Step by step, eighty -year -old Sien Sukhraj shuffles on her husband’s arm. It doesn’t go very smoothly, but it goes. “We don’t have to run, you know.” The two have been walking regularly for ten years of one or two hours with the walking group of Frank Kanhai (62), because “good for health and you come among people,” says Sukhraj. Her husband has dementia, which sometimes limits social activities.
Her husband was “his adult life” Diabeet, says Sukhraj. When they started walking ten years ago, he soon went much better: more energy, less pain in the joints. “We started piercing blood together and the doctor said: the diabetes has disappeared,” she says. “I heard it thunder in Cologne. Then I started to understand how important walking is. Even if you are at the back.”
The two are Hindustan-Surinamese, just like the other walkers this Friday in The Hague. In that community, type 2 diabetes appears much more often Then among native Dutch people. For people over fifty years old, the risk is about five times greater, for people under fifty even to ten times greater. Diabetes is also more common in the Turkish-Dutch and Moroccan-Dutch communities. That has to do with both lifestyle and heredity.
The medals that are awarded for every walk hang the Sukhrajs at home at the door handle. “Then we hear the burglars coming.” Walker Asha Boejharat-Soekhoe (61) has a basket “with a hundred medals from Frank” at home.
She came alone today, but often she takes a child or grandchild. None of them has diabetes, and she does not, but it is in the family. “So we have to keep moving and I try to stimulate my children and grandchildren from a young age, by walking with Nana [opa] Frank. ”
Genetic
In people with Hindustani descent – descendants of contract workers from India – heredity may be related to the colonial past. According to the Thrifty Gene-Hypothesis have descendants of people who had to deal with famines a higher risk of diabetes. Their bodies would have started to save fat more efficiently in order to be better able to deal with scarcity – but in times of abundance are disadvantaged. In India, from the eighteenth to the twentieth century, great -hunger nods, largely caused or exacerbated by the policy of the then British rulers.
That may have influenced genetic predisposition, but also on epigenetics: a kind of on/off buttons of the genes, Mary Nicolaou explains. She is a researcher at the Amsterdam UMC and one of the project leaders of the largest European study of ethnic diversity in health and health care (Helius). In that context, she does a lot of research into diabetes.
“Change in genetic predisposition is less likely, because something like that usually takes thousands of years,” says Nicolaou. Changes in epigenetics are faster. “For example, if your mother is malnourished during pregnancy, it already influences your eggs that will be fertilized later. And therefore not only on you, but also on your children.”
White walking groups
The lifestyle factor in type 2 makes a stigma on rest: type 2? Then you just have to eat healthier. So it’s not that simple. Moreover, says Nicolaou: “Lifestyle is often the result of the circumstances in which people live. We see In our research That factors such as discrimination, poverty and chronic stress have a lot of influence on that. ”
“From research It appears that up to 25 percent of the ethnic differences in depression can be attributed to experienced discrimination. From other research It appears that chronic stress, for example due to discrimination and living conditions, does something with your lifestyle and your body. ”
The Bas van de Goor Foundation – a foundation of former professional volleyball player Bas van de Goor, himself Diabeet – has been focusing on diabetes prevention and improving the quality of life for diabetes patients for years, including with hiking groups. The Foundation does this in collaboration with pharmaceutical out Novo Nordisk, known for diabetes drug Ozempic. But they were unable to reach people with the highest risk of diabetes (certain groups with a migration background). “In short: we were white hiking groups,” says Van de Goor, who is walking in The Hague this Friday.
So Sophie Rijntjes and Younes Bouadi, project leaders of the walking groups at Novo Nordisk, went looking for ways to reach those groups. At the Turkish welfare organization DSB they saw how key figures from certain communities get people on their feet much better than regular authorities such as the municipality or the doctor. They went looking for famous people within communities – such as Frank Kanhai.
That that does work has everything to do with trust and familiarity, according to Kanhai. “Because I look like people. They call me cousin, Uncle, Nana.”
