Fatuma's HbA1c dropped from 12.4 to 7.1 in six months.

Fatuma (not her real name) arrived at our Wednesday clinic in May with an HbA1c of 12.4%. That number means the average blood sugar over three months has been dangerously high. Left unchanged, it causes nerve damage, kidney damage, and eventually death.

In six months, with weekly navigator visits, insulin adjustments, and a simple SMS-based tracking system, the number came down to 7.1%. Inside the target range.

Fatuma has stopped missing school. Her mother has stopped being afraid to let her walk to the market.

The tools were not expensive. What was expensive — what every family without a navigator still cannot afford — is attention.