Improving foot care in rural Queensland

For many people living in rural and remote Australia, getting specialist care for diabetes-related foot disease can mean travelling hundreds of kilometres, often after serious complications have already developed.

It’s a challenge Dr Chanika Alahakoon hopes to change.

Originally from Sri Lanka, Dr Alahakoon came to North Queensland to complete a clinical PhD at James Cook University, but her research quickly became about far more than earning a qualification. It became an opportunity to improve care for people living with one of Australia’s most serious and overlooked health conditions.

“As a clinician, I always wanted to do a Clinical PhD, and Prof Jonathan Golledge offered me the opportunity to choose between Peripheral Artery Disease (PAD) or Diabetes-related Foot Disease (DFD),” she says.

“As diabetes is a major problem in Sri Lanka, I opted to do my studies in diabetes-related foot disease. This is how I came to work in the Queensland Research Centre for Peripheral Vascular Disease (QRCPVD).”

As she began studying patients in North Queensland, Dr Alahakoon saw how devastating diabetes-related foot disease could be — not only for individuals, but for families and communities.

“Many people in Australia are affected by diabetes-related foot disease due to poor control of diabetes,” she explains.

“They usually had polyneuropathy and PAD on top of their diabetes which made them more prone to foot ulcers and infections. There were a significant number of patients undergoing repeated hospital admissions to manage this condition. Many patients had to undergo foot amputations .”

Her research also highlighted another concerning finding. Around one in five patients included in her research were Aboriginal and Torres Strait Islander people, despite being less than five per cent of the local population.

For Dr Alahakoon, this reinforced the importance of improving access to quality foot care for communities outside major cities.

“The emphasis should also be placed on improving the quality of care for Aboriginal and Torres Strait Islander people, a population for whom diabetes and DFD is a prevailing problem,” she says.

Dr Alahakoon has also received a further grant of $15,000 from the Cairns Hospital Foundation to conduct a study to identify biomarkers for diabetes-related foot disease. The research was deeply personal as well as professionally rewarding.

Before arriving in Australia, Dr Alahakoon had worked as a medical doctor and lecturer in physiology in Sri Lanka. Rather than pursuing full-time clinical practice, she chose research and teaching because she believed they could have abroader impact on patient care.

Today, Dr Alahakoon continues collaborating with the QRCPVD on research designed to improve care for people living in regional, rural and remote Australia.

One project is investigating whether home-based exercise programs, delivered remotely, can help people with Peripheral Artery Disease improve their walking ability without travelling long distances to specialist centres.

“This research is important to improve foot care and outcomes in areas like North and Far North Queensland where tertiary care centres and podiatry services are clustered in city areas. We aim to improve the care given to remotely located individuals, without the need for them to travel hundreds of kilometres to the nearest city .”

For Dr Alahakoon, the goal has always been simple: use research to improve the lives of people who face the greatest barriers to health care.

“This research helps open the eyes of policymakers to the need to improve foot care services in North Queensland,” she says.

Dr Alahakoon has also won the STEM sisters-Women of Colour award in the “Health Impact” category for her work in diabetes.