Tonga DFC training

Okalina with her new cast shoes, standing next to her son, and MA prosthetist orthortist Narelle Cook and prosthetist orthotists.

In December last year, Motivation Australia’s Consultant Podiatrist Nalini Natesan, delivered two days of training on diabetic foot screening and wound care to community nurses. She returned to Tonga in March, with volunteer podiatrist Emma Winter and Motivation Australia’s Prosthetist Orthotist Narelle Cook, to deliver the second part of the training as part of the TRaM project. The team delivered five days of training to further develop the nurses’ skills in wound management and infection control practices.

During the practical component of the training, the team met Okalina (pictured) who had been attending the National Diabetes Centre (NDC) for wound management for over two years. She developed a wound on her foot as a result of a severe foot deformity caused by Charcot foot, a complication of diabetes. While the NDC nurses were providing the best care with the resources available to them, Okalina required specialist offloading to take the pressure off her wound for it to heal. Okalina agreed to have cast shoes made for her by the rehabilitation team, while the NDC nurses provided wound management with guidance from Nalini and Emma.

Okalina is the first person in Tonga to have received this wound offloading treatment. Her story highlights the value of the rehabilitation team and the NDC nurses working collaboratively to manage diabetic foot wounds in Tonga. The NDC and rehabilitation team will continue to work with Okalina to monitor the progress of her wound and look forward to seeing it healing and her being more mobile in the future.


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.