Introduction to Diabetic Foot Care in Tonga

Nalini Natesan with Head of NDC nurses Selini Soaki and NDC nurse Litania Akoteu. Litania is holding her certificate.

In December, 2018 Motivation Australia consultant podiatrist Nalini Natesan together with Selini Soakai, head of Non-Communicable Disease nurses, delivered two days of training on diabetic foot screening and wound care to community nurses in Tonga.

As part of the Tonga Rehabilitation and Mobility (TRaM) project, Nalini facilitated and supported the delivery of introductory level diabetic foot care training. During this time she also had the opportunity to consult with nurses working in the National Diabetes Centre (NDC) and community about their experiences in providing diabetic foot care and the challenges they face. The stories she heard are really valuable, and they will inform further planning for diabetic foot care in Tonga.

While observing current practices, workload and resourcing, Nalini met Katoa who had been regularly attending the NDC for management of a wound on his foot. Katoa did not have access to a shoe to protect his foot and wound. He has also been waiting for a wheelchair so that he does not have to walk on the foot – giving it time to heal. The only currently available options in Tonga, for taking the pressure off a wound are wheelchairs or crutches. Katoa’s story highlights the current gap in service for providing wound offloading.

As the TRAM project moves forward, Motivation Australia will work alongside the National Diabetes Centre to further strengthen the training and resources needed for offloading diabetic foot wounds with an aim to increase healing and prevent amputation in Tonga. This will hopefully enable people like Katoa to have access to the footwear and wound offloading support he needs.

Learn more about our Keep Moving Training resources that we developed to support diabetic foot care training here. Download a copy our poster presentation on the effectiveness of diabetic foot care in Samoa here.


The Tonga TRaM project is supported by the Australian Government and implemented by Motivation Australia and the Ministry of Health in Tonga.

Thank you to everyone who met with us and told us their stories.