Diabetes outreach in Kenya - facing the challenges

In February this year second year PhD clinical academic, Simbarashe Richard Tanyanyiwa, visited Kenya as part of his podiatry outreach activities. Here, he gives an account of his visit and describes his experiences.

This was a pilot trip at the invitation of the Kenya Diabetes Association, and supported by Health Sciences’ PhD supervisory team (Keith McCormick and Dr Cathy Bowen) and Simbarashe’s host clinical placement team at Solent NHS Trust. Simbarashe was invited to run a patient workshop and education exchange seminar in Kisumu, about 200 miles from Nairobi, which ran over two days.

Simbarashe writes: The objective of the education seminar was to share experiences of wound care with other clinicians; this consisted of those involved with, or having an interest in, diabetes wound care, including community nurses, dieticians, nurses and medical and nursing students working at the main public hospitals (Maseno Hospital (ACK); Nyanza Provincial General Hospital, and Port Florence Community Hospital Kisumu).

The education programme was conducted in a church, and involved educating patients about diabetes and the risks it poses to general health. Many of the participants were unsure how diabetes affected their feet.

Following the educational talks, I led a foot screening workshop which aimed to provide some context around how diabetes can affect the feet and explain the risk classification of patients to clinicians.

Overall about 1000 participants, consisting of mainly patients, attended and over 30 clinicians. They highlighted trying circumstances and it was interesting to learn how they overcame different challenges with limited resources.

What I did find a real challenge was discussing local practices which were at odds with my own training in a Western culture that promotes the ideals of an evidence-based practice approach to healthcare. For example, an existing practice is to treat wounds by washing with vinegar. However this also presented an opportunity to share approaches to wound care and to explain the research objectives of my PhD.

This outreach activity has provided me with invaluable experience in managing complex wounds in challenging environments with limited resources. I will approach future outreach schemes with an open mind and be flexible towards practices in different cultures and environments.

Whilst there I established several contacts with the teaching hospitals and both they and the Kenya Diabetes Association expressed a wish to make this an annual event. It was suggested that the next event take place within the next 12 months, and which would include clinical time spent at treatment clinics and medical and nursing schools.

I would thoroughly recommend outreach activities such as this to my research and clinical colleagues, and many have already expressed an interest in participating in future events.