Bermudian who is going places.

Sitting in his tastefully appointed offices in the Cedar Parkade on Washington Street, the podiatrist sails through our interview with assurance, and a clear-cut sense of his professional destiny. He lays out his academic background, traces his career paths past and present, and then addresses his concerns with regard to the care and treatment of those with specific medical problems, all without affectation or hesitation.

Beyond this, one senses a "different'' individual -- someone who has experienced a broader world than Bermuda's tiny confines, and indeed Mr. Binns agrees.

"I attribute a lot of my mentality to London,'' he explains. "Those were my formative years. The cultural diversity is rich, and the city is steeped in history.'' The son of Myron and Maxine Binns, young Germaine attended Purvis Primary School, Northlands Secondary School, and the Bermuda College before proceeding to London, England, at age 19 to study medical laboratory science at the Polytechnic of Central London and Guy's Hospital.

Once qualified as a medical laboratory technician, Mr. Binns quickly found employment in his chosen field, and settled down to enjoy life in one of the world's greatest cities.

In time, however, doubts began creeping into the active mind of this self-described "people person''.

"I realised that there had to be more to life than a smelly laboratory,'' he remembers, "so I began to look around and see what was out there.'' A summer trip to Bermuda provided the answer: Podiatry.

"I looked around in the community and noticed the profession was crying out for someone to get into it,'' he relates.

So Mr. Binns returned to London and entered the University of Westminster, where his background in medical sciences allowed him to take an accelerated three-year course in Podiatric Medicine, from which he graduated with a Bachelor of Science (Honours) degree in 1997.

"We had 60 in the classes, and they were from all over the world,'' he recalls. "I can remember being constantly tired because I would work until late in the evening. As a locum, I worked in various clinics until I found a permanent position in Dr. School's Foot Care Clinic in Knightsbridge.

During the years of intense study this go-getter also found a way to see the world cheaply -- as a courier for British Airways.

"You carried documents, which were collected at the other end by a BA courier,'' he explains. "The flights were an absolute bargain, and since travel was my passion, I visited Israel, Egypt, Japan, France and the Caribbean.'' Around age 27, however, Mr. Binns felt it was time to decide where he was going to settle down. He adored the cultural diversity of London, but he also missed his homeland. Again, a trip home after a two-year absence provided an immediate and irrevocable answer.

"As I stepped off the plane it was almost like I had `Island fever','' he recounts. "The colours were so brilliant, the fragrances so alive. I sensed a certain vibrancy, and I fell in love with the Island. I got friends to pack up my belongings, and I haven't been back to London since!'' Getting established in Bermuda, however, was not quite the smooth sailing he envisaged. With no professional openings apparently available, Mr. Binns decided to open his own practice, only to find a certain reluctance on the part of the business community and lending institutions to assist him.

"When you sit down to talk to business consultants and banking officers they are so used to someone selling a product that I had to explain to them that the `product' I sell is my knowledge and the skills I have in my hands,'' he explains.

As with everything else this positive thinker tackles, Mr. Binns successfully overcame the hurdles, and is today the head of a growing practice, The Foot and Ankle Clinic.

Although Bermuda's clients do not present all of the medical problems which are seen in London, the challenges are nonetheless wide-ranging.

"On a day-to-day basis we see people who have problems as a result of wear and tear from shoes, and we also get a lot of referrals from the medical community. As foot care specialists, we are asked to see diabetics, people with sports injuries, children with problem feet, as well as a lot of ingrown toe nails, fungal infections, and a great deal of arthritis, both rheumatoid and osteo. The range is vast.'' General practitioners also refer patients to Mr. Binns for his professional assessment on the merits or otherwise of surgery.

"Surgery is always the last option when it comes to the feet, and the reason is because the feet are weight-bearing. When you alter the bone structure you also alter the bone function, so you are causing more problems and not really correcting the underlying problem,'' the podiatrist explains. "There are many things that can be done, such as orthotic devices. They won't correct the problem but they will control it.'' On the subject of foot care generally, Mr. Binns feels that a lot more needs to be done in the way of public education. Unlike Europeans, and Germans in particular, who are assiduous in pursuing regular foot care every two months, Bermudians tend to take their feet for granted -- until there is a problem, that is.

"People don't use podiatry for the right reasons here,'' Mr. Binns says. "I find that feet are a low priority mainly because people can't see them. If feet -- like teeth -- were permanently on display, they would have a lot higher priority. People spend so much more on their teeth because they are seen when they talk and smile.'' While Mr. Binns concedes that women tend to take better care of their feet, possibly because they are covered by insurance, men tend to visit him when it's almost too late.

"Education is so important,'' he stresses. "Part of the approach I hope to foster here is a complete approach. People should know that the first place to go is to a foot care specialist or a general practitioner.'' Mr. Binns is particularly concerned about the lack of education on proper foot care among the diabetic community, and he feels much more needs to be done in the way of communicating with them.

"That is one of the things I see lacking in Bermuda,'' he says. "I feel the diabetic task force should have a podiatrist on the team. The prevalence of diabetes in Bermuda is very, very high, and many amputations are the result of neglect.

"Education includes things like making sure diabetics have the right sized shoes, and that the shoes are of all natural materials instead of synthetics.

Then there are the most basic things, like drying between the toes, and checking the feet each week.

"Diabetics should keep regular appointments with a foot care specialist, and I like to encourage patients to have a vascular assessment to make sure their blood is flowing adequately to the lower limbs. Also, because their sensory perception is impaired, they could step on something and have an infection without realising it, so I also check clients for this.'' Nonetheless, Mr. Binns remains optimistic that podiatrists will have closer links with the hospital in relation to having an active role in the treatment and education of diabetics.

Asked to explain the difference between a podiatrist, a chiropodist, and a pedicurist, Mr. Binns says that while podiatrists investigate and treat foot disorders, chiropodists treat minor foot ailments, such as corns and callouses, and pedicurists provide cosmetic services.

"The British were the founders of chiropody,'' he says. "Originally, they visited fairgrounds along with dentists, and were known respectively as corn cutters and teeth pullers. The Americans had a lot of time and money to research chiropody, and they advanced it so far that they weren't practising the same thing as the British, so they gave it the name `podiatry.' The British are now having to adopt podiatry.'' Mr. Binns notes that while podiatry is a degree course, chiropody is a diploma course. Furthermore, in the United States surgery is part of the podiatrist's training. Hence they are referred to as "Dr.'' In Britain, because surgery is a separate course, podiatrists are referred to as "Mr.'' The podiatrist says that the Chiropody and Podiatry Board is currently working to produce a code of ethics and bye-laws to bring members up to a uniform standard.

"That is not to say that they are not good, but it is a question of quality control,'' Mr. Binns explains.

"It is the only way for everyone to have proper communication with the profession and the medical community. To come to Bermuda you have to present your qualifications, but once you start to practise, what happens after that? Is there anyone who says that you have to do refresher courses to keep up with the times? Things that were done 20 years ago are different from what is happening today.''