Diabetes and At-risk Foot in Low- and Middle-income Countries or Humanitarian Crises, the International Committee of the Red Cross (ICRC) Approach for Better Interprofessional Care

Research Objectives: The International Committee of the Red Cross (ICRC), based in Geneva, Switzerland, is large neutral humanitarian organisation, aiming at protecting life, health and dignity of persons facing violence.
One of its action tracks is health and rehabilitation in which diabetes care and post amputation rehabilitation is a growing concern, reminding us that in industrialised countries, it's responsible of most lower limb amputation but that most people with diabetes live in low- and middle-income countries (LMICs).
In ICRC settings, they represent now up to 40% of total amputations rate.
Based on these findings, ICRC decide on a teaching program for its healthcare workers.

Design: An interdisciplinary training program was designed in collaborations with Geneva University Hospitals, D-Foot International, Université Numérique Francophone and other stakeholders.
It's based on 3 pillars:
1) e-learning (18 comprehensive modules)
2) 5-days hands-on course
3) monthly post-course meetings

Setting: ICRC healthcare collaborators in LIMCs.

Participants: Aimed at the whole classical ICRC interprofessional team (nurses, doctors, physiotherapists, orthoprosthesist and psychologists).
22 out of Iran, Lebanon, Jordan, and Syria, participated in the hands-on course in Beyrouth, Lebanon.

Interventions: E-learning began in December 2022, a 5-days hands-on course was run in March 2023 in Lebanon. It consisted in theoretical teaching, workshop, and direct care sessions. A monthly post-course internet follow-up meeting was proposed (2023).

Main Outcome Measures: Online course inscriptions, participant’s confidence after the hand’s on course, participation at the online meetings.

Results: Concerning the hands-on course, on a 5 degree scale the 22 participants increased their knowledge confidence from 3.39 to 4.22. Interprofessional patient's centred goal settings was often mentioned.
As of the e-learning, In January 2024, 229 registered, 56 at completed and 130 were in progress.
5 follow-up session could be organised. Each time 20 more collaborators participated and showed through case reports how they could use their new knowledges.

Conclusions: Although not run on strict high scientific criteria, this interinstitutional partnership, through an adapted teaching, will contribute to enhance lives of patients living with diabetes in LMICs.
Trainees out of the hands-on course clearly state they gained confidence. Internet follow-up sessions showed hoe well they could use what they had learned.
This type of blended approach should be proposed to a wider audience and better metrics could be used in order to better show results.

Author(s) Disclosures: None