The Ministry of Health is moving to decentralise its Diabetic Foot Project, which is responsible for a 42% reduction in diabetes-related amputations at the public hospital.
The project, which was successfully piloted at the Georgetown Public Hospital close to two years, will be targeting some 15,000 patients as it enters its second phase. There is a growing diabetic population and many are in need of foot care.
Health Minister Dr. Leslie Ramsammy signed a memorandum of understanding with officials from the Canadian Association of General Surgeons (CAGS) for Phase Two of the foot project to be rolled out across the country over the next three years. The Canadian International Development Agency (CIDA) has contributed G$100M to the second phase of the project and had previously supported the pilot model.
Phase Two of the project is to be implemented in regions 2, 3,4,5,6 and 10, with the aim of creating a sustainable, cost-effective and multi-level diabetes foot prevention programme. It will also add training in blood sugar and blood pressure control, which together with foot care, are the highest development priorities for diabetes control in developing countries.
The goals of the second phase include targeting some 15,000 diabetic patients; training 300 health care workers in level-specific education; rehabilitation and supply of the seven new regional diabetic foot centres in regional hospitals or other public health facilities and developing and applying training modules in diabetic education and glycemic and blood pressure control for local health professionals.
Medical Director at the public hospital Dr. Madan Rambarran pointed to the success of the initial phase of the project, saying the impact has been tremendous. He said diabetic foot care had been an issue prior to the first phase, noting that diabetic patients had occupied one third of surgical beds in the hospital. According to him, a Centre for Excellence for Diabetic Foot Care was established at the hospital and it is currently serving patients.
To date, some 1200 patients with high risk status and diabetic complications have been screened and treated at the centre. Ramsammy underscored the growing number of diabetic patients in the country and he stressed that heavy focus need to be placed on prevention strategies. He said over $400M is spent annually on medicines and commodities to treat diabetic patients, adding that more than 13 percent of the budget goes towards the care and treatment of diabetes and hypertension.
He stressed the extent of the problem should not be underestimated.
He pointed to the issue of obesity in the population, saying that more than a third of the Guyanese adult population is obese. “We have to do something about it,” Ramsammy said and he stressed that people need to make an effort to control their weight. He mentioned too that many diets also leave people predisposed to chronic diseases.
The Minister said further that early diagnosis poses a huge challenge to the sector. He noted that the health sector needs to develop the capacity to screen and diagnose diabetic patients early. “We have to target and empower people living with diabetes so that they can prevent for a long time any diabetes- related complications,” Ramsammy said. According to him, the goal is to eliminate amputations as a major consequence of diabetes.
Ramsammy said too that it costs around US$2,000 for a stay of about three days for a patient at the public hospital, and this he said does not include the cost of operating the theatre. He noted that some patients would spend longer in hospital than others such as diabetic surgical patients. Dr. Brain Ostrow of CAGS is the project coordinator and he travelled here a few days ago to discuss the project with various stakeholders. He said that Canadian consultants are expected to visit the country for training programmes over the next few years, but stressed that Guyanese are in the forefront of the initiative. A project manager was recently hired and a project office has also been designated.
