We are delighted to announce that prose written by our Practice Business Manager, Reggie Simpson, will be featured in the Rennie Grove Hospice Care’s Rhyme & Reason 2018 diary, now in its 26th year. The theme for this forthcoming year’s diary is ‘Freedom’. All proceeds from sales of the diary go to support this worthwhile charity.
Reggie says: ‘Although my entry wasn't among the top poetry and prize winners, I was chuffed to be selected for the 2018 diary. The theme was quite broad, but my degrees in politics and love of writing invariably drew me to entering the competition. In the end I settled on a focus of freedom in healthcare, no doubt inspired by my current employment at Betafeet Podiatry and the noble work of Rennie Grove Hospice Care ( www.renniegrove.org ).
Rennie Grove Hospice Care, formally known as Iain Rennie Hospice at Home, merged with Grove House, St Albans in 2010 to integrate services in south western Hertfordshire. The ethos and values of the two charities were closely aligned with the principle of allowing patients to lead a good quality of life at home for as long as possible, helping patients and their families avoid the distress of unnecessary hospital visits whenever possible.
The diaries can be ordered from the Rennie Grove website, payment by debit/credit card. It's part of their annual Christmas/holiday promotion. There will also be copies in local Rennie Grove shops. They are £5 each with additional postage if bought online. Shop locations can be found here: http://www.renniegrove.org/support/our-shops/online-shop/page/2/ .
Here is Reggie’s entry (to appear in the month of September 2018):
‘Do not count the days; make the days count.’
Muhammad Ali. Professional Boxer. Audacious. Charismatic. A winner in the ring.
But even when you have won it all, life throws you a few more punches.
Yes, his name opened doors and wealth, but the bombastic man of his younger years was humbled in later life, and following retirement, he dedicated himself increasingly to charitable work. Parkinson’s was already taking hold.
He received the Presidential Medal of Freedom in 2005, the highest honour the USA can bestow. He died in June 2016, aged 74.
Now the news is about boxing helping dementia sufferers.
So what does this mean for freedom? Does getting battered around the head spell freedom and choice? One would say yes; a boxer is free to take such risks. When the consequences deal you a fatal blow as a result, when do you lose your freedom? Is it when you have been reduced to a shadow of your former self, a normal human being, and have to rely on others? Muhammad Ali likely had plenty of resources to ensure his final days would help him on his final journey.
We tend to think of freedom in political terms. It is hard to remove freedom in healthcare from politics. Think NHS reform, among others. Freedom in a healthcare environment means more to the individuals and families when they have life-limiting illnesses and need the care of volunteer-run hospices such as Iain Rennie Grove.
The NHS gives patients the rights to make choices about different aspects of the care they receive, from the different treatment options available. How these are chosen is individual, although for those with life threatening or limiting illnesses this choice will fall on family members.
I quote the following:
‘In health there is freedom. Health is the first of all liberties’.
Henri-Frédéric Amiel, Philosopher
September is World Alzheimer’s Month.
After a stellar educational background and career, Andre joined babylon Healthcare Services, UK based, with a view to helping them set up and deliver the first digital healthcare pilot services to the NHS. Digital healthcare is a cluster of new and emerging applications and technologies that exploit digital, mobile and cloud platforms for treating and supporting patients. Digital Healthcare is being applied to a wide range of social and health problems, ranging from monitoring patients in intensive care, general wards, in convalescence or at home – to helping doctors make better and more accurate diagnoses, improving drugs prescription and referral decisions for clinical treatment.
Rwanda then beckoned.
Since joining babylon Rwanda in April 2016, Andre has been instrumental in successfully setting up and launching Africa's fastest growing digital healthcare service. According to Lindsey McConaghy, babylon's PR manager, 'Rwanda has a population of around 12 million but doctor numbers are in the hundreds. There’s an imbalance between supply and demand'.
Digital Healthcare is not without its sceptics nor controversies - at what point do you let an app do the diagnosis? Will GPs embrace technology in this way?
Here is Andre's report about his experiences in Rwanda:
Rwanda is a small ambitious country known as the land of 1000 hills with a population around 12 million and a rapidly growing economy. It has rolling hills for as far as you can see, a rain forest, gorillas and volcanoes, making for quite the site to any visitor. However, it is also known for the 1994 genocide in which over 1 million people were killed in 100 days across the country.
This tragic event has led to some very big health issues, which the country still faces, but thanks to a range of donor funding and strong political leadership, the country is on its way to quickly becoming a middle-income country.
As countries shift from low incomes to middle income economies, health issues become complex, where the country can face a mix of communicable disease (ie. malaria, HIV, TB) and the introduction of non-communicable disease (ie. diabetes, high BP, cholesterol) with changes in lifestyles.
Now you are probably wondering what this has to do with podiatry?
Well, as clinicians we play a role in the overall wellbeing of every patient that walks through our door for treatment and we become advocates for a number public health issues. While our specialist area is focused on the foot and ankle, an understanding of the bodily systems is imperative for understanding the impacts on the lower limb. This allows us to transition from clinical practice to other work streams such as health policy, public health programmes, service management and research.
As a podiatrist with a public health background, the increase of diabetes and chronic conditions in developing nations has become of personal interest. In many of these countries, diabetes is poorly understood and without proper prevention and care, can lead to a large economic burdens on the healthcare system. In 2012, the UK alone spent a whopping £639 million on foot ulcers and £662 on lower limb amputations, so the prevention and monitoring of these conditions is of paramount importance in the developing world.
The quality of life for individuals with diabetes is also drastically affected if not controlled, impacting mobility, footwear and overall lifestyle. Additionally, chronic ulceration and limb amputation, creates an increases risk (approximately 80%) of mortality within the first 5 years post amputation.
How did all this lead me to Africa, I hear you say?
In April of 2016, I (sadly) departed from the Betafeet clinic to implement an mhealth project in Rwanda in partnership with the Ministry of Health. This project, allows patients across the country to speak with a doctor and receive a prescription via SMS through their mobile phone, reducing the travel time, wait time and expense of receiving care from one of the local physical hospitals. The system is also working on monitoring both communicable and non-communicable disease using artificial intelligence, engaging patients to take ownership of their health.
This could be a major milestone for a country with stretched resources. To put things into perspective, over 80% of the population lives in remote areas of the country and works in the ‘in-formal’ sector as subsistence farmers with an average income of 2-3 dollars per day, which is not very much. To receive care, a patient may travel over an hour to reach their nearest hospital where a doctor is present and then wait anywhere from a few hours to a few days to receive the care they need. However almost 80% of the population already has a mobile phone.
Appropriate access to clinical care is a large part of the prevention and management of many conditions and undertaking this project has been a great experience. As a clinician, I have had the opportunity to utilise my knowledge to develop operational pathways and input into the technology development to shape the way patients receive their care.
It is with
this experience I now look to move on to my next adventure focusing on Aboriginals
and the utilisation of technology in the prevention of major non communicable
disease such as diabetes.
Final comment from Reggie Simpson and Betafeet Podiatry
We wish Andre the very best in his future and thank him for this interesting blog account. We look forward to his next blog focused on his work with the Aboriginal population.