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More than 30,000 children in Africa are born with clubfoot each year. With treatment simply not available where they live, many thousands of these children get no treatment and end up with severe deformities that make it hard and very painful to walk.

Close up of hands in hospital gloves holding an amecty measuring tool © CURE International / Joel Witwer

World Clubfoot Day, 3 June, is the birthday of Dr Ignacio Ponseti, who developed the simple Ponseti treatment, which is successful in up to 95 per cent of clubfoot cases, especially if initiated early. The technique involves gently manipulating the feet to a better position and putting them in a cast. Many older children with untreated clubfoot can also be successfully treated by applying the same Ponseti principles, followed by orthopaedic surgery to help correct the foot, plus rehabilitation.

NDORMS is working with CURE Ethiopia Children’s Hospital on developing a training course for healthcare professionals to treat these older (walking age) children who did not receive treatment as a baby for their clubfeet.

The team at CURE Ethiopia have been filming a new series of teaching videos to support the course. These include how to: assess a child, plan treatment, apply plaster casts, surgical techniques, rehabilitation, and family-centred care.

Consultant orthopaedic surgeon, Dr Tim Nunn says: We’re creating medical education videos to provide a resource for pre-course and post-course learning. The surgical videos allow delivery of good content without changing into operating room scrubs, and the techniques for a learner can be reinforced by repeat viewings. We find that videos are more novel and engaging for teaching a multidisciplinary group of learners. They help us to communicate key ideas and practical skills and can be translated too.”

Joel Witwer, a videographer based at CURE Ethiopia Children’s Hospital, has been helping to film and produce the teaching videos. He says: “It's a big honour to be a part of this process. As a videographer, I spend my days telling other people's stories. By working on this project, I feel like I get to be a part of the story in the sense that my work here will be used to help train up the next generation of doctors and medical staff treating clubfoot in Ethiopia, and hopefully around the world.”

The course will be piloted in September with physiotherapists and surgeons in Ethiopia. It will then be revised and finalised, translated to Amharic, and made available to other organisations involved in clubfoot training and treatment, through the Global Clubfoot Initiative network.

The project is part of a global health grant from Africa Mother and Child Grants Programme funded by Tropical Health Education Trust funded by Johnson & Johnson. 

before and after pics of child with clubfoot© CURE International

Above: before and after treatment for delayed presenting clubfoot.

The NDORMS project leads are Prof Chris Lavy and Grace Drury. It follows on from successful global health collaborations between NDORMS, CURE Ethiopia, Hope Walks and Global Clubfoot Initiative to develop basic and advanced courses for practitioners in clubfoot treatment, and a tailored training of trainers course through the Africa Clubfoot Training (ACT) project.  Although originally designed for training in Africa these courses are now used in many countries in Africa, Asia, Latin America and the UK to train healthcare workers to treat children with clubfoot. 

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