World Clubfoot Day, marked annually on June 3, raises awareness of clubfoot and celebrates the birthdate of Dr Ignaçio Ponseti who, in the mid-20th century, developed a non-surgical method for treating clubfoot.
Known as the Ponseti method, it consists of using a series of casts, gentle manipulation and a clubfoot brace. This ground-breaking method enabled the correction of clubfoot without surgical intervention and at less expense.
Oranjezicht non-profit STEPS supports 38 partner clinics in the state health sector and has directly trained 599 healthcare professionals in the use of this method to help babies born with clubfoot.
Since the organisation’s establishment in 2005, more than 15 000 children have accessed the Ponseti method of treatment. “We were established in response to the huge need for clubfoot treatment support in Southern Africa,” says STEPS founder, Karen Moss.
“Less than 8% of patients have access to health insurance or the means to pay for treatment. Since clubfoot is a treatable condition, we had to do something to help children avoid a life of disability. The Ponseti Method was successful with my own child and so I introduced it to Southern Africa to try and assist all parents whose children are born with the same condition.”
Despite the pandemic and lockdown challenges, 2020 saw 11 846 patient clinic visits and 678 new patients enrolled at partner clinics, while 1 042 clubfoot braces were distributed by STEPS to clinics and suppliers and there are currently 3 079 patients in treatment.
Clubfoot is a musculoskeletal birth defect where a baby is born with one or both feet twisted downwards and inwards, in a rigid position. If left untreated the child will be unable to wear shoes or walk normally, leading to a life of disability, isolation and pain.
“The Ponseti method requires a four to eight week correction phase where the foot is gradually positioned into place with a series of manipulations and full-leg plaster casts, changed weekly,” says Dr Marí Thiart of the Tygerberg Academic Hospital Clubfoot Clinic.
“A minor procedure is then performed which can be done using local anaesthetic, and we enter the maintenance phase. This is where the child wears a clubfoot brace full-time for three months, and then when sleeping. Clubfoot is a time sensitive condition and the maintenance phase should not be interrupted due to the possibility of negatively impacting treatment outcomes. Despite being in the midst of a pandemic, we still need to treat conditions other than Covid-19. Parents should not delay in seeking medical assistance for clubfoot,” says Dr Thiart.
STEPS immediately registered as an essential supplier to ensure continuous clubfoot brace supply for patients, says Ms Moss. “We are extremely grateful to all of the clinic teams that continued operating in such challenging environments and to the parents who worked with us to ensure that their children continued treatment.”