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::

380 million people

will suffer from

Diabetes world-wide

by 2025

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 Need:The Need:

50% to 80%50% to 80% of these of these legs can be legs can be SAVEDSAVED

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

ROTARYROTARYHumanity in Humanity in

MotionMotion

INTERNATIONAL

Rotary District 1100

Thank you for your interest

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www.ledbury.rotaryweb.org