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INTERNATIONAL
Rotary District 1100
Presentation toPresentation to
Caribbean Rotary ClubsCaribbean Rotary Clubs
by by Rotary Club of LedburyRotary Club of Ledbury August 2008 August 2008
CaribbeaCaribbeann
Diabetic Diabetic Footcare Footcare
ProjectProjectA humanitarian programme by A humanitarian programme by the Rotary Club of Ledbury the Rotary Club of Ledbury
and the International Diabetes Federationand the International Diabetes Federation
INTERNATIONAL
Rotary District 1100
The BackgroundThe Background::
World-wide,
Diabetes kills
more people than
HIV/AIDS and
Malaria combined
The BackgroundThe Background::
20% suffer from 20% suffer from
Diabetes in the Diabetes in the
Caribbean islands Caribbean islands
Caribbean amputation Caribbean amputation
levels are among the levels are among the
highest in the world…highest in the world…
The Need:The Need:
Diabetes Diabetes is a killer… and is a killer… and amputation amputation leads to deathleads to death
DIABETES CAN RESULT IN FOOT AMPUTATIONS DIABETES CAN RESULT IN FOOT AMPUTATIONS UNLESS REGULAR SCREENING AND SIMPLE TREATMENT IS UNLESS REGULAR SCREENING AND SIMPLE TREATMENT IS
PROVIDEDPROVIDED
DIABETESDIABETESCauses circulation problems especially in feetCauses circulation problems especially in feet
Affects nerve endings resulting in loss of feelingAffects nerve endings resulting in loss of feeling ↓↓
RESULTRESULT Patient cannot feel minor skin problems Patient cannot feel minor skin problems
eg splinter thornseg splinter thorns↓↓
The minor skin problem becomes ulceratedThe minor skin problem becomes ulcerated Regular screening
↓
Skin problems treated to allows
ulcers to heal
↓
Foot saved
Untreated
↓
The ulcerated skin develops gangrene
↓
Amputation is the only solution
The PatientsThe Patients::
Lose two Lose two legs…legs… 18-month life 18-month life expectancyexpectancy
The Need:The Need:
Ledbury Rotary Ledbury Rotary Club identified Club identified the need for the need for action during a action during a social visit by John social visit by John Greedy to TobagoGreedy to Tobago
The PatientsThe Patients::
Lose one leg – Lose one leg – 61% die61% die in 5 in 5 yearsyears
30%30% lose other leg lose other leg
The PatientsThe Patients::
Lose two legs -Lose two legs - The patient will The patient will only have anonly have an 18-month life 18-month life expectancyexpectancy
The Community Cost:The Community Cost:
The cost of the loss The cost of the loss of a single limb is of a single limb is
US$50,000 to US$50,000 to US$86,000US$86,000
(Dr Karel Bakker IDF)(Dr Karel Bakker IDF)
The Price:The Price:
The proven cost to save The proven cost to save a limb is a limb is US$300 - US$300 - US$900US$900
(Tobago data)(Tobago data)
The Strategy:The Strategy:
Ledbury and Tobago Ledbury and Tobago Rotary Clubs entered Rotary Clubs entered into a joint projectinto a joint project
Working together to Working together to provide simple and provide simple and effective interventioneffective intervention
How it Works – Who does How it Works – Who does What:What:Ledbury clubLedbury club: provides facilitators, : provides facilitators, co-ordinators, marketing, raises co-ordinators, marketing, raises fundsfunds
Caribbean clubCaribbean club: provides local : provides local leadership, community & medical leadership, community & medical links, clinical supportlinks, clinical support
Canadian Footcare SpecialistsCanadian Footcare Specialists: Train : Train local staff, treat patients, record results, local staff, treat patients, record results,
What does the project do?What does the project do?
Raises awareness of diabetesRaises awareness of diabetes Wins community confidenceWins community confidence Trains local staff in modern Trains local staff in modern techniquestechniques Local tutors then expand the Local tutors then expand the serviceservice
The Outcome – 2000-2006:The Outcome – 2000-2006:
Following a four-year Tobago Following a four-year Tobago pilot scheme…pilot scheme…
Two weeks community training Two weeks community training programme annuallyprogramme annually
Three dedicated footcare clinics have been established
The Outcome – 2000-2006:The Outcome – 2000-2006:
3,750 patients treated
35 staff trained
54% fewer amputations
Progress to 2007Progress to 2007
2006… Theproject is adopted and partially funded by Government of Trinidad & Tobago
Progress to 2007Progress to 2007
2007… The TTGovernment extended the Projectto the island of Trinidad
The future?The future?
Nine more Caribbean Rotary Clubs have declared a need and asked to join the project
Montserrat, Nevis, Dominica, Barbados, Guyana, St Kitts, St Lucia, Grenada, St Maarten
This Footcare Project is
The Footcare Project is:
Simple Effective Low cost Proven and sustainable Rewarding
IT SAVES LIVES AND FAMILIES
Simple
Effective
Low cost
Proven and sustainable
Rewarding
IT SAVES LIVES AND FAMILIES
The Project has won RIBI Awards
“Ordinary Rotarians doing
Extraordinary things”and
“International Service”
and it is endorsed by leading academics
Professor David Armstrong Dr Karel Bakker
Professor Andrew Boulton
The futureThe future
Add new training teams
More funding
Involve new Rotary Club partners
Partnership with International Partnership with International Diabetes Federation (IDF)Diabetes Federation (IDF)
Our Partners, IDFOur Partners, IDFInternational Diabetes Federation
QUOTE
“This project is wonderful example of how a small group of
committed people can make a significant
difference to the lives of people living with
diabetes”.Dr Karel Bakker
Chair IWGDF section of IDF
Our Partners, IDFOur Partners, IDF
QUOTE
“Diabetes deaths equal HIV-AIDS and Malaria combined…
…It is worst in low-and middle-income
countries……Lack of education
and care”.
Rotarian Martin Silink President of
International Diabetes Federation
andChair of Rotary International
Diabetes Action Group
The IDF/Rotary The IDF/Rotary partnershippartnershipInternational Diabetes Federation
On February 14, 2008 talks between Ledbury
Rotary Club and the IDF were started…
…leading to our international
agreement and partnership
The partnership will merge the IDF’s STEP-by-STEP programme
(India; Sri Lanka; Bangladesh; Tanzania; Pakistan; Egypt)
with the Rotary (Caribbean) programme
expanding the life-saving project intoother Caribbean islands
and South American countries
The IDF / Rotary The IDF / Rotary PartnershipPartnershipInternational Diabetes Federation
A memorandum of agreement has been reached between the
new partners with the IDF offering a start-up matching grant
of US$80,000
The IDF / Rotary The IDF / Rotary PartnershipPartnershipInternational Diabetes Federation
Caribbean Rotary clubs can provide
• local leadership•community links•medical links
to ensure that this life-saving programme is sustained and grows
The IDF / Rotary The IDF / Rotary PartnershipPartnershipInternational Diabetes Federation
Survey forms are being sent to Caribbean Rotary Clubs
and Health Authorities
to confirm the need and maintain the project on a professional and
scientific basisAugust 2008
The IDF / Rotary The IDF / Rotary PartnershipPartnershipInternational Diabetes Federation