WELCOME TO THE WEBSITE OF THE GUYANA DIABETIC FOOT PROJECT - PHASE 2
The photo below is an example of the all too common problem of the Diabetic Foot in Guyana - infection associated with gangrene requiring at least local amputation for limb salvage. This is what the Phase-1 Project was designed to prevent and treat. And we have been successful! In the first 2 years of the Project the diabetes related major amputation rate at the Georgetown Public Hospital Corporation, the national referral hospital in Guyana, has been reduced by 42%.
Please stay tuned as we prepare to tell you the story of Phase 1 and to discuss how we will expand these benefits in Phase 2
Guyana Diabetic Foot Project Team
A SUMMARY OF THE PHASE 1 PROJECT
The Guyana Diabetic Foot Project in collaboration between
Canadian and Guyanese health professionals, aimed at creating a comprehensive
diabetic foot care clinic at Georgetown Public Hospital Corporation (GPHC), the
national referral and training hospital in Guyana,
South America. The Project developed out of
the Canadian Association of General Surgeons (CAGS) supported University of Guyana
Postgraduate Diploma Course in Surgery, the first postgraduate medical
training program in Guyanese history.
At the 2006 Bethune Roundtable, Dr. M. Rambaran, Director of Medical and
Professional Services at GPHC reported that diabetic foot complications were
the single (10%) most common reason to be admitted to a surgical ward at GPHC,
most a result of severe infection. Forty-two percent of these patients went on
to have an amputation, ½ of which were major amputations. This is part of the
world pandemic of type II diabetes.
As part of CAGS’ mentorship program, Dr. Brian Ostrow visited GPHC and
carried out a needs assessment on diabetic foot care in January 2007. He
interested Dr. Gary Sibbald, (Director of the Wound Healing Clinic, Women’s
College Hospital, Professor at the Dalla Lana School of Public Health in
Toronto), a world authority in wound care. After a year of planning, in
February 2008, GPHC was awarded a $97,460 grant from the Canadian Caribbean
Cooperation Fund (CIDA), as the Canadian government’s contribution to a $150,000
18 month project.
The Project, which completes its second year of activity in May 2010,
uses multi-level, longitudinal, primary and secondary education strategies to
create an evidence-informed, interprofessional, patient-centered diabetic foot
clinic at GPHC. Three Canadian expert visits, modeling interprofessional care,
have taken place. Eight Guyanese key opinion leaders, chosen to lead the local
work, have completed or are completing the International Interprofessional Wound Care Course from
the University of
Toronto. The project has
trained over 65 Guyanese health professionals in applying the Best Practice
Recommendations of the Canadian Association of Wound Care to their local
The Diabetic Foot Centre (DFC) opened in July 2008. Both prevention and
treatment components of comprehensive care are promoted. A specific 60 second
screening tool, created to identify high risk status, has been adopted by the
Ministry of Health. In the first 18 months over1200 persons with diabetes have been
screened. Over 1400 high risk and ulcer patients have been seen in the centre.
Preliminary data show a dramatic outcome.
In the first 21 months of DFC operation, the
number of patients having diabetes-related major amputations was reduced by 42%
compared to the three previous years!
The Project works closely with the Ministry of Health to create
sustainable new capacity inside the public health system. It declared the DFC,
a Centre of Excellence in diabetic foot care, in November 2009. The next step
was to create a national program.
CAGS has recently received funding from the Partnership Fund of Canadian
International Development Agency (CIDA) for a 3 year $840,000 (CIDA
contribution $500,000) project to regionalize diabetic foot care. This Phase 2
project will target ½ of the country’s 37,000 people with diabetes and train
353 local doctors, nurses, medexs, rehab specialists and community health
workers to provide comprehensive care, including glycemic and anti-hypertensive
therapy along with foot care – recognized high priorities for diabetes control.
This Project may serve as a model for other collaborations between
Canadian and International health professionals.