Hearts & Soles Community Foot Care Clinics
By Molly Fessler
I never had an innate interest in foot care. When I first set out to create the Hearts & Soles Community Foot Care Clinics for my Albert Scheweitzer Fellowship project, I felt primarily driven by service. I wanted to help address a need in the community experiencing homelessness: lack of access to comprehensive foot care. The Hearts & Solesclinics, which are mobile and take place in a variety of shelter and community settings, work with folks who are unhoused or unstably housed. We provide our patients with access to foot care, including nail trimming, callus removal, foot soaks, as well as supplies and resources, such as referrals to higher levels of care. Foot care, it turns out, has implications for the health of the whole body. Many health problems experienced by individuals experiencing homelessness can be identified or better understood through a comprehensive foot exam. Circulatory problems (Shabani et al, 2018), progression of metabolic conditions such as diabetes (Pendsey, 2010), and cardiac health are possible to better understand through an evaluation of a patient’s feet (Yeborah et al, 2016). Even foot pain and mental health are related; changes in mental health are associated with an individual’s perception of the well-being of their feet (Butterworth et al, 2014; Hoban et al, 2014). Foot care is primary care, preventative health, mental health, and it is public health.
It is true that, initially, I wasn’t very excited about foot care. But as so often happens, when given the chance to pursue an effort passionately and creatively, I have become somewhat of a foot care Evangelist. I often think of Dr. Schweitzer’s quote, “I don’t know what your destiny will be, but one thing I know: the ones among you who will be really happy are those who have sought and found how to serve.”
I am (really) happy doing this work. I feel grateful to have the chance to learn from and serve my patients.
Butterworth PA, Urquhart DM, Cicuttini FM, Menz HB, Strauss BJ, Proietto J, Dixon JB, Jones G, Wluka AE. Relationship between mental health and foot pain. Arthritis Care Res (Hoboken). 2014 Aug;66(8):1241-5. doi: 10.1002/acr.22292. PMID: 24470151.
Hoban C, Sareen J, Henriksen CA, Kuzyk L, Embil JM, Trepman E. Mental health issues associated with foot complications of diabetes mellitus. Foot Ankle Surg. 2015 Mar;21(1):49-55. doi: 10.1016/j.fas.2014.09.007. Epub 2014 Sep 22. PMID: 25682407.
Woroch RA. Sole Care. J Christ Nurs. 2021 Jan/Mar;38(1):10. doi: 10.1097/CNJ.0000000000000777. PMID: 33284207.
Pendsey S. P. (2010). Understanding diabetic foot. International journal of diabetes in developing countries, 30(2), 75–79. https://doi.org/10.4103/0973-3930.62596
Schweitzer, Albert. “Albert Schweitzer Quotes about Serving Others.” A-Z Quotes, https://www.azquotes.com/author/13192-Albert_Schweitzer/tag/serving-others.
Shabani Varaki, E., Gargiulo, G. D., Penkala, S., & Breen, P. P. (2018). Peripheral vascular disease assessment in the lower limb: a review of current and emerging non-invasive diagnostic methods. Biomedical engineering online, 17(1), 61. https://doi.org/10.1186/s12938-018-0494-4
Yeboah, J., Bertoni, A., Qureshi, W., Aggarwal, S., Lima, J. A., Kawel-Boehm, N., Bluemke, D. A., & Shah, S. J. (2016). Pedal Edema as an Indicator of Early Heart Failure in the Community: Prevalence and Associations With Cardiac Structure/Function and Natriuretic Peptides (MESA [Multiethnic Study of Atherosclerosis]). Circulation. Heart failure, 9(12), e003415. https://doi.org/10.1161/CIRCHEARTFAILURE.116.003415
Molly Fessler is a University of Michigan medical student and 2022-23 Albert Schweitzer Fellow. August 19 is World Humanitarian Day, 2022.