‘Your Future Ends Here’ - Diabetes Warrior Bounces Back from Stigma
PEN-Plus Clinic and Camp Restore Hope for Young Woman Who Dropped Out of College After Type 1 Diabetes Diagnosis
Misconceptions in her community led Naomi Mwila to lose hope in her future after her type 1 diagnosis. But that hope has been restored by the support she receives at the PEN-Plus clinic in her hometown of Lusaka, Zambia, and by a week in August at Camp Tuli Bonse, an integrated PEN-Plus camp where peer support and mentorship from other warriors living with noncommunicable diseases restored her ability to dream. (All photos by DOD Media Hub, courtesy of the Centre for Infectious Disease Research in Zambia.)
Before Naomi Mwila was diagnosed with type 1 diabetes in March 2024, she was attending college for civil engineering, planning her career, and dreaming of a bright future for herself and her young daughter.
But in places where awareness is low and misconceptions run rampant, fueled by harsh social stigma, a diagnosis can change everything.
For Mwila, then 24, it quickly changed her entire outlook on her life, as neighbors, other community members, and even a college professor told her that her disease meant she no longer had anything to live for.
“After I was diagnosed, I lost hope,” Mwila recalled in August, sitting in the shade of a tree at Camp Tuli Bonse, just outside of Lusaka, Zambia. “So I gave up on my education because it was not taking me anywhere. It had no use for me, because any time, I am going to die. So, I just dropped out.”
Naomi Mwila shares her story in this video interview. (Video by DOD Media Hub, courtesy of the Centre for Infectious Disease Research in Zambia.)
Yet nothing else had changed for Mwila. She had dealt with symptoms such as shortness of breath all her life and still had become a mother and a successful university student in a challenging field. She had always thought her spates of breathing difficulty were just from stress, changes in the weather, or other environmental factors. And she had always found ways to deal with those bouts of illness.
But after experiencing blurred vision and severe dizziness on a bus ride to her home in Lusaka in early 2024, she decided to see a doctor and try to find the cause of the symptoms she had been dealing with since childhood.
At the PEN-Plus clinic at Lusaka’s Matero Hospital—now one of five district hospitals in Zambia with a PEN-Plus clinic for the treatment of severe, chronic noncommunicable diseases—Mwila at last learned she had type 1 diabetes.
An accurate diagnosis is a landmark step in disease treatment and management, ideally paving the way for medication, healing, and self-sufficiency through regular checkups and care. For Mwila, the type 1 diabetes diagnosis—and follow-up care at the PEN-Plus clinic—has achieved all those things. It also brought her in August to Camp Tuli Bonse, where she met other people who shared her condition or lived with sickle cell disease, another severe NCD.
The Centre for Infectious Disease Research in Zambia (CIDRZ), the Sonia Nabeta Foundation, and the NCDI Poverty Network hosted Camp Tuli Bonse to pilot an integrated camp for children, adolescents, and young adults living with type 1 diabetes or sickle cell disease. Tuli bonse in the Bemba language translates to “we are together.”
The nearly 60 camp participants were of ages ranging from 10 years to the mid-20s, and all of them, like Mwila, attend health clinics that use PEN-Plus, an integrated care delivery strategy focused on increasing the accessibility and quality of chronic care services for people living with severe NCDs—such as type 1 diabetes, sickle cell disease, and rheumatic and congenital heart disease—in rural areas of lower-income countries.
PEN-Plus is proving effective in Zambia, where more than 1,200 people with severe NCDs were actively receiving care at PEN-Plus clinics as of March 2025. That’s a dramatic increase in just a few years; when PEN-Plus data collection began in late 2022, 77 patients were enrolled.
Camp Tuli Bonse was created with the idea that care could extend beyond clinical settings. For Mwila, the week of peer support, empowerment, and solidarity showed her that she could not only live but thrive.
Those feelings of hope were a long way from her initial despair after her diagnosis, when so many people in her community told her she no longer had a future.
“I was discouraged by one of my teachers, who said: ‘Now that you have diabetes, you won’t go anywhere. Your future ends here. People with this disease, they don’t go anywhere. I don’t even think you should finish this year. I don’t even know if you should give birth. Because people with diabetes, they don’t give birth. And once, if you are lucky and have a child, you will be paralyzed.’”
Mwila paused, recalling the conversation.
“That’s what made me drop out of school.”
Despite her assumption that she could die at any time, in her heart, Mwila knew she wanted to live. And she wanted the chance to grow her family—a desire she expressed months later, during an advocacy session at Camp Tuli Bonse.
Camp participants proudly referred to each other as “warriors,” because of the daily challenges they all encountered. In the advocacy session, warriors spoke about the stigma associated with their condition and what change they most wanted to see in their communities.
Some warriors spoke about fair employment opportunities, as stigma could prevent young adults living with NCDs from getting jobs. Others spoke about fair treatment in school, or from friends’ families. Mwila spoke about the fear of childbirth, because of what she had been told previously. She wanted to be able to dream about a future sibling for her daughter, Miriam, now four years old.
Naomi Mwila (seated at right in purple headband, facing the group) participates in an advocacy session at Camp Tuli Bonse in August. Nearly 60 youth and young adults living with type 1 diabetes or sickle cell disease attended the weeklong camp, which focused on empowerment, education and peer support. In this session, participants shared their experiences with misconceptions and stigma, and talked about possibilities for positive changes.
Emmanuel Kisembo, programs manager for the Sonia Nabeta Foundation and a type 1 diabetes warrior, led the advocacy session that day. He said Mwila’s fear is not uncommon, particularly because very few programs help adults with type 1 diabetes navigate social issues such as stigma.
“Many, many young adult warriors have fears about childbirth,” said Kisembo, who has also served as a Voices for PEN-Plus advocate since the program’s inception in 2023. “Misconceptions about type 1 diabetes lead them to fear they will not get into a relationship, get married, or have children.”
Kisembo said that among NCD warriors who are doubly burdened with extreme poverty, there often is a lack of awareness about advocacy itself, and how to use one’s voice.
During the Camp Tuli Bonse advocacy session, Kisembo said, “We spent an hour trying to get participants to tell stories—because the more you speak up, the freer you become. Naomi was one of those who opened up and shared her fear.
Mwila said the support she received at camp gave her hope and restored her ability to dream.
“Coming here to the camp, I’ve learned many things,” she added. “I can give birth and I can live a normal life, like any other patient with diabetes.”
The PEN-Plus clinic at Matero continues to be a source of strength for Mwila. She visits monthly and, at home, takes insulin that the clinic provides for free.
“The PEN-Plus clinic has added a lot to my life,” Mwila said. “The encouragement I can give to any diabetes patient out there is that they just have to believe in themself. Once they feel that the community or their family is putting them under pressure, saying you can’t do this, you can’t do this…they can always go to the clinic. They will find people there who will counsel them.”
During the August camp, Mwila talked about potentially returning to school. At that time, she spoke about continuing in engineering, to one day work as an aviation technician.
By early October, though, her mindset had shifted. While she still hopes to resume her studies, she said she might change her career track—to the health field.
“I want to go back to school, but I want to do something that has to do with health,” she said. “I want to see people like me be happy—and realize they can live and thrive like anyone.”