Caribbean Rotary Clubs Presentation to Caribbean Rotary Clubs by Rotary Club of Ledbury August 2008 INTERNATIONAL Rotary District 1100

Caribbean Diabetic Footcare Project Rotary District 1100 INTERNATIONAL A humanitarian programme by the Rotary Club of Ledbury and the International Diabetes Federation INTERNATIONAL Rotary District 1100

The Background: World-wide, Diabetes kills more people than HIV/AIDS and Malaria combined

380 million people will suffer from Diabetes world-wide by 2025 The Background: 380 million people will suffer from Diabetes world-wide by 2025

20% suffer from Diabetes in the Caribbean islands The Background: 20% suffer from Diabetes in the Caribbean islands Caribbean amputation levels are among the highest in the world…

is a killer… and amputation leads to death The Need: Diabetes is a killer… and amputation leads to death

Skin problems treated to allows ulcers to heal DIABETES CAN RESULT IN FOOT AMPUTATIONS UNLESS REGULAR SCREENING AND SIMPLE TREATMENT IS PROVIDED    DIABETES Causes circulation problems especially in feet Affects nerve endings resulting in loss of feeling   ↓ RESULT   Patient cannot feel minor skin problems eg splinter thorns ↓  The minor skin problem becomes ulcerated  Regular screening ↓ Skin problems treated to allows ulcers to heal Foot saved  Untreated ↓ The ulcerated skin develops gangrene  Amputation is the only solution

The Patients: Lose two legs… 18-month life expectancy

social visit by John Greedy to Tobago The Need: Ledbury Rotary Club identified the need for action during a social visit by John Greedy to Tobago

The Patients: Lose one leg – 61% die in 5 years 30% lose other leg

Lose two legs - The Patients: The patient will only have an 18-month life expectancy

50% to 80% of these legs can be SAVED The Need: 50% to 80% of these legs can be SAVED

The cost of the loss of a single limb is US$50,000 to US$86,000 The Community Cost: The cost of the loss of a single limb is US$50,000 to US$86,000 (Dr Karel Bakker IDF)

The proven cost to save a limb is US$300 - US$900 The Price: The proven cost to save a limb is US$300 - US$900 (Tobago data)

Ledbury and Tobago Rotary Clubs entered into a joint project The Strategy: Ledbury and Tobago Rotary Clubs entered into a joint project Working together to provide simple and effective intervention

How it Works – Who does What: Ledbury club: provides facilitators, co-ordinators, marketing, raises funds Caribbean club: provides local leadership, community & medical links, clinical support Canadian Footcare Specialists: Train local staff, treat patients, record results,

What does the project do? Raises awareness of diabetes Wins community confidence Trains local staff in modern techniques Local tutors then expand the service

The Outcome – 2000-2006: Following a four-year Tobago pilot scheme… Two weeks community training programme annually Three dedicated footcare clinics have been established

54% fewer amputations The Outcome – 2000-2006: 3,750 patients treated 35 staff trained 54% fewer amputations

Progress to 2007 2006… The project is adopted and partially funded by Government of Trinidad & Tobago

Progress to 2007 2007… The TT Government extended the Project to the island of Trinidad

The future? Nine more Caribbean Rotary Clubs have declared a need and asked to join the project Montserrat, Nevis, Dominica, Barbados, Guyana, St Kitts, St Lucia, Grenada, St Maarten

This Footcare Project is Simple Effective Low cost Proven and sustainable Rewarding IT SAVES LIVES AND FAMILIES The Footcare Project is: Simple Effective Low cost Proven and sustainable Rewarding IT SAVES LIVES AND FAMILIES

The Project has won RIBI Awards “Ordinary Rotarians doing Extraordinary things” and “International Service”   and it is endorsed by leading academics Professor David Armstrong Dr Karel Bakker Professor Andrew Boulton

The future Partnership with International Diabetes Federation (IDF) Add new training teams More funding Involve new Rotary Club partners

Chair IWGDF section of IDF Our Partners, IDF International Diabetes Federation QUOTE “This project is wonderful example of how a small group of committed people can make a significant difference to the lives of people living with diabetes”. Dr Karel Bakker Chair IWGDF section of IDF

Our Partners, IDF QUOTE “Diabetes deaths equal HIV-AIDS and Malaria combined… …It is worst in low-and middle-income countries… …Lack of education and care”. Rotarian Martin Silink President of International Diabetes Federation and Chair of Rotary International Diabetes Action Group

The IDF/Rotary partnership International Diabetes Federation On February 14, 2008 talks between Ledbury Rotary Club and the IDF were started… …leading to our international agreement and partnership

The IDF / Rotary Partnership International Diabetes Federation The partnership will merge the IDF’s STEP-by-STEP programme (India; Sri Lanka; Bangladesh; Tanzania; Pakistan; Egypt) with the Rotary (Caribbean) programme expanding the life-saving project into other Caribbean islands and South American countries

The IDF / Rotary Partnership International Diabetes Federation A memorandum of agreement has been reached between the new partners with the IDF offering a start-up matching grant of US$80,000

The IDF / Rotary Partnership International Diabetes Federation Caribbean Rotary clubs can provide local leadership community links medical links to ensure that this life-saving programme is sustained and grows

The IDF / Rotary Partnership International Diabetes Federation Survey forms are being sent to Caribbean Rotary Clubs and Health Authorities to confirm the need and maintain the project on a professional and scientific basis August 2008

ROTARY Humanity in Motion Rotary District 1100 INTERNATIONAL Thank you for your interest For further information and updates visit our website www.ledbury.rotaryweb.org Rotary District 1100 INTERNATIONAL