20 Jul, 2016
The warm summer weather will often call for a trip to the beach! but if you are not careful you can run into trouble:
• Wear shoes to protect your feet from cuts, athletic shoes are much better than flip flops as they provide support and cushioning
• Hot weather can cause your feet to swell, make sure you have plenty of room but not too big for your feet to slop around
• Wear socks to prevent blisters
• Moisturise to prevent rubbing or chaffing
• Don’t walk around bare foot or go in the water if you have cuts and protect against infection with a plaster or dressing especially if you have diabetes or circulation problems
• Protect your feet against sunburn, apply sunscreen to the top and bottoms of your feet
• Sand and hard surfaces can get very hot in the sun, wear shoes to protect against burns
If injuries occur reduce the risk of a small problem becoming a bigger one:
• Sprains – RICE (rest, ice compression and elevate) to relive the pain and swelling, if pain lasts more than a few days or unable to stand seek medical help
• Broken bone – immobilise and attend A & E to prevent further damage
• Bleeding – elevate the leg and apply firm pressure with a dressing if possible directly over the cut. If bleeding does not stop in 20 minutes seek medical help
• Cuts and puncture wounds – remove any foreign objects, clean, disinfect the area and apply antiseptic and a sterile dressing – seek medical help if the wound is large, will not stop bleeding or unable to remove the foreign object or signs of infection
• Blisters – don’t pop a blister but if they burst apply antiseptic and a dressing
• Infection – if you have a wound that is oozing, red or swollen it’s a good chance its infected, soak your feet 4 – 6 times daily in warm salt water (2 table spoons per gallon of water), keep the area covered in-between soaks with a sterile dressing. If you have any red streaks coming away from the wound going up the leg, soreness or a lump appearing behind the knee or in the groin is get professional help immediately. Infections are serious and should be dealt with urgently
• Stings – you can treat some stings yourself but if you have severe pain, trouble breathing or swallowing call 999 and request an ambulance immediately a sever anaphylaxis reaction needs to be treated in hospital. Also call 999 if you are stung on a large part of your body, face or genitals, have chest pain, very young or elderly. If not up-to-date with tetanus shots, a prophylactic dose may be needed. If your rash or pain gets worse or there is signs of infection seek medical help. Remove any large spines or tentacles with tweezers being careful not to touch them yourself with bare hands, any that have gone very deep or are near a tendon or joint may need an x-ray and be surgically removed - If in doubt seek medical help
Symptoms can vary from mid to the extreme with the different type of stings and are not to be taken lightly:
a) Server pain
b) Itching and skin irritation
d) Numbness or tingling
f) Nausea and vomiting
h) Feeling faint, weak and dizzy
i) Muscle spasms
j) Abdominal cramps
l) Tremors (shaking)
m) Seizures – (fits)
n) Shortness of breath
o) Swollen lymph glands
• Treatments - check out NHS Choices website:
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.