The objective of the project is to reduce the high rates of major amputations due to diabetes by building capacities within diabetic foot care and establishing regional foot clinics.
Expected impact
Reduce the rate of major amputations among patients admitted with diabetic foot complications from 38% to below 10%
20 new diabetic foot clinics established
240 health care personnel trained in diabetic foot care
10,000 foot patients treated
Results to date
11 diabetic clinics have been established. Foot care equipment has been purchased for 11 clinics.
240 health care staff (98 doctors, 116 nurses and 26 paramedics) have received training diabetic foot care (phase 1) . 56 health staff ( 10 doctors, 36 nurses and 10 paramedics) of these have received hands on clinical training as part of 2nd phase.
14,587 diabetic foot patients have received diabetic foot care and wound dressing at the established clinics.
Project details
People with diabetes are at much higher risk of having limbs amputated than people without diabetes. Some estimates indicate a 25 times higher risk.
With an estimated number of 246 million people having diabetes worldwide a lot of people are at high risk of amputation as well as the socio-economic adversities often succeeding a limb amputation.
In Sudan, around 38% of the patients admitted to hospitals with diabetic foot complications end up having a major, lower extremity amputation, while 12% die. The problem is aggravated by the lack of diabetic foot care in many areas of the country, requiring people to travel very far to get treatment for their diabetic foot complications.
Approach
The Jabir Abualiz Diabetic Centre (JBC) is the main implementing partner on this project, but the Federal Ministry of Health and the State Ministries of Health will also contribute and are responsible for the long-term sustainability of the project.
Ten diabetes and diabetic foot clinics will be established within existing health facilities in different parts of Sudan. In order to staff these clinics with multidisciplinary teams who can provide high quality services, 240 health care personnel - 24 for each clinic - will be trained.
The multidisciplinary teams will comprise of doctors, nurses, podiatrists, orthotists, dieticians, diabetes educators and social workers. They will be trained in the field of diabetic foot care including screening of high risk patients, podiatry care, patient education, and wound dressing.
The duration of the training is one month. During this month, the participants will be attached according to their specialities to the various units of Jabir Abualiz Diabetic Centre in Khartoum. The training will enhance the participants' knowledge of diabetic foot care and hands-on training before they initiate their work at the diabetes clinics. Upon completion of the training, the teams are provided with the basic equipment required to commence the foot care clinic.
The training of all of the 240 health care personnel will take approximately two years, with 20 health care professionals being trained each month.
The multidisciplinary teamwork constitutes a central element of the project approach with the underlying premise that when various health care professionals collaborate on caring for a patient, the services the patient receives are likely to be more integrated and the course of the treatment will be improved. The importance of multidisciplinary work will be stressed throughout the training and in the subsequent work at the clinics.
Once up and running, the clinics will provide screening and care to people with diabetes and thereby reduce the number of amputations and other complications due to diabetes.
