International Podiatry Day, Podiatrists play a crucial role in preventing limb amputations by treating foot problems early- especially in diabetic patients-because unchecked infections can lead to irreversible damage and loss of limbs. Diabetes continues to be one of New Zealand’s most pressing health issues, with Māori communities disproportionately affected. Among the most serious complications of uncontrolled diabetes are lower limb amputations, which profoundly impact individuals, whānau, and communities.
Māori are more than three times as likely as non-Māori to undergo diabetes-related amputations, according to Ministry of Health statistics. Contributing factors include higher rates of type 2 diabetes, delayed diagnosis, limited access to healthcare services in some regions, and socio-economic disparities that affect overall health outcomes.
A limb amputation is life-changing. Patients often face:
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Loss of mobility and independence
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Chronic pain and phantom limb sensations
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Increased risk of further complications, including heart disease and stroke
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Mental health challenges, including depression and anxiety
For many Māori, the loss extends beyond the individual. Whānau often become primary caregivers, which can strain family resources and disrupt cultural roles and responsibilities. The spiritual impact is also profound, as connection to the whenua (land) and ability to participate in community and marae life may be altered.
Healthcare providers acknowledge that systemic inequities play a role in the higher rates of amputations among Māori:
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Access to podiatry services: Rural and remote Māori communities often have limited foot care services, critical in preventing ulcers and infections.
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Education and awareness: Early signs of diabetic foot complications are not always recognised due to gaps in culturally tailored education.
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Socio-economic factors: Poverty, housing insecurity, and limited transport make regular medical appointments challenging.
Evidence suggests that community-led, culturally responsive interventions significantly reduce diabetes-related complications. Key approaches include:
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Marae-based diabetes programmes, where education, exercise, and nutrition support are delivered in a culturally safe environment
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Whānau-centred care, where the entire family participates in disease management
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Mobile foot clinics that reach rural Māori communities
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Integration of Māori health models, such as Te Whare Tapa Whā, which considers spiritual, family, mental, and physical health as interconnected
Some iwi, such as Ngāi Tahu and Waikato-Tainui, have already begun implementing marae-based clinics and diabetes awareness initiatives, resulting in measurable reductions in hospital admissions for diabetic complications.
