Fa'idodi ga marasa lafiya da masu ciwon sukari a shekarar 2019
Ciwon sukari mellitus - Cutar cuta ce ta tsarin endocrine, don maganin ta wacce ake buƙata magunguna masu tsada da kuma hanyoyin da ake buƙata koyaushe.
Kwanan nan, ciwon sukari yana samun sikelin "annoba."
Tare da wannan a zuciya, gwamnati tana duba hanyoyi daban-daban na taimako ga mutanen da ke fama da cutar.
Yawan biyan kuɗi ga masu ciwon sukari da fa'idodi ana nufin sauƙaƙe hanyar don samun magunguna masu mahimmanci. Magungunan Endocrinologists suna da damar da za a bi da su a cikin marasa lafiya kyauta. Ba kowane mai haƙuri ba ne ya san abin da ya kamata ya zama na masu ciwon siga kyauta. Bugu da ari, ko dokokin dukkan marasa lafiya masu ciwon sukari mellitus sun shafi, shin ya zama wajibi a yi rijistar matsayin mai nakasa, da dai sauransu.
Haruffa daga masu karatunmu
Kakata ta yi rashin lafiya tare da ciwon sukari na dogon lokaci (nau'in 2), amma kwanan nan rikice-rikice sun tafi a ƙafafunsa da gabobin ciki.
Na bazata nemo labarin a yanar gizo wanda ya ceci rayuwata a zahiri. An shawarce ni a can kyauta ta waya kuma na amsa duk tambayoyin, na faɗi yadda ake kula da ciwon sukari.
Makonni 2 bayan kammala karatun, babbar yarinyar har ma ta canza yanayi. Ta ce kafafunta ba su sake ji ciwo ba kuma raunuka ba su ci gaba ba; mako mai zuwa za mu je ofishin likita. Yada hanyar haɗi zuwa labarin
Fa'idodi ga masu cutar siga 1
Kasancewar matsayin mai haƙuri da cutar sankarau lamari ne mai rikitarwa a cikin jihar. Ba a taɓa faɗar wannan ba a cikin kafofin watsa labarai, kuma kawai endocrinologists sun faɗi. Duk da wannan, duk mutumin da ke zaune tare da masu ciwon sukari, ba tare da la’akari da irin nau'in cutar ba, zai iya amfani da fa'idodi ga masu ciwon sukari. Babu damuwa kasancewar ko rashin matsayin nakasasshe.
Shirin jihar yana samar da fa'idodi masu zuwa ga masu ciwon sukari:
- Kyauta ta karɓar magunguna masu mahimmanci.
- Fensho na nakasassu ya danganta da kungiyar.
- Bai dace da sabis a sojojin ƙasar ba.
- Isar da na'urori don gwajin kansa.
- Dama don bincika tsarin endocrine kyauta a cikin cibiyoyin kayan aikin musamman don masu ciwon sukari. A tsawon lokacin jarrabawar, kowane mara lafiya yana kebe daga azuzuwan a makarantun ilimi da ayyukan aiki ba tare da wani sakamako ba.
- Rarraban keɓaɓɓu na marasa lafiya suna da gata yayin da ake fuskantar jiyya a wuraren rarraba da sauran wuraren kula da wuraren shakatawa.
- Rage a kan kuzarin amfani har zuwa 50%.
- Daysarin kwanakin haihuwa ga mata masu fama da cutar siga.
Jerin magunguna na zaɓaɓɓen cututtukan cututtukan fata da na'urori don ganewar asali na gida, a matsayin mai mulkin, an ƙaddara ta likitan da ke cikin maganin. Ana buƙatar mai haƙuri kawai don ziyartar likitoci koyaushe, yin gwaje-gwaje na lokaci-lokaci kuma karɓar takardar sayan magani don sayan duk abin da ya cancanta.
Hakanan ana iya yin gwaje-gwaje kyauta ba tare da izini ba a cikin duk cibiyoyin likitanci, sakamakon da aka samu yana cikin kowace harka da aka aika ga kwararrun likitan da suka yi maganin mai ciwon sukari.
Ga duk abubuwan da ke sama, zamu iya ƙara da cewa marasa lafiya masu ciwon sukari suna da 'yancin ƙarin fa'idodi ba tare da rajistar nakasassu ba, suna mai da hankali kan nau'in da tsananin cutar.
