Podiatry Students Under Threat?

University of Johannesburg 4th year podiatry students are in for a new experience on Tuesday 5th February! For the first time in 12 years I am returning to lecturing. I will be lecturing Private Practice Management, which is part of the course on Health Systems Management.  I’m looking forward to re-joining the academic team, despite a dislike of marking. It seems to me that full-time academic life in 2008 is like a road full of potholes called "admin,"  so I hope I can avoid these potholes as a part-timer! Being burdened with too much "admin" was one my reasons for leaving in 1995!.

Podiatry education in South Africa started in 1977 at the Witwatersrand College for Advanced Technical Education (WCATE), as a 3-year Diploma plus a year of in-service training. Then it became a National Higher Diploma after 4-years of study after WCATE became Technikon Witwatersrand(TWR). It evolved into a 4-year Bachelor’s Degree at TWR and when TWR and the Rand Afrikaans University merged to form the University of Johannesburg(UJ), this became the latest home for the degree. The degree isn’t offered by any other University in South Africa,  which is disappointing and leads to all sorts of difficulties in enrolling students from around the country. However graduates from UJ are distributed all over the world and many have gone on to become leaders in the profession in their new countries. In fact this week another young podiatrist is leaving Johannesburg for Australia, another went to Canada last Christmas and another two also left for Australia in 2007 whilst yet another relocated to Saudi Arabia (Hopefully this is only a temporary posting).

Fortunately there are some of us left in South Africa, mostly in private practice, but there are more posts being created in the State Health Services, including the Military, with students having to work back their bursary committments. As yet there is no requirement for podiatrists to do Community Service, mainly it seems due to the lack of available supervisors and posts. If and when Community Service becomes a requirement, podiatrists are well qualified to perform an important role in the management of foot problems associated with chronic disease and more importantly I think those affecting children.

Fitting Children’s Shoes – Again!

Fitting children with shoes can be really difficult and is often unpleasant for all involved. That includes brothers, sisters and fathers hanging around nearby! This means that the responsibility for getting the correct usually lies with Mum. The trauma increases due to the fact that in South Africa, there are virtually no shops who know how to measure children’s feet and fit the correct size of shoe.

Some stores have had measuring boards available in the shoe section for some years, but using it was left to the customer. At the same time there was no guarantee that the size system on the board matched the size system of the shoes. Anyone who has bought sports shoes/trainers recently will know that they have three or four different size numbers on the tongue of the shoe. This is because the shoes are made in Asia for sale all over the world where the basic unit of measurement differs – including different centimetre units.

In an attempt to bring some order and science into the art of shoe fitting, the South African Podiatry Association (SAPA) has been working with various manufacturers and retailers to establish standards for footwear in this country. There is a committee of experts headed by a podiatrist who has done ground-breaking original research into the feet of South African women. This committee assesses lasts(the plastic shape around which a shoe is built) and footwear design, against a checklist based on this scientific research.

One retailer is Woolworths and if you buy your child’s shoes there – although you will have to fit them yourself – you will see certain styles have the SAPA approval logo on the green tag. Look out for other large retailers getting involved in 2008.

Do Your Children’s Shoes Fit?

Children’s feet need special care and attention and nothing is more important than selecting and fitting children’s shoes.

Oh yes, Happy New Year! The year is racing along already with Christmas holidays a fading memory. At present summer in Johannesburg also feels like a fading memory thanks to all the rain. With January came the start of a new school year and being too distracted with moving the practice I missed a great opportunity for ‘back to school tips’, but it’s never too late to review some of the basics. Especially as children grow so quickly and usually don’t tell you about short shoes because they get used to squeezed toes, or they hate the look of their prescribed school shoes. (Remember how long they stay as soft cartilage).Look at the page on Children’s Feet.

Did you have your children with you when you bought their shoes? Many parents buy based on size and take the shoes home to fit. [There are valid socio-economic reasons in South Africa, but it’s still a bad idea]. Also getting children into school shoes can be difficult if they are first-timers or have just spent six weeks barefoot or in sandals. (Or possibly Crocs!!)

Did you buy the shoes with your children wearing the socks they normally use for school?

Are the shoes stable and protective for those soft  vulnerable feet?  Is the sole firm with a flexible leather upper?How much synthetic material is there which is going to make the feet sweat? How do they fasten? Velcro is ‘cool’ but not often found on a school shoe. Doing up laces is currently ‘uncool’.

I doubt very much that you were able to check the fit of the shoes by having your child’s feet measured! A simple method of checking fit is to pour some powder into the shoes, put them on and have the child walk round the kitchen. Carefully take off the shoes and look inside for a centimetre of powder beyond the end of the toes. If you don’t see it then the shoes are probably too small.On the other hand never buy shoes too big so that they "can grow into them" or in the hope that the shoes will last a school year.

Children can outgrow shoes as quickly as new cars lose their value, so at the end of every school holiday check the fit of your children’s school shoes.

It could be that your "little Einsteins" are suffering irrepairable damage to their feet and you haven’t checked.