A Unique Continuing Education Mission Opportunity To Improve Diabetic Foot Care In Haiti

I love it when solutions to problems evolve naturally and you get the “light bulb” appearing above your head. I have been working on a solution for the Haiti Diabetic Foot Program located in the Hospital Bernard Mevs Project Medishare Program in Port-au-Prince, Haiti for some time. This is a comprehensive diabetic foot program run by Haitians for Haitians and supported by doctors from the United States.

Since I am in private practice, I am limited to two to three trips to Haiti per year. The key component to a program like this is continued sharing of education and experience in one-on-one or group settings with the educators in Haiti. It is not a one-time thing. It takes multiple visits and working together side by side. I have gone through a similar program development with the Haitian Clubfoot Program, serving as the program's Director of Education.

The diabetic foot program in Haiti faces some limitations for sure with the primary limitation being a lack of reconstructive vascular surgery. Due to this fact, functional amputations, preserving as much of the limb as possible, are the reality. Of course with a comprehensive preventative program, we hope to lower the overall rate of amputations significantly, especially below-the-knee amputations.

The idea I had was to start a continuing education/fellowship program that takes place partially in Haiti and partially in Indiana. The term “fellowship program” is a difficult one as the Council on Podiatric Medical Education is the only organization that can certify a fellowship program and due to the international component of this program, it is not possible to obtain such certification. Recognition of a program is nothing more than a piece of paper but an important one, I believe. I have approached two international organizations for recognition of the program and the American Society of Podiatric Surgeons has agreed to recognize the program as an International Podiatric Medical and Surgical Mission Program.

The structure of the program is one year in length with two physicians who rotate every two months between Haiti and Indianapolis. While in Haiti, the rotating physician will be working side-by-side with the Haitian physicians, nurses and medical personnel to teach, operate and treat. They will help establish the comprehensive diabetic foot program including wound care, surgery, routine diabetic foot care, an orthotic program and diabetic foot exams. Research opportunities abound in the program and will occur accordingly. Additionally, the physician will work on grant submissions to obtain funding for patient care, supplies, surgical and program administrative costs.

While in Indiana working directly with me, the physician will receive training in all aspects of podiatric reconstructive surgery, especially pediatrics. Additional research opportunities, including a sports medicine related research project, will be available in this setting.

My initial call to duty was to get the word out and the response has been very encouraging. Seeing so many recent residency program graduates willing to give a year of service for such an important project is inspiring. The opportunity in Haiti is significant but this may also lead to other opportunities in developing countries worldwide. There is a growing, palpable excitement about this program. This is rare opportunity in which a few people can affect a developing country for the better.

As Gandhi said, “Be the change you want to see in the world.” So I ask you: do you want to change the world? If so, email me at padeheer@sbcglobal.net to find out more.



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