Foot note Zanzibar

In July of 2004 my 18 year old daughter Clare and I accepted an invitation to learn of the conditions for people with diabetes in the developing world. Our extensive diabetes advocacy efforts for the last 11 years and recent appointment to the IDF Consultative Section on Childhood and Adolescent Diabetes enhanced our desire to learn more and perhaps share what we found with others.

Our diabetes journey took us to a hospital ward “foot clinic” on Zanzibar .  I stress the term “foot clinic” in quotation marks for a reason.  If there was ever a hell on earth, this had to be it.  With one dedicated Dr. who makes under $100 a month and works 20 hour days, this was purgatory at it’s worst.  Thirty or more men lay in hospital beds in an open air room awaiting amputation.  Their feet overwhelmed with gangrene ( dead and decay of tissue), and the flies and smell almost unbearable.  Yet, Clare sat on beds, holding the hands of these men, listening to their stories.  Nothing she could tell them would ease their pain…pain which was mental because the blessing in this is, diabetes kills the nerves first and they really did not recognize their blackened limbs.

As I watched my daughter with these men, my own protective instincts played havoc with my heart. Clare also has diabetes. She was diagnosed with Type 1 at age seven. Without quality diabetes education and support, Clare too could face this fate.

Then I turned from the scene before me to observe a nurse in a stark white, perfectly pressed uniform, change a dressing on a wound of the patient in the next bed. Her skill was flawless. Tenderness and compassion foremost in her every move. She shared with me that this man has six children. If he loses the foot he will no longer be able to provide for them. She is honored to help because she can make a difference in his life. Her wish would be that education and supplies could be made available earlier so her job would not be so difficult.

There are remarkably dedicated health care professionals in remote areas in the developing world. There are committed organizations and corporate partners who are making progress as well. My observation is these efforts are dwarfed by the magnitude of this problem and help is genuinely needed. Quality diabetes education, access to supplies and treatment as well as encouragement of others to join in this endeavor is paramount if we are to make real progress.

The decision to provide this opportunity for education, to allow us to see first hand the plight of these people, was insightful. The knowledge that any person should face amputation caused by a disease that is treatable is unacceptable.  Armed with this new education, Clare and I are even more committed to spreading the word of our findings. We welcome any and all who wish to join in this advocacy effort.

Text and photo by:

Kari Rosenfeld
Diabetes Advocate

Clare Rosenfeld, LLC
Eugene , Oregon,USA

Back to top