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A doctor’s big idea is transforming limb care halfway across the world

Pittsfield, Maine and Kano, Nigeria are 5,049 miles apart as the crow flies. Imagine the differences in culture, size, and weather, and the distance between one of Maine’s quintessential small towns and Nigeria’s tropical, fast-paced second city seems even greater. Yet James Fullwood, DPM, a podiatrist at Northern Light Sebasticook Valley Hospital is changing lives in both communities.

By day, Dr. Fullwood provides specialty foot and ankle care in Pittsfield. Outside of the office, he serves as president of the International Limb Salvage Foundation, guiding a team of 10 United States-based doctors and nurses that’s partnering with Nigerian healthcare providers to reduce foot and leg amputations caused by diabetes. The Foundation’s doctors and nurses take turns traveling to Nigeria during their vacation time.

There are no foot and ankle specialists in Nigeria, and vascular surgeons, orthopedic surgeons, and other doctors who may treat limb issues are limited in number. Often, this type of care falls to primary care providers who may have little formal training in caring for highly complicated diabetes-related foot and ankle problems. The result is a high amputation rate.

“If a person gets a foot wound in Nigeria, there’s a 53% chance they will experience an amputation below the knee,” says Dr. Fullwood. “There’s no safety net in Nigeria, so if a person has a limb amputated and can’t work, it can destroy a family. That’s why this is so important.”

Many international humanitarian organizations in Nigeria work directly with those who can benefit from their assistance, but do not engage others in the country who can affect policy, funding, and trust building in communities. Dr. Fullwood sees the International Limb Salvage Foundation as a different kind of organization, a true partner in creating lasting change by tackling the problem of limb salvage at all levels: in the hospitals, community, and government.

In the hospitals, the team shares ideas with doctors about clinical care, medical clinic operations, supply chain issues, and other logistical challenges. At the community level, the organization facilitates education to patients. And at the governmental level, they’re working to establish podiatry as a recognized medical specialty in Nigeria. This approach helps the organization build credibility throughout the country.

“When you walk with a person to the graves, when you go to the wards, and then you go back to the boardroom to figure out what you're going to do, it's a different ballgame,” he adds. “Now you have the support of the politicians. You have the support of the hospitals. You have the support of the people.”

A core belief of the International Limb Salvage Foundation is that learning is a two-way street. While Nigerian healthcare providers are eager to soak up knowledge from the American doctors and nurses, Dr. Fullwood notes that what he’s learned in Nigeria has made him a better foot and ankle doctor for his patients in Pittsfield.

“A lot of these doctors are world leaders in their practice,” he says. “They’re treating severe wounds and seeing 80 to 100 patients every single day. We have the benefit of technology, and they have the benefit of being more creative. When I’m there, I learn just as much as I teach. We have a lot of the same struggles, a lot of the same conversations.”

The Foundation recently expanded its footprint into Kano and is now active in several cities, including Lagos, Nigeria’s largest city. In the future, Dr. Fullwood and his team would like to create a center in the United States to offer year-long mini-fellowships to Nigerian doctors. And, they’d like to establish podiatry as a recognized medical specialty in Nigeria within the next few years. Eventually, Dr. Fullwood and his colleagues would like to build a small specialty hospital in Nigeria focused on limb salvage.

Dr. Fullwood and his team are making a world of difference with an organization rooted in rural Maine. Their success is proof that big, transformational ideas can begin in small places like Pittsfield.

“I wanted to be in a rural area, in a small town where people needed me, and where I could also grow an international program at the same time,” he says. “You don’t have to be at a large medical institution to have an international program. Just follow your passion and let it truly be yours.”

For more information about the International Limb Salvage Foundation, please visit