Sustainable Clubfoot Care Sustainable Clubfoot Care in the Developing Worldin the Developing World

Sue BantonSue Bantonsteps Charity Worldwidesteps Charity Worldwide

Clubfoot - a spiral into Deformity Disability Clubfoot - a spiral into Deformity Disability Dependency Demoralization Depression DespairDependency Demoralization Depression Despair

Worldwide there are 136,500 annual newborns with Clubfoot - the majority in the developing world have little access to treatment.

Neglected & inadequately treated CF is one of the biggest causes of locomotor disability.

Asia Sub-SaharanAfrica

Middle East LatinAmerica

Europe Northamerica

Why treat clubfoot?Why treat clubfoot?

Uganda SustainableClubfoot Care Project

April 1, 2004 – September 30, 2010

Participants

University of British Columbia (UBC)

Makerere University Medical School (MUMS)

Orthopaedic Technology Training School, Mulago (OTTS)

School for Orthopaedic Officers, Mulago (SOO)

Nursing Council of Uganda (NCU) Comprehensive Orthopaedic

Rehabilitation Services of Uganda (CORSU)

Uganda Ministry of Health (MOH) Christian Blind Mission (CBM) Canadian International

Development Association (CIDA)

Canada-Uganda collaboration to Canada-Uganda collaboration to improve sustainable clubfoot careimprove sustainable clubfoot care

6 year CIDA funded project.6 year CIDA funded project. 1500 babies are born with clubfeet each year in 1500 babies are born with clubfeet each year in

Uganda.Uganda. 1999 - 2003 pilot project introduced a non-1999 - 2003 pilot project introduced a non-

surgical method of clubfoot correction (the surgical method of clubfoot correction (the Ponseti Method).Ponseti Method).

Aims:Aims:• Build capacity throughout the Ugandan Healthcare Build capacity throughout the Ugandan Healthcare

System for the early detection and treatment of the System for the early detection and treatment of the congenital clubfoot.congenital clubfoot.

• Build capacity in Ugandan Healthcare Schools to teach Build capacity in Ugandan Healthcare Schools to teach detection and management of the clubfoot.detection and management of the clubfoot.

• Collect baseline and efficacy data of this method in Collect baseline and efficacy data of this method in Uganda.Uganda.

Outputs: (end of 2 years)Outputs: (end of 2 years) Incorporated clubfoot Incorporated clubfoot

detection and detection and management by the management by the Ponseti Method into the Ponseti Method into the curriculum of all medical curriculum of all medical and paramedical schools in and paramedical schools in Uganda.Uganda.

Clubfoot clinics were Clubfoot clinics were established at five established at five Regional Referral Regional Referral Hospitals.Hospitals.

An Ethnocultural Survey An Ethnocultural Survey was completed.was completed.

An incidence at birth An incidence at birth survey was started.survey was started.

Does it work in Uganda?Does it work in Uganda?

A multi-partner A multi-partner collaboration is collaboration is building capacity in building capacity in Uganda by:Uganda by:• teaching clubfoot teaching clubfoot

care.care.• detecting and detecting and

treating clubfeet in treating clubfeet in a way that is a way that is economically and economically and socially sustainable socially sustainable for Uganda.for Uganda.

Can it work Globally?Can it work Globally?

The dream is for all countries to have a sustainable clubfoot care programme to eradicate the neglected clubfoot disability that stops so many children from walking.

stepssteps involvement involvement Supported training in:Supported training in:

• BulgariaBulgaria• BrazilBrazil• ChinaChina• EthiopiaEthiopia• FijiFiji• KenyaKenya

Looking for funding to Looking for funding to develop a Sustainable develop a Sustainable Clubfoot Care Clubfoot Care programme in Kenya.programme in Kenya.

Thank YouThank You

Ignacio V. Ponseti, MDUniversity of Iowa Hospitals and Clinics, Department of Orthopaedics, Iowa City, Iowa

Shafique Pirani, MD, FRCSCProfessor, Department of Orthopaedics, Faculty of MedicineUniversity of British ColumbiaProject Director -Uganda Sustainable Clubfoot Care Project

Dr. Norgrove PennyUniversity of British ColumbiaCanada

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