s about the spirit over time, and there’s no one incident. It’s just the day-to-day things that happen when you cope with this condition.

Pam 4:51

That’s amazing. And I love that you’ve turned it into something really positive in a way to help people and we were recently on a panel together and I knew that you were doing a lot of different things and helping a lot of people. But that’s the first time I really listened to you formally present what you’re doing. And it’s like three times more than what I realized you were doing. So can you share with us your work around advocacy and other things that you’re working on?

Cyrine 5:20

Yeah, sure. So I think the first time I formally felt like I want to be an advocate, or I want to stand for something was, like, maybe three years ago. My dad was diagnosed with Type 2 Diabetes, which is something I left out of that panel. And I felt like my dad is 60, he’s not educated, he doesn’t have a group of people that support him or know how to support him with diabetes. And I was honestly stressed about like, how is he going to manage his Type 2 Diabetes? I don’t want him with complications, I don’t want them to, like, have an amputated leg or something, you know, and I realized that there were no communities for people with diabetes. I started searching for NGOs, and I found two NGOs. One supports juvenile diabetes. So like, it’s kids, mostly, like under the age of like, it supports people up to the age of 21. But it was mainly made of kids under the age of 16. And there was this other group that kind of did some work, but it wasn’t like, like as a diabetic, I don’t feel like it saturated my needs, you know? So that’s where it started. I was like, okay if no one’s doing it, I’m gonna do it. And I started like, I created this page on Instagram. The name just came up. I was like, okay, Positive on Glucose, because it was like something with two meanings. Like Positive on Glucose, meaning there’s glucose in your bloodstream and you are diabetic. And Positive Glucose, like I, have diabetes, but I’m positive about coping with this condition. And then I started meeting with people online through this Instagram account, I kind of stumbled across something called Swan International. And they were doing amazing community efforts. That community mobilization, amazing work in terms of back then was in terms of the US. And I was like, how can I start a chapter in Lebanon? I just randomly commented on one of their posts, and they responded, and one thing led to another. I received advocacy training. And there I was looking for people to kind of join my advocacy attempt. And that is when I firmly started grading my NGO, Positive On Glucose. And honestly, like things from there, and Lebanon, were kind of going downhill. This is back in 2019, we had a revolution in October, the country kind of completely stopped functioning. I was pregnant, I had a baby loss. And on New Year’s Eve, I had a stillbirth at 35 weeks. And like every single obstacle, every single hardship, every single challenging thing was fuel. You know, like it was diesel to my engines. It just kept me pushing and going forward. And I kept pushing, you know, I wanted to make my NGO formal, I wanted to reach out to people, we created a support group, I became a certified life coach, I wanted to support people with diabetes for free. We started with a support group of three people, and now it’s grown to 60 people from all over the world, not just from Lebanon. Then the Beirut blast happened. And things, you know, just kept getting worse, I was just pushing harder, you know, the worst they become, the harder I push. And two years later, two years or something later, and here we are, you know, my organization’s finally, a legal entity. We finally are starting to formally do work other than other, you know, relief efforts we’ve been doing out of pocket for the past two years. And I started doing more advocacy work in terms of global cooperation with the World Health Organization. With the International Diabetes Federation. I connected with people that looked like me, had the same goals have the same objectives. And, you know, it’s like this big picture that keeps getting clearer. And you feel the dots are connecting. And when I look back that I feel like I’ve done so much work. But when I look at the present moment, I feel there’s so much work to be done. So it’s like pride, but at the same time, there’s so much work that needs to be done and I will keep pushing, to kind of help people in the region in terms of democracy in terms of mobilisation, in terms of empowerment, because we need it.

Pam 9:34

This is so true. It seems almost never-ending because there is always someone that needs support or things that can happen that can make it so much better. And I also love that you’re very focused on this region because, when we go to the Internet, and we look for support for diabetes groups, I mean to be very honest, and I struggled with this. Even though I was American, when my son was diagnosed, the only groups that I could really find were in the US and I wasn’t living there, and having you know, while we’re very fortunate and we have access to things here in Dubai and the UAE, it was very difficult to relate to those things on the internet because they’re not having the same experience as you. So I think it’s super important what you’re doing to really focus on the region and diabetes. And I love that WHO has found you, or you found each other. So that you can continue to grow and, and get people the support that they need. So now after all of these things have been happening in Lebanon in the last few years? What is or let me rephrase that, what are some of the challenges that people with diabetes are having in Lebanon?

