Clinic Equipment Required

• Patient tables for each room
• Hand-held dopplers (2-4) with gel for exams
• Basic dressings such as 4x4’s, kling, kerlex, coban, ace wraps, cast padding, non-adherent dressings such as adaptic, foam, hydrogel, calcium alginate dressing, collagen dressings, silver nitrate, cotton-tip applicators
• Local anesthesia
• Surgical equipment such as #10 and #15 blades with #3 blade handles, tissue nipper, #3/5/7 ring curettes disposable if possible
• Gloves of various sizes
• Off-loading devices – surgical shoes, ¼ adhesive felt padding, possibly kits for total contact casting and materials to make accommodative insoles at the clinic, and crutches
• Possibly venous stasis ulcer compression wrap materials

Documentation Requirements

I recommend an ulcer charting template be used in conjunction with digital photos, additionally some form of an initial history and physical form should be included in the chart.

Physician Requirements

The doctor or doctors involved should have some type of surgical training, either in orthopedics or general surgery. I could help train specific surgical and debridement skills over many repeated trips.

On-Going Consultations

I could make consultations over the web via email with photos or even utilizing web cams. Phone consultations are also a possibility. I would need to make regular trips to provide direct training.

Education

Formal educational training programs are essential. This would include lecture seminars, hands on clinic training, and surgical hands on training. Once an established program has been arranged, those who work at that program could help teach new clinic sites and at national seminars. Additionally, webinars could be arranged for on-going training on a regular basis.

Funding

My initial thoughts would be to start a NPO for this project with a website to solicit donations from the US and worldwide. Any help provided by the Haitian government would be additional. This type of program would save a significant amount of money to the Health Ministry. Health care funding by the government has decreased from 24.8 goudes in 1990 to 15.7 goudes in 1995. The most recent information on the healthcare budget for Haiti has decreased 27% when adjusted for inflation from 157 million goudes in 1990 to 421 million goudes in 1996. Healthcare costs are approximately 7.8%-10.7% of the entire governmental budget, which is about 1% of GDP. Public spending on healthcare has also decreased from 25 goudes in 1990 to 16 goudes in 1998 per person per year. The cost of this program would be substantially less than the cost of the surgical and hospital care diabetic foot ulcers result in yearly. Any help in establishing relationships with current NGOs in Haiti would greatly facilitate this project.

Why Patrick A. DeHeer, DPM to guide this project?

I have a deep affinity for Haiti and her people. I have been here several times on various trips mainly associated with the Haitian Clubfoot Project and feel very comfortable in the country and interacting with the people. I have extensive training in reconstructive foot and ankle surgery. I lecture both locally and nationally on foot surgery. I currently work at the Johnson Memorial Hospital Wound Healing Center.