Hakanan ana bayar da ƙarin fa'idodi ga masu ciwon sukari na 1, sun haɗa da:
- Issuaddamar da magunguna kyauta waɗanda suka zama dole don magance cutar da hana haɓakar rikice-rikice na ciwon sukari.
- Samun kayan aikin da ake buƙata - sirinji don injections, glucometer don auna glucose jini da ƙari mai yawa. Ana aiwatar da batun ne ta hanyar rubutattun magungunan da likitocin masu halartar suka rubuta, suna mai da hankali kan abubuwan yau da kullun.
- Jagora ga masu ciwon sukari da ke fama da rauni idan har aka zana kuma aka sanya kungiyar nakasassu.
Shirin na jihar yana ba da kulawa ta gida ga masu ciwon sukari na nau'in 1 da ke buƙatar irin wannan tallafin. Hakanan an sanya mara lafiya ma'aikacin zamantakewa don taimakawa wajen kula da kansu.
Innovation a cikin ciwon sukari - kawai sha kowace rana.
Fa'idodi ga masu cutar siga 2
Kamar nau'in cutar ta farko, ana bayar da magani kyauta da kuma bincika marasa lafiya da ke da nau'in ciwon sukari na 2.
An bayar da fa'idodin masu zuwa ga marasa lafiya masu fama da ciwon sukari na 2:
- Jiyya a cikin sanatoriums. Marasa lafiya a ƙarƙashin kulawa na kullum game da cututtukan endocrinologists suna karɓar littafin jagora ga masu ciwon sukari a cikin tsarin kyautata rayuwar jama'a. A cikin tsarin tallafi na jihohi, marasa lafiya na nau'in 2 na iya shiga cikin aiki na jiki a ƙarƙashin kulawa na kwararru.
- 'Yancin nau'in mai ciwon sukari na 2 don yin karatu, darussan horarwa don ci gaba da ilimi har ma da cikakken farfadowa.
- Biyan kuɗi don masu ciwon sukari don tafiye-tafiye na kiwon lafiya zuwa sanatoci, ba tare da la'akari da matsayin mai nakasassu ba. Hakanan ana bayar da diyya don tafiya zuwa wurin dawo da abinci.
- Yana nufin don ganowar gida na sukari na jini. An bayar da isasshen batun glucose da kuma matakan gwaji.
- Biyan kuɗaɗe ga marasa lafiya da ciwon sukari.
- Bayar da magunguna kyauta.
Marasa lafiya tare da nau'in ciwon sukari na 2 dole ne yasan menene fa'idodi kuma yai amfani dasu na kwanaki 365. Game da rashin amfani, mara lafiya dole ne ya rubuta sanarwa kuma ya gabatar da takaddun da ya dace don rama abin da aka kashe.
Nuna rashin ƙarfi
Ga marasa lafiya da masu ciwon sukari tare da matsayin rashin ƙarfi, ana ba da ƙarin fa'idodi. Don samun nakasa, kuna buƙatar bincika ku a cikin cibiyoyin likita na musamman waɗanda ke gudanar da gwaje-gwaje daga Ma'aikatar Lafiya. Anwararren endocrinologist kawai wanda yake ganin buƙatar irin wannan matsayin zai iya aikawa don irin wannan binciken. Hakanan, idan kwararrun masu magani ba su ga irin wannan bukatar ba ko kuma ya ƙi bayar da takardar neman magani, mai cutar kansa yana da 'yancin zuwa irin waɗannan cibiyoyin.
Ya danganta da tsananin cutar, akwai ƙungiyoyi 3:
- Rashin raunin rukunin 1 - ya haɗa da marasa lafiya waɗanda, saboda cutar, ba su iya gani ba, tsarin jijiyoyin jini, akwai rikice-rikice na tsarin juyayi, akwai ilimin cutar sankara na cocin. Hakanan, ana sanya rukuni ga marasa lafiya waɗanda suka kasance fiye da sau ɗaya a cikin matsala kuma waɗanda ke buƙatar kulawa ta koyaushe ta mai kulawa.
- Abilityungiyar rashin ƙarfi 2 tana da matsala iri ɗaya kamar 1, amma tare da ƙarancin wahala.
- Groupungiya ta 3 - marassa lafiya da ke fama da alamun cutar sankara tare da rauni ko matsakaici.
