Monthly Archives: June 2008

SA Men “Push and Bhobhoza” their feet

Men usually escape the painful feet we associate with poorly-fitting shoes. Surely it’s women who are wearing high heels and sharply pointed toes. They were doing it when I was at varsity. However I was amused by an article by Thando Pato entitled ” Men in sharp shoes miss the point” in the Sunday Times Lifestyle section on May 18th.

I checked with my associate Tshidi and sure enough “P&Bs” as they are known, are a real fashion item. Especially amongst black men. Ms Phato expresses her concerns about the growing number of South African men in all situations wearing shoes “so long and pointy that they look like spears.” (The word ‘bhoboza’ means to pierce in Zulu).

She also expresses a concern that I often use as a humour line in foot health talks – that shoes for women are designed by “cruel European men who claim to love women”. The message from Thando Pato is a great – not only are these shoes sold in garish colours, apparently white is cool – but she is also “traumatised” by the damage inflicted on the wearer’s feet.

She uses a great expression to describe corns, bunions, calluses and a host of other foot deformities that we traditionally associate with women; “Hammer Time”. I think this should become part of podiatry terminology. Her description of the pain experienced by one guy she sees is really funny. Thando Pato you must have been a podiatrist in a former life!

If you want to study the effect of high heels on how you walk, get along to the Victory Theatre in Johannesburg and take in The Rocky Horror Show. We went last night and it was a great show. Obviously I went for the anatomical study!

By the way the references for Angiosomes are: Taylor 1991. Plastic & Reconstructive Surgery.102.599. There is a fully illustrated article in Plastic & Reconstructive Surgery. 2006.117. 261-293.

I know these are not 100% accurate but that’s what I wrote down at the congress, so put on your best Google and see what you get!

A Fresh Start At The Practice?

Fresh from the long weekend we welcome Ms Lauretta Zikalala to our podiatry practice. Lauretta is our new receptionist and will be the voice of the practice from today. Back at the practice today, (not exactly fresh!) after a tiring but stimulating weekend at the Diabetic Foot Working Group (DFWG) Congress. Armed with some new knowledge and revision of existing, Tshidi and I feel that we have more to offer our patients with diabetes.

We know that Podiatry and diabetes is not just about managing the serious complications such as foot ulcers. The key issue is the prevention of this complication and research shows that multidisciplinary interventions can reduce both ulcers and amputations. There is a major challenge in South African health care to educate everybody involved in diabetes about the need for proper foot health care.

Just to get patients and professionals to look at feet could prevent many complications. So many patients do not feel pain and are therefore misled into thinking that there is nothing wrong with their feet. Meanwhile they develop blisters from footwear, ulcers from objects like drawing pins, stones and other foreign bodies and burns and scalds from heaters or hot water. It is clear that we will have to develop innovative and cost effective interventions to reduce the numbers of amputations and to improve foot health awareness in South Africa.

For any health professionals reading this; do you know what an angiosome is? I’ll publish some references tomorrow. (I think you will be amazed). For the lay person, angiosomes allow vascular specialists and podiatrists, in the context of patient examination, to accurately assess the quality of blood flow to every part of the lower limbs and feet. This enables really accurate identification of those areas at risk due to inadequate blood supply. Most of us are familiar with the dermatomes which map out the nerve supply, but angisomes are something new. (Well they are to me!).

Diabetic Foot Congress: Johannesburg 2008

Tomorrow morning sees the start of the first Diabetic Foot Working Group (DFWG) Congress in Johannesburg. In South Africa it is also a long weekend – meaning that Monday June 16 is a National Holiday, when we remember the youth of SA and their part in the struggle against apartheid. Especially the riots which broke out on June 16 1976.

For those of us dedicated to another great cause, we will spend the next 3 days learning, sharing and discussing the causes and effects of the diabetic foot, with a special emphasis on our local problems and solutions. We have speakers from Cameroon, the UK and USA, in addition to a variety of local speakers. The benefit of this type of congress is that you get to meet the members of the wider multidisciplinary team and the exchange of ideas and information will help to increase the core of health professionals available to manage the feet of people with diabetes in South Africa.

Recently I have been requested to try to assist with the development of training in foot health in Nigeria and have a new contact with an orthopaedic surgeon in Iraq. There are no podiatrists in Nigeria at all, where the population is more than 140 million. Furthermore there is no government support for foot care either.

I am very pleased to report that the lady featured in the ‘bean bag’ blogs, is making fantastic progress, thanks to the skill of my associate Tshidi Tsubane. We are also very proud of the fact we have had a paper published in a new journal – Wound Healing Southern Africa – Volume 1 No 1. visit

Currently we are working onpapers concerning nail surgery for people with diabetes and the costs of ulcer care from a podiatrist.

Finally for Friday 13th! I spent the day as an examiner for the podiatry students at the University of Johannesburg. I’m not sure who was more tired the students or me. At the end of two sessions of assessing competency in clinical skills you actually feel quite sorry for them.

Have a great weekend.  

Diabetic Foot Congress 2008

June 14,15,16 are landmark dates in the history of diabetic foot care in South Africa.

The Diabetic Foot Working Group (DFWG) is holding its first congress. Noted overseas speakers will be Professor Andrew Boulton (Miami and Manchester) and Dr Zaheer Abbas from Tanzania.

This will be the first truly multidisciplinary diabetic foot meeting to be held in South Africa.

More information from