James providing Podiatry care at the Wellington Local Aboriginal Land Council Drop-In Clinic
This month I am joined by Footscape committee member James Gerrard to take a look at our work with a culturally responsive podiatry clinic on Wiradjuri Country at the Wellington Local Aboriginal Land Council. During 2021 Dr Matthew West (Wiradjuri), Prof Viv Chuter, James Gerrard, and the Wellington Local Aboriginal Land Council first applied to Footscape for material aid items on behalf of the podiatry clinic.
Five years later, the material aid that Footscape provides to this clinic consists of footwear, socks, and foot care kits. These are made available at clinics running approximately every 3 months and compliment the clinical and culturally responsive service by enabling display and distribution of items. Clinically, the evidence around the role of indicated footwear in the treatment of a variety of presenting pathologies is well known (1, 2), as are the benefits of foot care kits in diabetic foot self-care. What is also important is that material aid contributes to the reciprocity of the clinic, giving something to Community in return for the gifts of their invitation to come on Country, their time, and their teachings.
To provide background on the establishment of a culturally responsive clinical setting being led by First Nations Community and a First Nations podiatrist, this clinic was established by Community, for Community, and was designed to create an environment centring First Nations definition of health (3); not just the physical well-being of an individual but the social, emotional, and cultural well-being of the whole Community (4).
It is important to understand that First Nations definitions of health are inclusive of individuals being able to achieve their full potential as a human being, thereby bringing about the total well-being of their Community. This is a whole of life view and includes the cyclical concept of life-death-life (4). The clinic provides a range of podiatry care and foot health promotion with a focus on diabetes-related foot disease and prevention education responsive to these definitions of health and to place (3).
Additionally, the approach to working with and for clients within this clinic ‘is one that recognises the importance of culture, family, and Community’ (3). This for example sees no appointment times, but rather a drop-in clinic, one-on-one or group setting consultations, and an environment conducive to social, clinical, and research Yarning; which engages deep listening and 2-way learning (5, 6, 7).
The Footscape material aid starts yarns and is a constant topic in them; between Community, between podiatrist and client, and between podiatrists and Community. Yarning about footwear styles, function, purpose, and ability to house orthoses all inform individuals, families, and Community, promoting informed self-determined choices for school, sporting, recreational, work, and personal use. Importantly, yarns in this clinic are led by local Community, Elders are present, Country has input, and ownership and power within the space are help by First Nations Peoples. This means that 2-way learning in Yarning has podiatrists learn more about local history, cultures, and First Nations perspectives of foot health. It also means that podiatrists listen to some Truth-Telling.
First Nations determined clinical governance of Yarning in a culturally responsive foot health space teaches practitioners about protective determinants of foot health for people in the area. Non-Indigenous cultural humility (8) in this setting brings respect for a cultural identity other than one’s own and makes non-Indigenous clinicians reflect on their own biases, beliefs, and thoughts on social justice in healthcare. Discussing foot health shares stories of strength and connection to Country, families, and to Ancestors, and promotes collaborative partnerships and shared decision making.
The Footscape material aid in this space therefore doesn’t simply promote foot health awareness, it can position the podiatrist as a learner. Footscape material aid contributes to positive healthcare experiences, and improved foot health outcomes. As a clinician entering this space with material aid, you think it may be involved in treatment planning; leaving, you learn that it has a place in ongoing culturally responsiveness.
References:
1. McRitchie M, Branthwaite H, Chockalingam N. Footwear choices for painful feet–an observational study exploring footwear and foot problems in women. Journal of foot and ankle research. 2018;11(1):23.
2. Kurup HV, Clark CI, Dega RK. Footwear and orthopaedics. Foot and Ankle Surgery. 2012;18(2):79-83.
3. West M, Sadler S, Hawke F, Munteanu S, Chuter V. Effect of a culturally safe student placement on students’ understanding of, and confidence with, providing culturally safe Podiatry care Journal of Foot and Ankle Research. 2021;14(9)
4. National Aboriginal Health Strategy Working Party. A national Aboriginal health strategy. Canberra: Australian Government Department of Aboriginal Affairs. 1989. In: Australian Indigenous HealthInfoNet. https://aodknowledgecentre.ecu.edu.au/key-resources/policies-and-strategies/10967/?title=A+national+Aboriginal+health+strategy&contenttypeid=1&contentid=10967_1. Accessed 15 April 2026.
5. Lin I, Green C, Bessarab D. ‘Yarn with me’: applying clinical yarning to improve clinician–patient communication in Aboriginal health care. Australian journal of primary health. 2016;22(5):377-82.
6. Barlo S, Boyd WB, Pelizzon A, Wilson S. Yarning as protected space: Principles and protocols. AlterNative: An International Journal of Indigenous Peoples. 2020;16(2):90-8.
7. Barlo S, Boyd WB, Hughes M, Wilson S, Pelizzon A. Yarning as protected space: Relational accountability in research. AlterNative: An International Journal of Indigenous Peoples. 2021;17(1):40-8.
8. So N, Price K, O’Mara P, Rodrigues MA. The importance of cultural humility and cultural safety in health care. Medical Journal of Australia. 2024;220(1):12.
Anthony Lewis
Chief Executive Officer