Amputation capital of the world

Amputation capital of the world

Jamaica leads as poor foot care takes huge toll on Caribbean diabetics

Executive editor – special assignment

Monday, October 28, 2019

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A stunning revelation that the Caribbean region, led by Jamaica, is the amputation capital of the world, due to poor foot care, has been made by a local The University of the West Indies (UWI) professor.

There is one amputation per 1,500 diabetic patients in Jamaica said Dr Dalip Ragoobirsingh, director of The UWI (Mona) Diabetes Education Programme, citing anecdotal but carefully considered information.

“The Caribbean has attained the infamy of being the 'amputation capital' of the world, losing more lower limbs amongst our diabetics, due to poor foot care, than any other region of the world,” said Dr Ragoobirsingh who is also UWI professor of medical biochemistry and diabetology.

Regarded as one of the world's top educators and researchers on diabetes, Dr Ragoobirsingh, said the Jamaican figure of one amputee per 1,500 diabetics was comparable to Barbados and his native Trinidad and Tobago.

“To say that this is higher than the United States, United Kingdom or Europe does not tell the full story. The fact that the amputation rate is much less in South India and Indonesia gives a better perspective, comparing like with like,” he told the Jamaica Observer yesterday.

The picture for Jamaica is not a pretty one. While the prevalence rate for diabetes in the region is 8-15 per cent, Jamaica's prevalence rate is about 8-10 per cent. Among Jamaican women the rate is 9.3 per cent compared with 6.4 per cent for men.

“This is not surprising as 33 per cent of adults and 25 per cent of adolsecents in Jamaica are obese. Females are the most affected in both age groups,” said Dr Ragoobirsingh.

The main cause of diabetes (type 2) is obesity, which accounts for 90 per cent of all diabetics worldwide. The remaining 10 per cent of diabetics are of autoimmune origin.

He added: “Already there are visible risk markers for chronic illnesses in the adolescents group, based on a study in 10 high schools in Jamaica in which I collaborated with the Florida International University.”

The professor believes that education is one of the cornerstones of the prevention and management of chronic diseases, mainly diabetes, to which he has devoted considerable time, generously sharing his findings in many local and international fora.

Among his body of work, Dr Ragoobirsingh has formulated a list of simple tips that would help to achieve better foot care at little cost. For example, he suggests that it is best to buy shoes at mid-morning “when our feet are between sizes, given that they are smallest when we awake in the morning and largest when we retire at night”.

He also advises that footwear should not be too tight in order to allow air to circulate freely between the toes; cotton

socks/stockings should be worn to help mop up sweat and keep the feet dry; and walking bare-footed should be avoided, especially when outdoors.

Dr Ragoobirsingh's body of research work will be on display at a diabetes exhibition throughout next month, in the museum on the ground floor of the Faculty of Medical Sciences Teaching and Research complex, Mona, in Kingston, which will concurrently host its annual conference on November 7-8, 2019.

“The purpose of the to educate health care professionals and impact patient care. Importantly, the aim is to increase public awareness and influence policymakers,” he said.

The exhibition, which will be free to the public, will also provide “useful tips for diabetics, including the use of herbal


In late November, Dr Ragoobirsingh will share the Caribbean experience when he participates in the International Diabetes Federation (IDF) Biennial Congress in Busan, South Korea, which is expected to attract some 20,000 health care practitioners from across the globe to discuss 'Shaping the Future of Diabetes'.

The IDF, headquartered in Brussels, Belgium, is the umbrella organisation of over 230 national diabetes associations in more than 160 countries and territories. It represents the interests of the growing number of people with diabetes and those at risk.

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