Bayan cikakken bincike, mai haƙuri yana buƙatar tsammanin yanke shawara ta kwamiti na musamman. Yanke shawarar sanya rukuni ya kara da cewa abin da ya shafi tarihin likita, sakamakon binciken da ya gabata da kuma wasu takardu da hukumomin likitoci suka bayar.
Musamman kulawa don samar da takaddun nakasassu saboda gaskiyar cewa irin waɗannan masu ciwon sukari sun cancanci amfanin zamantakewa. Biyan da ake biya wa marasa lafiya da ke dauke da cutar siga ana daukar su fansho ne da ba a karba daga jihar ba, ana tsara girman girman ka'idodin karɓa a matakin majalisa.
Rashin amfani
Shirin tarayya "Rasha ba tare da ciwon sukari ba" yana ba masu ciwon sukari damar da fa'idodi a gaba ɗaya ga mutanen da ke da nakasa, ba tare da la'akari da matsayin su ba.
Marasa lafiya masu ciwon sukari tare da rukunin nakasa na iya amfani da waɗannan fa'idodin da jihar ta bayar:
- Ba da sabis kyauta a wuraren kiwon lafiya. Akwai matakan da za a iya sabuntawa da kuma kula da ayyukan gaba ɗayan kwayoyin.
- Taimako daga ƙwararrun kwararru.
- Tallafin bayanai na kyauta daga ma’aikatan zamantakewa da kuma fannin ayyuka na doka.
- 'Yancin daidaitawar zamantakewa - horo, sake dawowa, tsaro na aiki.
- Sakamakon kashe kudi na kudaden aiki.
- Fensho fa'idodi ga masu ciwon sukari.
- Hakkin wasu kudadenda aka biya.
Sakamakon ba da katin ba da ba a amfani da shi
Idan masu ciwon sukari basa amfani da fa'idodin nau'in 1 da nau'in ciwon sukari na 2, zasu iya dogara da diyya.
Muna ba da ragi ga masu karanta shafinmu!
An bayar da kuɗin kuɗi don magunguna waɗanda ba a karɓa da baikatattun motocin diyya na wurin amfani da su. Marasa lafiya suna iya yin watsi da ɗayan nau'in fa'idodi ba fiye da sau ɗaya a shekara ba. Don yin wannan, yakamata a tuntuɓi Asusun Tallafi a wurin yin rijista tare da takaddun asali da sanarwa na mutum.
Dole ne a gabatar da aikace-aikacen kansa da takardu a kowane lokaci tare da yanayin da ya kamata a biya diyya ta farko ba a cikin watanni 6 ba. A cikin aikace-aikacen, nuna bayanan sirri da bayanan biyan kuɗi, kazalika da sabis ɗin da kuke buƙatar ƙi.
Samun magunguna
Yakamata a bai wa masu ciwon sukari magunguna masu rage sukari da sauran magunguna. Ana ba da waɗannan fa'idodi ga nau'in 1 da nau'in masu ciwon sukari guda 2 don lura da rikitarwa da ke tattare da cutar sankara.
Ana kuma kiranta nau'in ciwon sukari na 2 wanda ba ya da maganin insulin. Wannan mummunan cuta ce da ake ...
Abin da magunguna ne kyauta ga masu ciwon sukari na 2 ana ƙaddara ta likita mai halarta, amma sau da yawa ana ba marasa lafiya:
- kwayoyi waɗanda ke hana rikice-rikice na cutar - phospholipids (a daidaita aikin hanta na yau da kullun), maganin ƙwayar cutar ƙwaƙwalwa (yana taimaka wa kansa don aiki),
- shirye-shiryen wadata tare da bitamin, hadaddun bitamin-ma'adinan hadaddun (a cikin Allunan ko cakuda allura),
- magunguna don dawo da tsarin metabolism na al'ada,
- kwayoyi waɗanda ke taimaka wa bakin jini - thrombolytics (Allunan ko allura),
- magungunan zuciya wadanda ke tallafawa aikin zuciya,
- diuretic kwayoyi
- magunguna da aka shirya don marasa lafiya masu hauhawar jini,
- sauran magunguna na kwaya, dangane da kasancewar rikitarwa da kuma cutar.
