NEW !
Letters to the Editor
Continued from P4
Donor education has a role in the effective use of money raised . While accountability is essential it must be balanced against the burden of excessive reporting requirements . Many organisations spend precious resources on expensive appeals and meeting the needs of the donor .
While we all like something in return , perhaps it could be the knowledge of the positive change for those in need rather than a prize , an event , a tax deduction or an overdetailed report . Then more would reach where it is needed and our “ giving ” would have greater effect .
Many of us live in comfortable abundance through the good fortune of our birth , our health , our education and the work of previous generations . We have more than we need and indeed more than is our fair share . As long as there is an inequitable distribution of resources and the rich live as though they have more rights than those who are poor , basic human rights will remain out of reach for many .
An equitable share of both resources and opportunities is a human right rather than a favour to be bestowed .
Dr Jennie Connaughton , CINI Australia
Working together , head to toe
Dear Editor ,
RE : Embracing Life , Diabetes and All and Speak to the Feet , June edition .
From a vascular surgeon ’ s perspective , diabetes poses an ever increasing management challenge , with multiple factors such as macro and microvascular disease , polymicrobial infection , neuropathic sensory loss and mechanical foot deformity . The increasing incidence of diabetes amongst younger patients is contributing to the burden of chronic limb ischaemia facing tertiary vascular services .
Many diabetics fear losing a limb . Fortunately , in a contemporary setting this is rare , especially with aggressive management . The key is a combination of effective diabetic control , multidisciplinary tissue loss management ( vascular , wound care , podiatry , microbiology ), and aggressive vascular intervention when required .
In many instances , the most significant hurdle is a lack of awareness of the risk . Counselling patients to meticulously care for their feet and seek regular preventative podiatric review is essential . Allied to this is the awareness amongst primary care physicians that early referral to tertiary multidisciplinary foot ulcer services or to vascular surgeons with an interest in ulcer management can significantly improve outcomes and save limbs .
Significant technical advances in endovascular surgery over the last five years especially in the management of ‘ below knee ’ tibial occlusive disease , as seen in diabetes has had significant benefits . This has led to dramatic improvements in limb salvage . Recanalisation of even occluded vessels is now feasible . Using minimally invasive devices and novel techniques such as drug-coated balloons and stents , transpedal approaches , and specialised low profile endovascular equipment has led to high success rates . Revascularisation in combination with aggressive control of infection is often required .
Awareness of risk , early referral , and a multidisciplinary approach are key to saving toes , feet and limbs .
Quiet givers
Mr Stefan Ponosh , Vascular & Endovascular Surgeon
Dear Editor ,
There are two extremes in health philanthropy (‘ Give a little bit …’ June ) – the high end and the quiet end . The high end acquires great wealth and gives some of it away . Many become well known . The quiet end go the extra mile and do it at a 50 % discount . These givers are called GPs . Their philanthropy goes unnoticed since few of the recipients understand Medicare .
E / Prof Max Kamien , City Beach
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2011-2013
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