Cyrine 10:55

So I don’t know how much people know about what’s going on in Lebanon, but we had the currency devaluation after the revolution in 2019 and up till today, our currency has almost lost 80% of its value. That means that the government has kind of removed subsidisation from most subsidised goods, like fuel, like gas, like essential medication, like there are only a couple of more medications still subsidised by the government. And in turn, this has loved companies, medical companies that provide medical goods, kind of refuse this, you know, subsidisation on certain things, because it means that they’re actually paying out of pocket to be able to import things. So in turn, that led to things being out of the market, there was a point where some insulin brands were not available in the market. Some insulin brands are still not available in the market at the moment, like basic things like Novorapid, like Tresiba. Things you can’t imagine life to be, like a diabetic, you can’t imagine being without because you may die. And while there are other brands that substitute these names, for example, some people like they’re just not suitable for them, you know, there’s just doesn’t work. In terms of supplies, some supplies are still there, but they’ve become quite expensive. I think they’ve tripled now in terms of price. Sensors became out of the market, at a certain point for like, four or five months. That is where we came and kind of started talking to the MOH in Lebanon. We have someone who represents mothers of children with diabetes because basically, they’re the most purest, they would go and you know, they would go and attack anyone that would come near their children, so they’re like the best ally a diabetic can have. So we went and we extensively explained to the Ministry of Health that sensors need to be subsidised. They need to be in the market, they can’t be priced in USD at the moment, because that would mean that literally, they would cause a paycheck, you know, to like buy one sensor. So it was positive, the Central Bank was able to still subsidise sensors. But now, you can like you have like kind of an allowance. So that means you can only buy two sensors a month, which is I think, is decent, as long as they’re affordable for people and accessible. Test strips are out of the market. And if found, they have quadrupled in price. So it’s very challenging. And in terms of this, we’ve reached out to the World Health Organization, we tried to like reach out to community partners to help, but we haven’t received any feedback yet. But the price of this will be complications in the next 10 years. Because if the government doesn’t step up and do proper actions to support people living with chronic issues, like diabetes, like Type 1 Diabetes, people are going to develop complications because of lack of proper care. And that is going to cost the government 10 years or 15 years from now, a lot of money. So it’s very challenging. We’ve been trying to get things from out of the country, literally, we ask people to have drives in countries, and ship and bring in diabetes supplies and medication and their bags. And it’s been working, it’s been helping people to a certain extent. And we just keep going and pushing, you know?

Pam 14:29

That sounds very challenging. And so many questions and you know, in such a situation, there may not even be so many answers. So are people able, you know, with challenges of not able to get gasoline and different you know, things like this? Are people able to find even alternative insulins and pharmacies?

Cyrine 14:56

Honestly, people are at the moment reliant on the organizations that are bringing insulin and supplies from outside the country. And I’m glad you mentioned the gas crisis. I mean, it’s just starting to resolve this week. But we had five hard months of lack of gasoline and people would walk with their cars for like, I can’t even imagine how long miles just to kind of fill up their car with not even a full tank. And that has left people stuck in their villages. Suck in their hometowns, unable to search for the medication in different areas, or in different villages. Like Thank God, other community members, and other NGOs are active and are trying to help people bring in things from outside of Lebanon. Or else trust me, so many people would have died. And there are cases where people died, just because there wasn’t any Panadol. Can you even imagine that? There was a child that died because they couldn’t find anti-fever medication. So I think we’re fortunate to be able to still survive in these conditions. And that is why we need to kind of multiply our efforts because things aren’t getting any easier. They’re just getting worse. And people have lost the value of their money, they’re not able to support their basic needs. No one deserves to have to choose between buying themselves medication or putting food on the table. So we try, organizations are trying, and we have to see where, like we have to keep pushing, and we have to find a solution. I can’t see it any other way.

Pam 16:37

Once a few months ago, when I spoke with you, you mentioned that you know, because of the situation if people have the means to do so, many people are leaving. Because it’s a very difficult, very difficult situation. Are there still enough physicians around to support people with diabetes and chronic conditions?

