Step by Step (SbS) Foot Project 2003
Train the Foot Health Care Professional (TtFHCP) 2023
Step-by-Step Implementation Program 2003
It all began in March 2003 when nine representatives from the sponsoring organization visited Abbas Medical Centre in Dar es Salaam, Tanzania. During their visit, they witnessed the significant challenges posed by diabetes-related foot complications.
On 1st March 2003, a pivotal decision was made to establish an educational project aimed at addressing diabetic foot care in low- and middle-income countries. Dr. Karel Bakker, former Chair of the International Working Group on the Diabetic Foot, International Consensus Guidelines, and the International Symposium on the Diabetic Foot, described it as a landmark moment, stating: “It was a turning point in the history of diabetic foot care for low- and middle-income countries.”
The “Step-by-Step” program began as a groundbreaking initiative in low-income countries, gradually expanding to middle-income nations and eventually reaching higher-income countries. Its journey started in Dar es Salaam, Tanzania, and has since made a profound impact across 128 countries worldwide.
Step-by-Step Committee Members
To drive the success of the Step-by-Step initiative, a dedicated committee was formed with specific roles assigned to its members:
Zulfiqarali G. Abbas – Lead for Africa
Late Sharad Pendsey – Lead for India
Vijay Viswanathan
Dr. Karel Bakker
Late Ali Foster
Nine Sponsor Delegation Visit to Abbas Medical Centre – Dar es Salaam, Tanzania, 1st March 2003
Curriculum Development Meeting for the Step-by-Step Foot Project – Chennai, India 2003
Zulfiqarali G. Abbas – Leading in Africa
Late Sharad Pendsy – Leading in India
Vijay Viswanathan
Karel Bakker
Late Ali Foster
Two Members From Sponsors.
Meeting in Holland – May 2003
Zulfiqarali G. Abbas – Leading in Africa
Late Sharad Pendsy – Leading in India
Tanzania
Launch of the First Step-by-Step Foot Project in Dar es Salaam, Tanzania – Opening ceremony led by the Honourable Minister of Health of Tanzania, accompanied by the program’s first faculty members.
Advanced Session of the Step-by-Step Foot Project and Stamp Launch – 2005
In 2005, recognized globally as the Year of the Diabetic Foot, the Step-by-Step Foot Project held its second advanced session in Dar es Salaam, Tanzania. On November 14, 2005, in honor of World Diabetes Day, the Government of Tanzania launched a commemorative stamp to mark this significant milestone.
After the success of the SbS project basic and advanced courses, several other projects were conducted in Tanzania. Initially in 2004 and 2005, basic and advanced courses, Podiatry course in 2006, for other centres basic and advanced course in 2008 and 2009, podiatry course in 2010 and lastly surgeons basic and advanced course in 2009 and 2010.
Indian
The Step-by-Step Foot Project was later launched in India as part of a pilot initiative alongside Tanzania.
Late Sharad Pendsy – Leading in India
Arun Bal
Vijay Viswanathan
Late Ali Foster
Step-by-Step Foot Project: Expanding Globally
One of the primary objectives was to transfer knowledge and expertise among healthcare professionals and export successful practices to other low- and middle-income countries (LMICs). This initiative has since expanded to numerous additional countries, including:
Congo 2009-10
Egypt 2009 – 10
Caribbean Islands 2009-10
Guinea 2010-11
Botswana 2011-12
Malawi 2012-13
Zimbabwe 2015 – 17
Nigeria 2017-18:
Developed and implemented the ‘Train the Foot Trainer’ regional program in 2012, followed by a step-by-step nationwide rollout to ensure comprehensive dissemination and impact.
In 2012, the decision was made to launch a regional training initiative called ‘Train the Foot Trainer.’ This program brought together pairs of experts specializing in diabetic foot care from each country within the region. These experts were trained to return to their respective countries and implement the Step-by-Step (SbS) Foot Project, effectively cascading their knowledge to others. A dedicated committee was formed to design the program, and its outcomes were documented in a published paper, available via the attached link
Committee members as follows:
Kirstein Van Acker
Stephan Morbach
Vilma Urbancic
Neil Baker
Zulfiqarali G. Abbas
1st Train the Foot Trainer was done in 2012: South America (Brasilia/Brazil)
14 Countries
2nd Train the Foot Trainer was done in 2013: Caribbean Region
22 Countries
3rd Train the Foot Trainer was done in 2015: Eastern Europe in Slovenia
17 Countries
4th Train the Foot Trainer was done in 2017: Western Pacific Bangkok, Thailand
13 Countries
5th French Speaking Countries Train the Foot Trainer was done in 2019: Casablanca, Morocco
12 Countries
6th MENA region Train the Foot Trainer was done in 2020: Abu Dhabi
14 Countries
7th South East region Train the Foot Trainer was done in 2023: Chennai, India
4 Countries
Train the Foot Health Care Professional: Regional Program with Step-by-Step National Implementation 2023
In 2023, the ‘Train the Foot Healthcare Professional’ program was launched to address diabetes-related foot complications on a regional scale. Experts specializing in diabetes care were selected in pairs from each country within the region to participate in this targeted training initiative. Unlike previous programs, this project assumed a foundational awareness of diabetic foot complications and focused on equipping participants to manage and address these issues effectively. Upon completing their training, participants returned to their respective countries to implement the Step-by-Step (SbS) Foot Project, extending the program’s reach and impact. A dedicated committee developed the training framework, and the program’s outcomes were documented in a published paper, accessible via the attached link.
Committee members as follows:
Zulfiqarali G. Abbas
Harikrishna K.Ragavan Nair
Vijay Viswanathan
Hermelinda C. Pedrosa
Roberto Anichini
Beata Rakowska
Mariam Botos
8th TtFHCP 2023-25 Southern and Central America (SACA) Region – 16th to 19th August 2023.
8 Countries
9th TtFHP 2023-25 Western Pacific Region. Selangor, Malaysia, 6th to 8th October 2023
14 Countries
10th TtFHCP 2023-25. 15th to 17th February 2024, Bled, Slovenia
10 Eastern European Countries
11th TtFHP 2023-25. 15th to 19th August 2024, Zanzibar, Tanzania
11 African Countries
12th TtFHCP Meena Region 2023-25, War Affected Countries. 24th to 25th August 2024, Karachi, Pakistan
5 MENA Countries
