Solomon Islands: A suggested new approach to treating diabetic foot ulcers to reduce the risk of limb amputations
The incidence of diabetes is high in the Solomon Islands and the disease imposes a substantial economic burden on the national health system.
The cost of diabetes to citizens and families is also high.
Diabetes also incurs considerable disability when limbs have to be amputated resulting in a reduced quality of life and, often, loss of work and income.
We know there are several hundred former patients of the National Referral Hospital, some say more than 400 that have had a leg surgically removed due to suffering from diabetes which first started with a diabetic foot ulcer.
It concerns me greatly that the NRH does not have a workshop where artificial limbs can be made and fitted. There used to be such a workshop but it became derelict and was demolished completely some months ago when work ground work started at the NRH for the facility to house a CT scan.
I have several times appealed for a 20 or 40 foot shipping container to be converted into a suitable workshop and donated to the NRH. Such an idea met with the approval of the Medical Superintendant of the NHR, Dr.John Hue.
There has yet been no container forthcoming but rumour has hinted a donated converted container might be offered.
It is my understanding there are three technicians that could manufacture artificial limbs, with two having had specialist training overseas, but all three are currently ‘waiting in the wings’ and most likely laid off work.
Although not the answer to manufactured and fitted prosthetic limbs, some 300 crutches have been purchased with help from the Solomon Forest Association (SFA) but the container with those crutches is detained in the Philippines due to ongoing quarantine controls arising from Covid-19.
In a recent letter, I mentioned how Heberprot-P, an epidermal growth factor product was a cost-effective option for the treatment of advanced diabetic foot ulcer and it was available in Cuba where it was manufactured and in use in hospitals in several countries, including Canada and India.
Use of the product and method of treatment to prevent amputations due to diabetic foot ulcers has been granted in: Australia, China, South Korea, Europe, United States, Hong Kong, India, Mexico, Russia, Singapore, South Africa, Malaysia, Ukraine, Indonesia, Argentina, and Japan and filed in Brazil, Thailand and Chile.
The Solomon Islands has had formal diplomatic ties with Cuba since 2003 and it is my understanding the Solomon Isands Ministry of Health and Medical Services has had some past contact with the medical authorities in Cuba in regard to Heberprot-P.
If, as it is claimed, Heberprot-P use can prevent foot ulcers getting worse leading to amputation, could it be used at the NRH?
If it a question of issuing some form of import authority or marketing authorization from a controlling Medicines Agency, should this not be done as a matter of urgency?