Ciwon sukari ko cutar sukari cuta ce ga jikin mutum wanda ke da alaƙa da tsarin endocrine. Nau'in farko ...
Matsakaicin jeri na iya maye gurbin magungunan antihistamines, analgesic, antimicrobial da sauran magunguna, buƙatar da likitan halartar ya ƙaddara.
Amfanin yara
Lokacin da yaro ya dogara da insulin, lallai ne an sanya shi matsayin mara lafiyar.
- fa'idodin fansho na nakasa,
- tafiye-tafiye zuwa wuraren shakatawa da wuraren kiwon lafiya,
- kebewa daga haraji da kuma kudade,
- kasashen waje jarrabawa da magani,
- Akwai sauƙaƙan yanayi don ƙaddamar da jarabawar a makaranta, layi don shigar da jami'a kyauta,
- Biya taimako ga iyayen yara 'yan kasa da shekara 14,
- da damar yin ritaya da wuri don masu kula ko kuma iyayen,
- ragi kwanakin aiki, karin ranakun hutu.
Wurin cibiyoyin
Ya danganta da wurin zama, ana iya samun fasali na wadatar fa'idodin yanki.
Ba za a iya ba da fa'idodin gida na nau'in masu ciwon sukari na 2 a cikin Moscow ba idan kuna da yanayin nakasassu.
Wadannan sun hada da:
- tafiye-tafiye na shekara-shekara zuwa hadaddun sanatorium,
- tafiya da jigilar jama'a,
- rangwamen kudi har 50% don lissafin kayan aiki,
- kariya ta zamantakewa.
Saint Petersburg
Dangane da Ka'idodin zamantakewa na yankin, ana daukar cutar sukari cuta ce da ke ba da 'yancin karɓar magunguna kyauta, yana mai da hankali ga magunguna daga likitanka.
Marasa lafiya tare da nakasa suna da ƙarin fa'idodi:
- zirga-zirga mara kyau a kan sufuri na jama'a da ƙasa,
- EDV kowane wata, girman abin da aka ƙaddara shi bisa ƙungiyar.
Yankin Samara
A yankin Samara babu wasu fa'idodi na musamman. Masu ciwon sukari yakamata su sami sirinji na insulin, magungunan autoinjectors, allura masu canzawa, kayan aikin gwajin kai, da ƙari.
Gabaɗaya, marasa lafiya da ciwon sukari suna da'awar ainihin jerin fa'idodi. Marasa lafiya waɗanda suka sami matsayin tawaya suna da damar arearin fa'idodi na zamantakewa tare da daidaitattun - biyan fansho, biyan diyya, tafiye-tafiye kyauta, da sauransu.
Cutar sankarau koyaushe tana haifar da rikice-rikice. Wuce kima sugar yana da matukar hadari.
Aronova S.M. ya ba da bayani game da lura da ciwon sukari. Karanta cikakken
Wanene amfanin?
Don sanya nakasa yana buƙatar binciken likita da zamantakewa. An tabbatar da rashin ƙarfi idan mai haƙuri ya canza ayyukan gabobin ciki.
Mai bayarwa ya ba da izinin halartar likita. Marasa lafiya tare da ciwon sukari na rukunin 1 ana sanya nakasa saboda ƙarancin cutar, da kuma yanayinta. A cikin marasa lafiya da ke fama da ciwon sukari na 2, raunukan ba su da rauni sosai.
An sanya rukunin nakasa idan aka bayyana:
- makanta masu ciwon sukari
- inna ko ci gaba ataxia,
- m take hakkin halayyar hankali a kan asalin masu ciwon sukari encephalopathy,
- mataki na uku na rashin karfin zuciya,
- bayyanuwar 'yan dabarun ƙananan hanyoyin,
- ciwon sukari da ke fama da cutar siga
- na kullum na koda gazawa a cikin tashar mataki,
- akai-akai rashin jini na jini.
An sanya rukuni na biyu na nakasassu a makasudin makanta na cutar sankarau ko maƙarƙashiyar daga digiri na 2 zuwa na 3, tare da gazawar renal a cikin ƙarar matakin.
An ba da ƙungiyar rashin ƙarfi III ga marasa lafiya da cutar mai rauni na matsakaici, amma tare da rikicewar rikice-rikice.
Ta yaya girman amfanin ya canza a cikin shekaru 3 da suka gabata?