Cyrine 16:59

Honestly, we’ve lost so many good physicians. I’ve personally lost a very good physician, that was like my physician. And unfortunately, it’s getting harder by the day. And it’s hard for physicians too I mean. Like you hear the stories of people not able to kind of fill up their cars to go and deliver a baby. Or like unable to like operate in an operation room at the hospital, because like there was an electricity cut. There are so many horror stories. And it’s very challenging. But I understand, you know, I understand why someone would pick up their things and just leave because they want a better future for their children. I personally don’t intend to leave because, like, for me, if I leave if people like me leave, the would stay? You know, who would stay and help rebuild this country? So but it is getting very challenging, very hard. And we have to keep pushing to kind of find a solution together.

Pam 18:00

Amazing. I really love your dedication, and I’m sure those that you’re supporting, appreciated more than words can express. If there’s people out there that are listening, and they want to support or reach out to you and learn more, in addition to your Instagram account at Positive on Glucose, are there other places where they can find you?

Cyrine 18:27

Um, so basically, we are on Instagram, we have a Facebook page, we currently don’t have a website, because we had some, like, we had some issues with, you know, paying in USD to like the hosting website because of the current situation in Lebanon. But I’m reachable through the Positive on Glucose Instagram accounts. I’m always here if anyone needs any help. My phone number is even there. So I’m more than happy to support any person living with diabetes who needs to be in a support group, or needs to be heard or has a story to share or just has a way of, you know, thinking of an idea that can help the community, that’s where they can find me at the moment.

Pam 19:13

Great and do you feel that, you mentioned, that you know now, just recently there was a little bit more access to gasoline for the cars. Do you feel that that’s a sign that it’s improving? Or do you still feel there’s a very long way to go?

Cyrine 19:34

And no, because the price of gasoline has, it’s like I think 10 or even 15 times more what it used to be. So like even if there’s gasoline and that is what people our gas stations now like to talk about. There isn’t money to fill up your cars, and most people can’t really afford to fill up their cars more than once a month because it’s literally half their paycheck. So things are bad. But again, we try we keep pushing to find a way to make it an easy transition on people because we’re going into elections. And I think me like there’s, there’s a lot of work to happen here. So it’s gonna take a long time to come out of this. Maybe like, I think, five to seven years to come out of this economically. So let’s see how things go but, personally, throughout all of this, I’ll be trying to find solutions to every single problem diabetics will be encountering here in Lebanon and the region.

Pam 20:43

Amazing. And with, okay, gasoline is one thing, but I also read there have been power outages, is that daily?

Cyrine 20:54

That’s daily. Where I live, I have generator support from 7 pm to 6 am. I have no electricity during the entire day. So we have to kind, of as diabetics, find creative ways to keep our insulin alive. You know, it’s funny when you when we speak about it because we cope so well. And we joke about it so well, that it has become normal to us, you know like it’s just a normal part of our life. But it’s it is again, very, very challenging.

Pam 21:25

And going into winter, is it going to get very cold? And then will that become a challenge?

Cyrine 21:34

It will, and then we then will have to figure out ways to solve this. Yeah.

Pam 21:43

Okay. Now, I’m quiet because there’s so many questions to ask. But yet, nothing to say. When you’re faced with so many challenges. I do love the resilience that you have. And after having met so many people from Lebanon, they all have a certain sense of resiliency. And very, for lack of a better word creative in finding ways to solve problems. And I think that comes from, you know, the extreme adversity of situations like what you’re facing right now. And outside of, you know, insulin, and of course, a better economic situation. Are there other things that people with diabetes are in dire need of?

Cyrine 22:33

I mean, if you take all the things people in Lebanon have generally been through. I mean, I’m 30, I’ve already been through two wars, so many economic turbulences, so many assassinations, so many bombings, and I somehow survived. But like, given that apart, which is like major PTSD, which all Lebanese people have, there are like, the regular things, you know, that there’s like the social stigma, there’s like, the coping with diabetes, distress, there’s lack of education. So like, all of these things, of course, we have to work on. We have to, like find a solution to, but before we do, that, we have to survive, we have to stay alive to think of them. So it’s, it’s understandable, like, a matter of priorities. At the moment you want to survive as people living with diabetes. We want to survive with the minimum amount of distress and complications. And I know there will be a lot of education, there’ll be a lot of social environments, a lot of things that are going to happen for diabetics in Lebanon. But first things first.

