Transcript
EDDIE MCCAIG: We know that we do about one major amputation every twelve hours. And major meaning a below knee amputation or an above knee amputation. So one every twelve hours. The trend seems to be on the down. So if you asked me this a year ago, I would have said one every eight hours. Okay so it's one every twelve hours and thrown in amongst this is a lot of minor amputations, so toes.
JENNY MEYER: How is this happening, people must be in denial, not know that they've got a problem maybe, when they turn up to you and they're on the operating table. What are the early symptoms that people need to become aware of to prevent this so they can keep their feet?
EM: Sadly we have a high incidence amongst Pacific Islanders, a high incidence of diabetes. And we know for sure we have an incidence of about 15.8 per cent of our population. But some figures anecdotally say that we have 30 per cent of our adult population that are diabetic. It's gotten so bad. The symptomatology of diabetes is polydypsia, all the 'polys', including Polynesia. So the people are thirsty, polyuria they are always wanting to go to the toilet and if you're a Polynesian, there is a high incidence. It is high. And the complications of diabetes is the foot, the kidneys and the eyes. And we have them all. And the denial is, a lot of our population don't know they have diabetes. So yes we know that 15.8 of our people are diabetic, that's a random check off the street. And less than 50 per cent of those who are found, knew they had diabetes. And when we say, well we cut legs off. These are people within a day of admission. So they come in a real bad state.
JM: It must be very shocking. So what is your message as the person, you know as a surgeon, teaching other surgeons, as well as yourself, cutting off these limbs, what's your message to people, to the community?
EM: When it comes to the limb, we try and save the limb initially and then we try and save the life. So most times to save the life, we cut the limb. I also belong to Diabetes Fiji which is a trust and our message to the people of Fiji is that, yes we've got this very high incidence of diabetes, so 15.8 per cent, that's about 60,000 people in the country are diabetics. Those who know they have diabetes, we again know that about 80 per cent of them have poorly controlled diabetes. From the point of view of the surgeons and the opthalmologists and so you think about 60,000 diabetics, about 50 per cent or a little lower than that will get an eye problem that needs surgery. Whether this be a cataract or needs laser treatment for their retinopathy, so the eye. We have about nine hundred cases each year who need renal dialysis. And in Fiji that's very expensive, about 35million dollars on the kidney alone. So we're doing a good job, expensive, we can't afford to do it, but on the tertiary care. What we need to do is hone in on the preventive care.
JM: Yeah so people need to get moving, is that right? It is possible to prevent this illness isn't it?
EM: Oh yes, and of course just awareness, it's awareness. I've been considered a mean man because last year I had suggested that we must make this a ministerial decision, I even went as far as saying it should come from the Prime Minister. He should have a team of the Ministry of Health, the Ministry of Education, the Ministry of Labour, the Ministry of Agriculture, each ministry taking a role. No more blame game. So the Ministry of Education, we must start educating our kids. It must be introduced in the curriculum and enforced and examined. So people must know, what to eat, how to eat. The Ministry of Agriculture, right now our main crop is sugar. We should be taught about eat the right things, grow the right way, having a place nice and green. Ministry of Labour, I've been bad enough to say we should have people who get employed have their BMI done, and if they're considered having excess weight, should not have that contract renewed. Civil servants, police, army and the works. And until we start doing that you know we're not going to win. Everyone must get involved, the church groups, because right now we are failing big time.
JM: And exercise of course is a huge thing, that people can do for themselves right?
EM: Yip, we have a great rugby team that runs around the field, netballers, but as soon as they reach 30 they all swell up. Exercise is a huge factor and no we don't exercise far from enough.
JM: As the person who is most days, doing these amputations, cutting off people's toes, their legs, how does that feel for you, you know day in, day out?
EM: It's terrible, it's terrible. I mean no one likes to do this work. But what I keep reminding people is that when we get to see them, we have no option, but to cut the limb off. And yes by the way when we say one amputation every twelve hours, about 40 per cent of the surgery done in this country is for amputation. Let's stop playing the blame game. I think we all need to work together, there are too many people trying to work parallel to one another, and with the aim of getting people healthy.