A cikin shekaru 3 da suka gabata, yawan fa'idodi sun canza yayin yin la'akari da matakin hauhawar farashin kaya, yawan masu haƙuri. Amfanin gama gari ga masu ciwon sukari sun hada da:
- Samun magungunan da suka wajaba.
- Fensho bisa ga rukunin nakasassu.
- Fitowa daga aikin soja.
- Samun kayan aikin bincike.
- 'Yancin yin bincike kyauta game da gabobin da ke cikin tsarin endocrin a cikin cibiyar kwantar da cutar ta musamman.
Ga wasu ɓangarorin ɓangarorin Federationungiyar Rasha, ana ba da ƙarin fa'idodi ta hanyar halartar aikin jiyya a cikin wuraren shakatawa-irin, kamar haka:
- Rage takardar kudi ta amfani da kashi 50%.
- Izinin haihuwa ga mata masu ciwon suga yana ƙaruwa ne kwanaki 16.
- Measuresarin matakan tallafi a matakin yanki.
Nau'in da lambar magunguna, harma da kayan aikin bincike (sirinji, rarar gwaji), an ƙaddara ta likita mai halarta.
Menene girman fa'idodi ga marasa lafiya da masu ciwon sukari a cikin 2019
A cikin 2019, masu ciwon sukari na iya ƙidaya ba kawai akan fa'idodin da ke sama ba, har ma da sauran tallafi na zamantakewa daga jihar da ƙananan hukumomi.
Fa'idodi ga marasa lafiya da masu nau'in 1 masu ciwon sukari:
- Bayar da magunguna don maganin cutar siga da kuma tasirin sa.
- Kayan asibiti don allura, gwargwadon matakin sukari da sauran hanyoyin (tare da ƙididdigar bincike sau uku a rana).
- Taimako daga ma'aikacin zamantakewa.
Fa'idodi ga nau'in ciwon siga 2:
- Sanatorium magani.
- Tsarin kyautata rayuwa.
- Canjin sana'a kyauta.
- Classes a kungiyoyin wasanni.
Baya ga tafiye-tafiye kyauta, masu fama da cutar malaria ana biyansu ta:
Magunguna kyauta don kula da rikice-rikice na ciwon sukari suna cikin jerin fa'idodi:
- Phospholipids.
- Taimako na cututtukan farji.
- Bitamin da kuma bitamin-ma'adinai hadaddun.
- Magunguna don dawo da cuta na rayuwa.
- Magungunan Thrombolytic.
- Magungunan zuciya.
- Diuretics.
- Yana nufin don lura da hauhawar jini.
Baya ga magunguna masu rage sukari, ana baiwa masu ciwon suga karin magunguna. Marasa lafiya da ke ɗauke da ciwon sukari na 2 ba sa buƙatar insulin, amma sun cancanci glucometer da matakan gwaji. Yawan tsararrakin gwajin ya dogara ne akan ko mara lafiyar yana amfani da insulin ko a'a:
- don insulin dogaro da kara matakai na gwaji 3 a kullum,
- idan mara lafiya baya amfani da insulin - 1 tsiri gwajin yau da kullun.
Ana bai wa marasa lafiya da ke amfani da insulin allurar cikin allurar da suka wajaba don gudanar da maganin yau da kullun. Idan ba a yi amfani da fa'idodin ba a cikin shekara guda, mai ciwon sukari zai iya tuntuɓar FSS.
Kuna iya ƙin kunshin rayuwar jama'a a farkon shekara. A wannan yanayin, ana biyan kuɗi. An tara kuɗi mai dunƙulewa har shekara guda, amma a zahiri ba lokaci ɗaya bane, tunda ana biya ta kashi-kashi a cikin watanni 12 na ƙari game da fensho na nakasa.
A shekara ta 2019, ana shirin biyan kuɗaɗen masu zuwa ga masu ciwon sukari:
- Rukuni na 1: 3538.52 rub.,
- Rukuni na 2: 2527.06 rub.,
- Groupungiyoyi 3 da yara: 2022.94 rubles.
A shekara ta 2019, ana shirin nuna alamun biyan kuɗi da kashi 6.4. Za'a iya samun ƙarshen fa'idodi a cikin reshen ƙasa na FIU, inda ake buƙatar aiwatarwa don ƙirar sa.