Pam 23:40

For sure. While education and everything are extremely important, if you don’t have the basics like insulin, or the ability to check your blood sugar or the ability of, for example, the needles to administer insulin. That has to happen first and foremost.

Cyrine 23:58

True.

Pam 23:59

Is there anything else that you would like us to know about Lebanon?

Cyrine 24:04

Well, as a very proud young Lebanese, I will tell you that Lebanon is a very beautiful place to be. The people are amazing. They’re resilient, they love life, they find a way to live. They find a way to enjoy life, even though everything is horrendous. And diabetics in Lebanon are doing an amazing job and supporting and helping each other. I just hope someday you get to come and meet people here. You got to experience the culture. You get to experience diabetes and a sense of community. And until then, read about Lebanon, talk about Lebanon, be there for Lebanon, and Lebanon will do the same for you.

Pam 24:47

I love that. I’ve actually been to Lebanon before, years ago when Erin, my son, was really small. We were there, and it is everything you say it is. It’s lovely. it’s beautiful. The people are warm, and I loved everything about it. So once we kind of get past the logistics of COVID, and travel and everything else, I would love to come back again. And at that time, I didn’t really know anybody that had diabetes. So I would love to meet you face to face, and the community as well.

Cyrine 25:19

Honestly, Pam, there’s become such a great community of diabetics in the region, that it’s now easy to kind of connect with anyone in Egypt and Morocco and Jordan, in Kuwait. Like every everywhere you go, there’s a Positive on Glucose member that you can connect with, which I find so heartwarming. About a month ago, I was in Egypt, and I connected with one I saw one of our members, and it was beautiful. Like getting to touch and see and feel someone you’ve seen on the Zoom for like a year and a half. So the power of community is beautiful. What a community can do when they come together is beautiful. And we have done that, they helped so much, just by loving people inside with diabetes and other countries. So I really hope I can see you soon. I hope the entire community can come together and meet one day somewhere. And yeah.

Pam 26:10

That would be amazing. I think that’s a good goal for us to have, to do. To look forward to for the future.

Cyrine 26:16

Yeah.

Pam 26:16

Cyrine, thank you so much for joining me, speaking with me and telling us more about what is happening for you in Lebanon, and how you’re supporting people with diabetes there. I really appreciate your time. And we’ll put all the links in the show notes. So people can find you and your organization as well. So please go to the Diapoint website to look for that. Or even send us an email if you’d like to learn more. Thank you.

Cyrine 26:48

Thank you so much. And I hope everyone stays safe and sound.

Pam 26:51

Thank you, you too.

I want to thank Cyrine again for joining us, and sharing her experience and also sharing about the work that she’s doing. I’ll admit, there were a lot of times during the discussion that I was speechless, and didn’t know what to ask. And, you know, sitting here thousands of miles away, it feels really helpless. So I want to thank you again for sharing that and showing up to share that with us because that’s certainly not easy. And the other thing that I, or one of the things that I really noticed was when I asked about winter, and if it was going to get cold. I could feel that, I don’t think that they really you know been thinking about the future so much. When you are in a challenging situation like this, that part of our discussion just really shows that you are really living in the moment and living day to day, living in the present, which I think is always important because we never know what the future may bring. And while there were some little beams of rays of light of hope in that, I’m so happy to hear that Cyrine and others are still able to stay positive through this. So if you’re in Lebanon and out there listening, we send you much love and if you want to learn more about Cyrine’s organization and the work that she’s doing, we will have the links in the podcast notes. You can reach out to her or please reach out to me if you would like to get in touch with her. Thank you and have a wonderful day.

Show Notes and Links

Disclaimer: It should go without saying that the Diapoint podcast is not intended as or should not be used as personal medical advice. You will hear us interview medical experts and others, but please always always ask your qualified doctor, diabetes team or other expert about your health. What works for one person does not always work for another person. What you should always do when you discover any new health information is ask YOUR doctor about it. This information should empower you to have a discussion with your healthcare providers about it. Diapoint, our guests, sponsors and business partners are not here to replace that advice. Living a full, healthy life means taking the proper medical advice from your qualified physicians, diabetes team or other healthcare providers.

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