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Diabetes foot care: Ignorance, poor referral fuel diabetic limb amputations in Nigeria

Stakeholders have called for more awareness and capacity building to tackle the increasing prevalence of diabetes and its complications even as they identified ignorance and lack of prompt referral as factors fueling amputation among diabetic patients. The experts who gathered at the 5th annual International Podiatry and Diabetes Foot Care workshop organised by Rainbow Specialist Medical Centre, a private hospital with focus on the management of diabetes and other endocrine and metabolism conditions, in partnership with the World Walk Foundation, Jamaican Chapter, regretted that the podiatry medicine which supposed to focus on foot and ankle disorders are not taught in any Nigerian Universities. Speaking during the opening ceremony of a week-long workshop, the Workshop Coordinator, Dr Afokoghene Rita Isiavwe, said more Nigerians are losing their limbs to diabetic foot ulcer, a major complication of diabetes mellitus. She disclosed that the situation has become worrisome in Nigeria due to ignorance of both the affected individuals and the delay by medical personnel caring for them to refer them to appropriate centres where they can be properly managed. “These delays in presentation often times lead to amputations as a means of saving the person’s life or even death,” she said. Isiavwe disclosed that diabetes mellitus is the leading cause of non-traumatic lower limb amputation worldwide, including Nigeria. Unfortunately, she said, podiatry, a specialised branch of medicine that focuses on foot and ankle disorders, which is relevant in the care of persons living with diabetes mellitus is currently not taught in Nigerian universities hence, the introduction of the annual podiatry workshop by Rainbow Medical Centre to fill the gap. She told the participants and guests that the Centre had, in the last five years, been building local capacity to improve management and prevention of diabetes foot complications while also raising awareness on proper foot care in persons living with diabetes mellitus in the country. This, she further said, had been achieved through regular interactive workshops to provide needed training for doctors and other health workers with support from the World Diabetes Foundation Project, the Diabetes Podiatry Initiative Nigeria and training faculty from the American Podiatry Institute. “This year, we commence a formal certification course to train foot care assistants. The international training faculty is from the World Walk Foundation, Jamaican Chapter. Their collaborative efforts with The Jamaican Ministry of Health over The years with their ‘Special Certification Course to train Foot care Assistants’ has been making a posistive difference in saving diabetes feet in Jamaica. We hope to repeat same in. Nigeria.” In his speech, the Founder, World Walk Foundation Jamaican Chapter, Owens Bernard told the audience there was no podiatrist in Jamaica 25 years ago and foot care was therefore not on the raider in the country at that time. The situation, he said, had changed with the intervention of the World Walk Foundation through partnership with the country’s ministry of health which trained health workers and provided them with basic foot care tools “We need to prevent amputation, no matter what stage it is. We need to focus on the simple things that lead to amputations.
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We need to go to the primary care level and this starts with education. “We are here not to tell you what to but to share with you our experience and knowledge so you can prevent amputations in the interest of humanity,” he said. The Chairman of the occasion, Dr. Adeyemi Johnson, a cardiologist and vascular specialist, stressed the need for Nigeria to seriously consider measures aimed at reducing the rate of amputation in the country especially among the underprivileged. He noted that the management of diabetes and its complications could be very expensive, especially when complications such as diabetes foot set in. The burden, he however said, could be greatly prevented through awareness and enlightenment of the public. This, he said, remains the cheaper way out for the underprivileged that cannot afford the cost of management of diabetes foot complication and prevent amputations or death.

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