Category Archives for "Conferences"

On Safari – AFLAR Rheumatology Updates – Nairobi

Back from the AFLAR Nairobi Rheumatology Updates. Hard work, but enjoyable and successful.  I presented my “Foot Problems in Arthritis” talk to the Allied Health Professional’s Workshop and the formal Regional Rheumatology Symposium.

An ‘on safari’ report was intended, but my laptop was attacked by Trojan Horse and worm viruses, after picking them up from the generic computer we used for the workshop. Fortunately the IT expert at my hotel was able to clean the flash drive and I just shut the computer down. Now all is clean and healthy again.

Andrew Clarke receiving a gift from Dr Andrew Juma Sulah, National Chairman, Kenya Medical Association

Andrew Clarke receiving a gift from Dr Andrew Juma Sulah, National Chairman, Kenya Medical Association

The big ‘take home ‘ message of the workshop was the need for team work in assessing and managing the effects of arthritis in any form.

The interaction between the physiotherapist, occupational therapist, rheumatology specialist nurse, podiatrist and rheumatologist; plus all the other health professionals, was highlighted by the team that came to Nairobi from Glasgow.

Their big message was that the centre of focus must always remain the patient. They also showed how their individual professions have developed extended scopes of practice to enable a massive reduction in waiting lists in Scotland, due to the screening interventions that they are allowed to do.

Despite the apparent skills shortage in Kenya – there is only one rheumatologist in the whole country – there are many skilled and enthusiastic allied health professionals plus other doctors such as GP’s, physicians and orthopaedic surgeons interested in getting involved with managing arthritis. I met many of them during the week.

Delegates at the Regional Rheumatology Symposium

Delegates at the Regional Rheumatology Symposium

Additional talks were on ‘Arthritis, feet and podiatry’ and ‘Footwear for problem feet’. In the practical sessions, delegates were shown how to make a basic insole and use padding onto the foot and into the shoe. More on this another time.

Oh yes. Traffic. I will never complain about Johannesburg traffic jams or driving again. The rush hours are gridlock in extremis; unbelievable.

Thank you AFLAR for the invitation and Roche Pharmaceuticals for the financial assistance.

Rheumatology Updates:Fame At Last – An Ego Polished – Silence Broken

Fame is a passing thing, but all things come to those who wait! The Rheumatology Updates were originally planned for Febuary in Nairobi, Kenya. My ego was nicely polished by being invited to participate as a speaker at a 3-day workshop for Allied Health Professionals. The trip to Kenya was postponed twice due to the political unrest in that country. However last Wednesday I received confirmation that the trip is on.

The event is an initiative of AFLAR (African League of Associations for Rheumatology). The full title is The Regional Rheumatology Symposium and Workshops, Eastern African Region “Rheumatology Updates.”

Running from the 6th – 10th October there is a 3-day workshop for Allied Health Professionals, a Public Lecture (to be presented at the Holy Family Basilica Hall -the Cathedral) and the Rheumatology Updates will take place on the 8th & 9th at the Grand Regency Hotel.

I have to give three oral presentations plus two practicals at the workshops and (here’s the ego polish!) I have been invited to speak at the more formal updates on The Foot in Arthritis.

As far as I am aware, there is only one qualified Rheumatologist in Nairobi – possibly in Kenya. When I went there last year as part of a team from the Department of Rheumatology from the University of the Witwatersrand, for an AFLAR Congress, the hunger for knowledge was immense, but the resources very few. The intention is to not only impart knowledge but also to train people to provide better care to people with Arthritis.

I have also found out that there is only one podiatrist in Kenya too. A graduate of the University of Salford. Quite by coincidence I was a lecturer there in the 1970’s.

Sorry for the silence and lack of input to the site for the past month. Reasons? My associate got married and was on honeymoon, so I had to work harder! The winter respiratory dryness got me and I succumbed to a chest infection. Also got in a brief visit to my granddaughter in Hout Bay and the biggest time taker of all was setting year end examinations for the podiatry students at the University of Johannesburg.

However I can’t wait for the Rheumatiology Updates in Nairobi. As I said “fame at last, an ego polished and silence broken”.

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.  

Good News on the Diabetic Foot

The Diabetic Foot Symposium at the VASSA Congress yesterday was a great success. It marked the launch of DFWG, the Diabetic Foot Working Group.

This is a voluntary association which will serve as the overall representative body to promote awareness and optimal management of people with diabetic foot problems in South Africa. Its objectives include the prevention of amputation, promoting academic standards and the establishment of relationships amongst role players.

I have applied to join this group and I hope that it will be instrumental in developing a fully multidisciplinary  approach to the diabetic foot. The big challenge is to prevent some of the awful foot complications associated with diabetes in South Africa.

Also at the congress, Dr. Slabbert & Dr. Allard presented some data on a Lower Limb Amputation Survey in a South African Regional Hospital, which showed that, in their hospital, 74% of patients losing a leg for vasculopathy (disease of the blood vessels) are diabetic. (This by the way is in the first 6 months of 2007!!)

Through our practice we have set up a ‘virtual’ multidisciplinary diabetic foot clinic, where  as the podiatrist I can refer patients to a vascular surgeon, physician, opthalmologist, dietician and diabetes nurse educator. I say ‘virtual’ because although we are not all in the same place at the same time, we have quick access to each as required.

They said that "an intensive diabetic foot programme is necessary to decrease the amount of amputations performed in South Africa.