Za'a iya sauƙaƙa hanyar da ake buƙata don fa'idodi ko diyya ta hanyar tuntuɓar cibiyar lamuni mai yawa, ta hanyar gidan waya ko kuma hanyar tashar jama'a.
Keɓaɓɓen bayarwa na zamantakewa fakiti ga yara tare da ciwon sukari:
- wurin kiwon lafiya sau ɗaya a shekara,
- mituttukan glucose na jini kyauta tare da barcode, almarar sirinji da magunguna waɗanda ke rage sukarin jini.
An bai wa mata masu juna biyu da masu cutar siga ƙarin kwanaki 16 su bar don kula da yaransu.
Yadda ake samun fa'idar cutar kanjamau a shekarar 2019
Don samun fa'idodi ga masu ciwon sukari, dole ne a sami takaddun takaddun da suka tabbatar da rashin ƙarfi da rashin lafiya. Kari akan haka, ya zama dole a samar wa jami'an tsaro na zamantakewar su takardar shedar a cikin lamba No. 070 / у-04 ga manya ko No. 076 / у-04 ga yaro.
Bayan haka, an rubuta wata sanarwa game da samar da maganin sanatorium-wurin shakatawa ga Asusun Inshorar zamantakewar jama'a ko ga duk wata hukumar tsaro ta zamantakewa da ke da yarjejeniya tare da Asusun Inshorar zamantakewa. Dole ne a yi wannan kafin 1 ga Disamba na wannan shekara.
Bayan kwanaki 10, amsar ta zo don samar da izini ga sanatorium wanda ya dace da bayanin kulawar jiyya, yana nuna ranar isowa. An bayar da tikiti da kansa a gaba, bai wuce kwanaki 21 kafin zuwa ba. Bayan jiyya, ana ba da katin wanda ke bayyana yanayin mai haƙuri.
Documentsarin takardu don fa'idodi:
- fasfot da kwafi biyu daga ciki, shafi na 2, 3, 5,
- a gaban nakasassu, tsarin gyara mutum a cikin adadin kwafi biyu wajibi ne;
- kofe biyu na SNILS,
- takardar sheda daga Asusun fansho wanda ke tabbatar da wanzuwar fa'idantun tallafi na kudin bana, tare da kwafin sa,
- takaddun shaida daga likita na lamba No. 070 / y-04 na manya ko No. 076 / y-04 don yaro. Wannan takardar shaidar tana aiki ne kawai tsawon watanni shida!
Don samun magani kyauta, kuna buƙatar takardar sayen magani daga endocrinologist. Don samun takardar sayan magani, mai haƙuri dole ne ya jira sakamakon duk gwaje-gwajen da ake buƙata don kafa ingantaccen ganewar asali. Dangane da nazarin, likita ya fitar da jadawalin magani, ya ƙayyade sashi.
A cikin kantin magani na jihar, ana bai wa mai haƙuri magunguna a cikin adadi da aka tsara a cikin takardar sayan magani. A matsayinka na mai mulkin, akwai isasshen magani na wata daya.
Don karɓar takardar shaidar likita don tawaya ga yaro, ana buƙatar waɗannan takaddun masu zuwa:
- aikace-aikacen ɗan ƙasa (ko kuma wakilin sa na shari'a),
- fasfot ko wasu takaddun shaida don 'yan ƙasa daga fasfo na 14 shekara (na mutanen da ba su wuce shekara 14 ba: takardar shaidar haihuwa da fasfo ɗaya daga cikin iyayen ko mai kula da su),
- takardu na likita (marasa lafiya na asibiti, sakin asibiti, R-hotuna, da sauransu),
- magana game da likita daga likita (Tsarin Lambar 088 / y-06), ko sanarwa daga ma'aikatar lafiya,
- kwafin littafin aikin wanda aka samu da kwastomomin ma'aikata don 'yan ƙasa masu aiki, iyayen marasa lafiya,
- bayani kan yanayi da yanayin aiki (don yan kasa masu aiki),
- takaddun ilimi, idan akwai,
- halaye na ayyukan ilimi na ɗalibin (ɗalibi) wanda aka aika zuwa gwajin likita da zamantakewa,
- idan akai akai na jarrabawa, takardar tawaya,
- idan ana sake yin nazari, a sami shiri na mutum tare da bayanan abubuwan aiwatarwa.