After the walk there is always a gathering in the National Archives, where Kanhai works five days a week. The National Archive was prepared to second him to the foundation one day a week, so that he can organize the walking groups that day – paid by the foundation. With that being together there is also something to eat and drink.
That makes his walks such a success, Kanhai thinks. “Many people initially come for the social aspect, health is a side issue.” Yes, Van de Goor says, that is why we did not succeed: “We emphasized health through formal healthcare authorities.” And in formal authorities, says Kanhai, many people with a migration background have less faith. “Not without reason.”
In Kanhai, on the other hand, there is ample confidence. Because he has the people, he and the participants say, and knows who he can reach how. The Sukhraj couple, for example, he sends speech reports via WhatsApp. They always start with: “Aunt, grab a pen and paper …”, followed by a list of upcoming walks, told very quietly, so that ‘aunt’ (they are not a family) can write along. He reaches others via Facebook groups or by calling them.
Researcher Nicolaou also says that in prevention projects it is essential to “have knowledge of different cultures, eating patterns and living conditions.” “Many standard advice is aimed at average Dutch dietary patterns. It is important that the advice matches what people know. As a health scientist I track to participate in lifestyle programs for health reasons. But if someone is participating because it is fun, it is just as successful.”
According to her, the walks of Kanhai show that as an organization you “just have to do your best to reach some groups” and that it works best. In recent years, countless projects have been set up that shows that, according to her. The problem is that they are temporary. “Then the project is ready, the money up and it gets forgotten.” For example, ten years ago she made a recipe book together with Hindustani Dutch with healthy Hindustani dishes. “They were a success, but are no longer distributed.”
Ambassadors
Health insurers are finding it difficult to invest in structural prevention, says Nicolaou, let alone such targeted prevention. The financing of the walking groups is also temporary. In 2022, the project received a four -year subsidy from the Ministry of Health, Welfare and Sport. So one year to go. “The continuation of many walking groups is uncertain, completely in the current political climate,” says project leader Rijntjes.
Kanhai has several ‘hiking ambassadors’, such as 19-year-old Brighton Manniesing, who walks against the sun in a colorful blouse and with a cap and sunglasses. Through social media he tries to persuade people – some of his videos are viewed more than 40,000 times, he shows on his phone – and during the walks he makes talks with the people. “I make friendships with young and old, that motivates people to keep coming.” Manniesing has an intellectual disability, but that does not mean that he cannot contribute to society, he says. “This shows that this boy is also important for society.”
The friendships are also reason for Kamla Bandhoe (69), on Zwarte Crocs, to walk with. And of course health. “If you don’t move enough, you will expand.” She has diabetes and therefore walks with as many walks as possible. “I keep an eye on it via Facebook. Everyone knows Frank on the internet.”
Today – an early Friday afternoon – there are 65 people present. “Not a crazy turnout,” says Kanhai, but sometimes 150 come on weekends. To the special theme walks that he regularly organizes, such as the Anton de Kom walk or the Nelson Mandela walk, come up to 300 people. During those walks, for example, the group goes past statues or relevant places in the city, and is told about history. “I like those walks the most,” says Maltie Bhawanie (53), who since she participated despite her diabetes has lost weight, has less muscle pain and more energy. “It makes life more fun.”
Carbohydrate and sugar-arm bread is served during the after-sitting in the National Archive. On Mother’s Day there was carbohydrate and sugar-poor roti. “How did that taste?” Asks project leader Bouadi. Great, he is told. This summer he organizes a cooking workshop with Kanhai for the walkers in which they learn to make the healthier Roti herself. “Because you will not succeed in taking Roti from Hindustanis,” says Kanhai.
Leaving delicacies is not that easy, says eighty -year -old Sukhraj. “We eat, terribly. Rice pudding with sugar, raisins and cinnamon, really. But it shouldn’t be everyday. And if you walk enough, you can keep eating.” The couple is now in such a way that the group is out of sight. But not for long: Kanhai is coming again, to lead the two in the right direction. “You see, Frank is waiting for everyone.”
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