The Health Authority in Anguilla has embarked on a programme to train nurses and community health aides to assist in assessing and caring persons with diabetic feet. Medical Air Services Association (MASA) in Anguilla has been the largest contributor in funding the purchase of the necessary equipment. The other sponsors are the Diabetes Association and the Ministry of Social Development.
Mr. Owen Bernard with Nurses and foot care assistants
“Thirteen persons both from the public and private sectors have been trained to assess the diabetic feet,” Director of Nursing Services, Venetta Connor-Webster, told The Anguillian at one of the training sessions this week at The Valley Health Centre. “As part of the ongoing programme, earlier this year MASA gave us money for five screening health fairs and now that we have thirteen persons trained, we are going to bring foot-care assessment as part of our screening of diabetics. We normally have testing at the health fairs for free blood pressure, blood sugar, cholesterol and prostate cancer, and now we are incorporating foot-care assessment.”
The Director of Nursing Services said it was a week-long training programme for the Foot Care Assistants. In addition to receiving certificates, they were required to sign a code of ethics, and their licence to practice is to be renewed each year in Jamaica. “The work is part of our non-communicable disease programme at the Health Centre,” she continued. “Foot care is one aspect of taking care of diabetics. Diabetes affects the heart, eyes, kidneys and feet and this is just one part of it.”
MASA Country Manager in Anguilla, Donald Curtis, spoke about the company’s involvement in various local health fairs. He said the company was later approached by the Director of Nursing Services, and PAHO representatives, to assist with helping to prevent the ravages of diabetes which can affect the feet.”It is one of the biggest and the first problem that people experience and if you can prevent, or at least contain, problems of the feet, you can help control the ravages of diabetes,” Curtis stated.
Nurse Smith and Mr. Bernard (along with Mr. Curtis) with patient receiving foot care
“The problem they were having in Anguilla is that some people were trained, but the equipment needed to facilitate that training, was not available. That has been a big drawback. We were asked if we could assist with the equipment while they bring in the professions.” He said that MASA and the Diabetes Association sent the money for the equipment, most of which was now on the island.
Owen Bernard, a UK-trained Podiatrist, who deals exclusively with ailments of the feet, was in Anguilla several days ago assisting with the practical training of the foot-care personnel. Mr. Bernard is CEO of the Jamaica Chapter of the World Walk Foundation, an American organisation which deals specifically with foot health.
“I am on the Board and we have been working together for the past fourteen years,” architect of the Foot Care Programme in Jamaica went on. “We decided that it is time to have a chapter formally registered in Jamaica and we are going to facilitate the training of Foot Care Assistants because we see the need, not just here in Anguilla, but other countries have requested our services; so it is a world-wide foundation.
“In 2000, we came up with a plan to train people at primary care level to deal with those foot problems that seem to be causing a lot of problems.When somebody goes to a hospital to have an amputation done, it is not something that is arrived at overnight. It started somewhere and it is the simple things that we take for granted. I have seen a lot of those problemsthat cause so much distress to people. The amputation might be necessary, but the whole idea is to improve people’s quality of life. Hence the foot-care programme. “We realise we need not only to train people, but to give them the tools to do the job. A case where somebody with a foot condition is diabetic is a disaster in the making if it is left unchecked. Bad nail conditions wreak havoc on people’s toes, so with the right tools and the basic training you can reduce risks. At the end of the day, what we are trying to do is to reduce the risk of amputation. “The International Diabetes Federation reported in 2005 that every thirty seconds a lower limb is lost as a result of diabetes. We need to stop that…We need to go back to basics so these simple interventions [are important] and the results are most immediate…[By] having this training done now, not just in Jamaica, where we started the programme, but around the Caribbean, we can have formal foot care clinics.”
Staff Nurse at the Welches Polyclinic, Vesta Smith, who is one of the Foot Care Assistants, said, as she attended a patient’s feet, that the primary health-care service was one of the programmes she had seen coming for a long time. “Let’s take it and run with it,” she added.