James providing Podiatry care at the Wellington Local Aboriginal Land Council Drop-In Clinic

This month I am joined by new Footscape Vice President James Gerrard to take a look at our work with a culturally safe 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.

To give background on the establishment of a culturally safe clinical setting being led by an Aboriginal Podiatrist, the following excerpt is taken from West et al. (2021) (1):

‘The culturally safe Podiatry clinic is designed to create an environment that is considerate of the spiritual, physical, social, and emotional world view of Aboriginal and Torres Strait Islander Peoples, thereby creating a clinical experience which is conducive to, and supportive of, the specific needs of this community (2). Additionally, the approach to the management of clients within this clinic is one that recognises the importance of culture, family, and community for Aboriginal and Torres Strait Islander Peoples. For example, clinical consultations are structured around group appointments and two intake times, as opposed to a traditional individual appointment time. This collective-participation approach encourages open discussion amongst community members, assisting students in understanding lived experiences and history sharing, and creates a sense of ownership of the clinic for Aboriginal and Torres Strait Islander Peoples. The clinic provides a range of podiatry care and health promotion education, with a focus on diabetic related foot disease and prevention education.’

The material aid that Footscape provides to this clinic consists of footwear, socks, and foot care kits. These items compliment the clinical and culturally safe 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, as are the benefits of foot care kits in diabetic foot self-care.

The Footscape material aid starts conversations though too. Between Community, between Podiatrist and client, and between Podiatrists and Community. Conversations about footwear styles, function, purpose, and ability to house orthoses all educate patients, promoting informed self-determined choices for school, sporting, recreational, work, and personal use. But these conversations turn into yarns too, exemplifying two-way learning such that Podiatrists learn more about local culture and First Nations perspectives of foot health. Country people like to get out on, and importantly, some Truth-telling.

Clinical yarning like this in a culturally safe space teaches practitioners about protective determinants of health for people in the area. Cultural humility in this setting brings respect for a cultural identity other than your own and makes you reflect on your own biases, beliefs, and thoughts on social justice in healthcare. Discussing foot health shares stories of strength and resilience and promotes collaborative partnerships and shared decision making. Entering this space with material aid, you think it may have a place in treatment planning; leaving, you learn that culture is healing.

The Footscape material aid in this space demonstrates reciprocity, it promotes foot health awareness, and importantly, it can position the Podiatrist as the learner. It leads to positive healthcare experiences, and improved foot health outcomes.

1. 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)
2. Williams R. Cultural safety — what does it mean for our work practice? Aust N Z J Public Health. 1999;23(2):213–4.

Anthony Lewis
Chief Executive Officer