The awareness of what we can do is the major issue

Fred Holtkamp holds a masters degree in rehabilitation engineering and is associate lector at Fontys University in Eindhoven at the Institute for Allied Health Professions and holds a position as visiting professor at the University of Labour and Social Affairs (ULSA) in Hanoi, Vietnam.

He was involved in a program in Vietnam where students are educated in making and adapting shoes for patients with foot disorders. Now he is researching the possibilities of establishing a similar program also in Tanzania, Africa. In the interview he talks about the difficulties while setting up a program like this and why these programs are so important for spreading the knowledge about professional footcare.

Mr. Holtkamp, you were part of a succesful training program in orthopedic shoemaking in Vietnam. Now there are plans to set up a similar project in Africa. Who transferred the concept from continent to continent?

The idea of starting a project like the one in  Vietnam originated one and a half years ago in the Dutch Leprosy Relief Foundation, Liliane foundation and Fontys  University, which already had supported the project in Vietnam. In their mind, it would have been a missed opportunity if this program were only available in Vietnam and not in other parts of the world.

This foundation does a lot of work in Africa and we were discussing whether and how it should be possible to develop and run a program like the one in Vietnam also in Africa.

So when do you start?

As soon as we have the money. We are now working on finding the financial resources for the project. That means our major work right now is writing and telling people about this.

The program in Vietnam was made possible by the Dutch Postcode Lottery. They funded not only the development of the educational program itself. Setting up the workshops, buying all kinds or machinery, making it possible for students to come over to Vietnam and be supported in respect of travel expenses and the cost of daily living and the tuition fees for the students was all part of the project funding.

Are there any institutions in Africa who could fund the project?

What makes it difficult in Africa for projects like ours is a lack of awareness for the problem and the possibilities to help. In European countries there is an awareness of governments as well as of social and political bodies that every person must be enabled to contribute to society. Africa is still in the process of developing this awareness. In many countries people with handicaps are still being stigmatized. In some cases they are regarded as a shame for the family. They are hidden at home and are not a part of social life. They don’t exist. In Asia people are already more involved in this process.

Therefore you first have to work on the awareness of the policy makers, the people in health care organizations and of course of the families that people with some kind of disability are still able to lead their own life and support themselves. It is not just about fitting someone with a prosthesis or an orthopedic shoe. It is also about making people aware that those people are valuable and can contribute to society. This is a secondary goal of our project. This process is ongoing. A number of initiatives worldwide help to address this topic.

Isn’t this a process that may take years or even decades?

That is why we are extremely happy with the GATE-initiative of the World Health Organization (WHO). The vision of this initiative is a world where everyone in need has access to high-quality, affordable assistive products to lead a healthy, productive and dignified life. The fact that assistive technology is now a human right does not mean that this is already accepted everywhere. But the GATE-initiative really has helped worldwide to make people in the healthcare business more aware of what the benefits of assistive technologies are.

Working on the awareness seems to be the hardest part.

Always! This is something that should be worked on with the policy makers.

One of our students of the program in Vietnam made orthopedic shoes for a lorry-driver with clubfeet. By doing this, the lorry driver  was not only able to keep his job and earn his income but also to support his family.

These are the cases with which we can show that our work is able to make a difference for people and for the society. Everybody should be able to earn his own income, to live his own life and support himself independently. When a person works, from the perspective of meaning-making, he or she contributes to society and saves the society a lot of money because he or she does not have to be supported by the government. Our profession helps people overcome their deficiencies in mobility. We need more cases like this and we have to tell the policy makers about the results.

What advice would you give people who would like to set up a training program in their own country?

My advice would be to make this a major topic at an IVO- or ISPO-congress. You could set up a round table discussion to gather ideas, to exchange experiences and to bring together those people who are willing to commit themselves to this issue. You should make some kind of inventory where the people come from and what they would like to achieve. Then you have to nail down an approach how you can deal with those challenges.

We have to start with our own professionals. At the moment there is only a small group in our profession that has committed itself to the goal of spreading the knowledge in pedorthics all over the world. This group should be expanded.

We also have to learn to cooperate and exchange ideas, experiences and students who will learn how things are done in other parts of the world. Collaborations are already much more part of our professional life than years ago. In a profession like ours we should be more aware of that.

Of course you cannot just copy one training program from one country to another. You will always have to adapt existing programs to the context of the specific country. But I really think that these initiatives can make a difference for many people. And I honestly believe this is the only way to move forward. M

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