More than one million diabetics worldwide lose at least a leg annually. In The Bahamas, with 13.6 percent of the Bahamian population suffering from diabetes, the country is at an epidemic status, according to Ministry of Health statistics, with at least 1,000 people undergoing amputation each year. But with the shift in podiatry worldwide, the shift has moved towards prevention.
“Attention is being drawn to the awareness of foot health in relation to general awareness, followed by access and action,” said Dr. Danny Johnson, consultant podiatric surgeon in public health and consultant at the Foot and Ankle Institute, as the Bahamas Medical Podiatric Association hosts the conference “New Hope for the Diabetic Foot,” October 24-26 at the University of The Bahamas (UB) media room and the Meliá Resort.
“All around the world, the diabetic foot has become a crisis due to the cost of not just medical amputations, it’s a human cost as well, because these people become dependent on the National Insurance Board (NIB), lose their livelihood and families, so the action is towards prevention. Podiatry is shifting its focus from cutting people to saving limbs – shifting focus from the old idea. The new technology that Atlas Foot Alignment Institutes (Atlas FAI) and my techniques are bringing to The Bahamas tells us that 90 percent of limbs can be saved,” said Johnson.
“So, the action is towards prevention [and] not what we’ve been doing – these fancy procedures that they can’t afford, and we can’t afford. The focus is on the power of prevention in preventing crisis of the diabetic foot.”
In that vein, a podiatric team led by Johnson has undertaken the task of training medical staff and nurses around the country to assist in helping to stave off the increase in diabetic-related amputations in The Bahamas as a part of the Fix My Feet campaign. The training is for a protocol on screening. Johnson said as with breast cancer screenings, early detection of foot issues gets great results.
“A 60-second screening tool, spread all around The Bahamas, tells us people’s risk factors – low, medium or high – and high risk have to be paid special attention to, the other’s get screening and encouragement to be screened every year,” he said.
Since April, the team has successfully trained nurses on Abaco, Grand Bahama and The Berry Islands. The training takes place over three days which is followed up with a practical hands-on session six weeks later.
“The doctors in those settings are now able to recognize and treat a number of diabetic foot complications and they now have access to a team that specializes in amputation prevention, shifting focus from cutting people to saving limbs.”
The training is expected to continue with medical personnel on Cat Island, Exuma and Eleuthera.
Johnson said a handle can be gotten on the diabetic foot issue.
In an effort to get it right, Johnson also noted that the South Beach Clinic now has an amputation clinic where the focus is on amputation prevention.
“We can get this right – reduce morbidity, mortality, cost and life and limb loss,” he said.
Foot and ankle surgeons will participate in the conference to train and update staff, as well as do an update for storm survivors who need to have any sort of work done.
At last year’s Bahamas Podiatric Medical Association conference, international podiatrists Dr. Victor Horsely of Belleville, Illinois, and Dr. Stan Kalish of Jonesboro, Georgia, showed medical professionals how feet can be saved from amputation with cutting edge medical procedures. They have returned again with an additional eight podiatrists for this year’s conference.