Alethea Foster (known to us as Ali) died peacefully on 2 January 2011 surrounded by members of her family. She was Lead Clinical Specialist Podiatrist at King’s College Hospital NHS Trust between 1985 and 2004, where she worked within a multidisciplinary team in the Diabetic Foot Clinic.
The esteem in which she is held by her colleagues and, perhaps most importantly, by her patients, was demonstrated by the number of awards she received during her career. These included:
- 1994 Meritorious Award of the Society of Chiropodists and Podiatrists.
- 1995 King’s Commendation for Services to Patients (internal King’s College Hospital award, for which she was nominated by patients and colleagues).
- 1999 M Vaswanathan Gold Medal for services to diabetes.
- 2003 International Diabetic Foot Award (awarded by a panel of distinguished international healthcare professionals every 4 years to an individual who has played a pivotal role in developing diabetic foot care).
Ali played a fundamental role in the work of the multidisciplinary foot care service at King’s College Hospital. She was a pioneer in total-contact casting in the UK, a technique she introduced in 1986 to treat neuropathic ulcers and Charcot feet. These techniques are now used throughout the country and many professionals come to King’s College Hospital to learn and practice the technique. Ali also pioneered diabetic foot care for people with kidney failure and demonstrated that amputations can be reduced in this group with the involvement of skilled podiatrists. She also promoted the concept of emergency care within the foot clinic for people with diabetes.
Ali was a superb teacher, lecturing nationally and internationally. She was a member of a multidisciplinary team sponsored by the British Diabetic Association (now Diabetes UK) that visited Bulgaria for three consecutive years to deliver lectures and conduct masterclasses in an effort to improve diabetic foot care. For a number of years Ali also travelled to Slovenia annually to lecture and conduct workshops as part of an educational programme in diabetic foot care for nurses and physicians. Ali visited many countries – including Romania, Lithuania, Poland, Turkey, Greece, Russia, China, Barbados and India – to assist in the establishment of multidisciplinary diabetic foot care teams. She played a pivotal role in the International Diabetes Foundation’s Step by Step Programme, teaching diabetic foot care skills in India, Tanzania, Sri Lanca, Nepal and Bangladesh.
Ali was a prolific author and published her original observations in esteemed journals. She wrote the acclaimed textbooks Podiatric Assessment and Management of the Diabetic Foot (Churchill Livingstone) and co-authored Managing the Diabetic Foot and A Practical Manual of Diabetic Foot Care (both Wiley-Blackwell), the latter winning the British Medical Association’s 2004 Book of the Year Award.
Ali actively and successfully promoted the importance of ongoing education for podiatrists. She established a successful rotation of podiatrists from the community into the King’s College Hospital Diabetic Foot Clinic. This allowed podiatrists to learn diabetic foot care skills in the King’s clinic and take their new-found knowledge and skills back to the community and apply it. This was much appreciated by the community podiatrists. She also organised and co-chaired an annual diabetic foot conference, which has been held in London since 1993.
Her distinction in the field was demonstrated by the fact that for periods during her career she sat on the Editorial Boards of a number publications concerning diabetes including Practical Diabetes International, The Diabetic Foot Journal and the Journal of Diabetes Nursing. Furthermore she was an Expert Advisor to the Journal of Wound Care and Podiatry Now. She was a core member of the International Working Group on the Diabetic Foot (IWGDF), which authored the International Consensus on the Diabetic Foot and Practical Guidelines on the Management and the Prevention of the Diabetic Foot (IWGDF, 1999) and progress reports and further guidelines in 2003 and 2007.
Ali’s contribution to diabetic foot care has been recognised worldwide because of its dramatic impact on the overall care of people with diabetes. The role of podiatry is now recognised as paramount in the care of the diabetic foot and this is due in part to Ali’s many contributions.
Ali actively promoted the three main aims of the diabetic foot clinic: (i) to provide the best possible care for the person with diabetic foot problems; (ii) to research into the causes of the diabetic foot disease, and; (iii) to teach and train healthcare professionals to provide a high-quality diabetic foot care services.
The value of Ali’s work – treating individual patients, educating healthcare professionals and devising new techniques for the treatment of diabetic foot problems – cannot be over-estimated. Ali remains an inspiration to us in our care for people with diabetic foot disease.
