BROCKTON – Mary MacGregor developed Type 2 Diabetes during a pregnancy three decades ago and it never went away.
Years later, circulatory problems caused MacGregor, 69, of Brockton, to lose the toes on her right foot.
Recently, as she sat in an office in Brockton, Dr. Barry Rosenblum examined and cleaned that foot. MacGregor has also developed a type of nerve damage called neuropathy, which means she cannot not feel the limb. Because of that, she uses a custom-made pad to protect a wound on the bottom of her foot.
But, for all the trouble her diabetes has put MacGregor through, she is grateful. If not for the treatment available in the United States, MacGregor might have lost her entire leg. “It probably would have just spread,” she said.
MacGregor’s gratitude came into sharp relief this month when, during her regular checkup, Dr. Rosenblum was shadowed by a Cape Verdean counterpart, Dr. Danielson Veiga.
Dr. Veiga visited Brockton recently through a program organized by Signature Healthcare Brockton Hospital and Dr. Rosenblum, a foot surgeon at Beth Israel Deaconess Medical Center. Dr. Veiga’s goal is to learn techniques that will help him save the limbs of people with diabetes in Cape Verde. “It’s not easy to manage diabetic problems,” Dr. Veiga said. “People live in remote areas. They have to pay a lot of transportation costs to see a doctor.”
Dr. Veiga estimated that of those people in Cape Verde who develop serious “diabetic foot” – problems with blood flow and infections that fester – some 30 to 35 percent will undergo amputation. Doctors in the U.S. are able to save limbs at a far better rate, Dr. Rosenblum said. Last November, Dr. Rosenblum and some of his colleagues traveled to Cape Verde to create a diabetic limb salvage unit at a hospital in Praia, the nation’s capital. The city, slightly larger than Brockton, is on the island of Santiago, one of 10 islands that make up the country off the coast of West Africa.
New England is home to hundreds of thousands of Cape Verdean immigrants, with Brockton in the center of a population line that stretches from Boston to New Bedford. The country’s president and three of its mayors visited Brockton last summer. While in Cape Verde, Dr. Rosenblum and fellow surgeons taught Cape Verdean doctors surgical techniques to avoid amputations and help heal wounds faster. They are planning follow-up visits as well.
Meanwhile, Dr. Veiga, a surgeon trained in Russia and China, is learning vascular surgery, which allows doctors to pinpoint and fix diabetic circulatory problems without removing a limb. Right now, such techniques do not exist in Cape Verde.
Doctors instead send diabetic patients requiring vascular surgery to Portugal or Brazil. But with a financial crisis in Portugal, opportunities for Cape Verdeans have been limited.
Dr. Veiga said now the decision to send someone for surgery often depends not on medical considerations, but on whether they have enough money.
By Joseph Markman /The Enterprise
Joseph Markman may be reached at firstname.lastname@example.org.