The Challenges And Rewards Of Establishing A Diabetic Foot Program In Haiti

There are times in your life when you know you are a part of something important, something that has the potential to be significant. These are the events that give meaning and depth to life. I recently had such an experience. I knew even before it happened that I was going to be involved in something special.

John MacDonald, MD, asked Neil Donohue, DPM, and me to establish a comprehensive diabetic foot program for the entire country of Haiti. Dr. MacDonald is a remarkable man. He previously worked as a thoracic surgeon in Florida. He stopped doing surgery and became one of the national and international leaders in wound care. Dr. MacDonald has authored many articles on lymphedema and wound care, including the white paper for the World Health Organization titled, “Wound and Lymphedema Management.” He also started the wound care clinic in Haiti on the fourth day after the 2010 earthquake through the Project Medishare Hospital and the University of Miami.

I took over the wound care center the second week after the earthquake in Dr. MacDonald’s absence until he returned the following week. The wound care center that Dr. MacDonald established at the Project Medishare Hospital has continued to serve Haiti at Hospital Bernard Mevs in Port-au-Prince ever since.

Dr. Donohue, his daughter Taylor (who was along to film a documentary about the project), my fiancée Erika Jagger (who worked on the marketing and IT for the project) and I met Dr. MacDonald in Port-au-Prince the week of October 21. This was my 11th trip to Haiti. I was excited for Erika to see and experience a country and people that I truly love. Hurricane Sandy did skirt east of the island, causing a tropical storm while we were there. This was my first time back since after the earthquake. I am sad to say not much has changed with the infrastructure of the country but happy to say the people and culture are the same.

The staff at the Wound Program at Hospital Bernard Mevs Project Medishare includes Adler Francius, MD, and several well-trained and caring workers. Our task is to establish a diabetic foot program for the entire country. This program will include preventative care, education, orthoses and bracing, wound care and surgery. The week consisted of several meetings, strategic planning, lecturing and patient care. Our greatest accomplishment was getting us all together in Haiti focused on the goal. Our first step will be to organize a conference for primary care physicians in Haiti to educate them about the diabetic foot and inform them about the center. We are targeting February 2013 for this conference.

Dr. Donohue has a long history of medical service work through his non-profit World Walk organization. Dr. Donohue practices in the Philadelphia area, is a regional director for Healogics Wound Centers and a national lecturer. He is a seasoned, tireless and equally devoted global medical service volunteer. We are both aware of the privilege and honor Dr. MacDonald has given us to put our stamp on this project. With Dr. MacDonald’s position as Secretariat for the World Alliance for Wound and Lymphedema Care, this project may serve as the model for establishing diabetic foot programs in the developing world. This is a significant undertaking but we are both committed to the project. We will also be enlisting help from our colleagues along the way. There are several fantastic aspects of this project but one that I find most fascinating is the opportunity podiatric medicine has to make a mark worldwide in the care of the diabetic foot in the developing world.

Our goal is to establish an evidence-based comprehensive foot program to reduce amputation and accordingly save lives in Haiti. This program is going to be a Haitian program run by Haitians serving their fellow Haitians with us serving as resources to aid the program.

“Everyone has his own specific vocation or mission in life … Therein he cannot be replaced nor can his life be repeated. Thus, everyone’s task is as unique as is his specific opportunity to implement it.” – Viktor Frankl, MD, PhD

“Your work is to discover your work and then, with all your heart, to give yourself to it.” – Buddha

Best wishes and stay diligent.