The Sacred Connection of the Feet (Te Tuhono Tapu o ngā Waewae): The Cultural and Spiritual Impact of Diabetes‐Related Lower Limb Amputation Among Māori

Abstract

Diabetes prevalence in Aotearoa New Zealand is rising rapidly, disproportionately affecting Māori communities and contributing to significantly higher rates of diabetes‐related lower limb amputations. These inequities reflect systemic issues such as colonisation, racism, and limited access to culturally safe care rather than clinical factors alone. Embedding tikanga (Māori customs) within podiatry foot screening offers a pathway to culturally responsive practice that honours Māori spiritual, physical, and cultural well‐being. Integrating Rongoā Māori (traditional healing) and whānau‐centred approaches alongside biomedical care can improve engagement and outcomes, whereas marae‐based and community‐led models enhance accessibility and trust. Workforce development in cultural safety is essential to uphold Te Tiriti o Waitangi obligations of equity, partnership, and protection. Culturally grounded podiatry services not only reduce the risk of amputation but also restore connections to tūrangawaewae (place of belonging) and whakapapa (genealogy), ensuring that care is meaningful and effective for Māori communities.