Until recently, the diabetes foot care was virtually unknown in Georgia. A new project is taking steps to change that.
11 July 2016 Gwendolyn Carleton
Gulnara Sarjveladze lies on an examining table at Batumi Endocrinology Center in southwestern Georgia, her eyes closed.
“Vgrdznob,” she says, as Nurse-podiatrist Irina Kakhidze touches her feet with a short, wiry strand of monofilament. “I feel it.”
The foot check is a new addition to Ms Sarjveladze’s monthly diabetes checkup, and it’s here thanks to a WDF-funded project called ‘Diabetes Footcare Improvement’.
The project builds on a previous project, ‘Diabetes Care Improvement’, which established Diabetes Patient Centres in three target regions of Georgia, a former Soviet state at the crossroads of Western Asia and Eastern Europe.
“We found that foot disease is one of the major complications in Georgia, but no cost-effective system of footcare existed,” explains Simon Gabritchidze, director of Welfare Foundation, a Georgian NGO and WDF partner.
“When I said ‘podiatry’,” he recalls, “many people said, ‘do you mean paediatrics?’”
The project is establishing 11 foot clinics in existing health care centres already providing diabetes care across Georgia. It will provide the clinics with basic foot care kits, and train 11 nurse-podiatrists and 180 other healthcare professionals, and organise screening and awareness-raising activities. It aims to screen nearly 3000 people for diabetic foot at established clinics and train them and their relatives about diabetes foot care.
The project has 1.5 years left and is right on track, says Kirza Buch Kristensen, Programme Manager for the WDF.
“The project is targeting primary clinics with large numbers of diabetes patients registered but limited knowledge and equipment for diabetic foot care. It seems to be improving the quality and access to diabetic foot care across Georgia considerably.”
Better than before
The Batumi Endocrinology Center is part of this change. Today, only seven months after it began offering diabetes foot services, more than 150 of the center’s 3000 patients have been diagnosed with foot ulcers and are receiving treatment for them.
Mrs. Sarjveladze is not among them. But today’s examination reveals that she has lost some sensation in her feet. She listens seriously as her nurse-podiatrist urges her to check them regularly for cuts and lesions.
Dr Inga Abseadze, who also was trained through the project, stops by briefly.
“Better than before,” she says approvingly, nodding to the pair of low-heeled black shoes beside the examining table. Mrs. Sarjveladze offers a small smile, the first of her visit.
Mr Gabritchidze says that such moments are increasingly common, and important.
“We see footcare as more valued now. Before, many doctors referred people with foot problems to surgeons, who were motivated to amputate. Now, we have nurse podiatrists who can care for feet and help people prevent and heal ulcers, so amputations aren’t necessary,” he says.
Protecting feet and reducing amputations in Georgia will take time and persistence. But ‘Diabetes Footcare Improvement’ is a step in the right direction, Mr Gabritchidze says.
“On our Facebook page, we recently had a patient write to thank us,’” he says. ”That was a nice feeling.”