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Recent pilot instructor training course for clubfoot practitioners in sub-Saharan Africa was a success.

Course photo of UK faculty, regional trainers and basic provider course participants.
Course photo of UK faculty, regional trainers and basic provider course participants.

NDORMS Consultant Orthopaedic Surgeons, Professor Chris Lavy and Mr Andy Wainwright, have returned from piloting a new instructor training course for clubfoot practitioners in sub-Saharan Africa.

There was a very positive feel to the course - there was an inspiring group of physios, doctors and assistants from all across Africa who were experienced in treating clubfeet and eager to develop their teaching. - Andy Wainwright

Around 200,000 children born each year are affected by clubfoot, with 80% of these in low and middle income countries. Without treatment, the condition becomes 'neglected clubfoot', a painful and severely disabling deformity. However, in up to 95% of cases, clubfoot can be treated successfully using the Ponseti method of treatment, especially if this is initiated early.

The five-day course was held 25-29 January 2016 at the CURE Ethiopia Children's Hospital in Addis Ababa. A team of visiting UK orthopaedic surgeons and physiotherapists delivered a two-day instructor training course which was attended by eighteen senior clubfoot practitioners and trainers from Rwanda, Ethiopia, Tanzania, Liberia, Zimbabwe, Zambia, Ghana, Malawi, Kenya and Mozambique.

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Image: Applying a cast under supervision from local trainers.

The regional clubfoot trainers then led a two-day basic training course in management of clubfoot using the Ponseti method, followed by a further one-day advanced training course. A total of thirty Ethiopian local health workers from clinics around the country were trained in managing clubfoot using the Ponseti method. Each day of training ended with a debrief session to capture the insights and feedback of UK and regional trainers to inform the next phase of development of the training courses and materials.

Mr Wainwright said of the course: “There was a very positive feel to the course - there was an inspiring group of physios, doctors and assistants from all across Africa who were experienced in treating clubfeet and eager to develop their teaching. What was really exciting was to see them able to teach people who had no or little experience of club foot treatment, so by the end of the course 40 babies' clubfeet were treated by 20 novices.”

The five-day course was the second in a series of pilot courses involving consultation of regional senior practitioners in the development of instructor and provider clubfoot training materials for use across sub-Saharan Africa as part of the Africa Clubfoot Training project. The aim is to help to scale up the number of instructors and practitioners across the region, enabling more children born with clubfoot to be treated.

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Image: Demonstrating Ponseti manipulation of the foot.

The Africa Clubfoot Training Project 2015-2017 is funded by the UK Department for International Development through the Health Partnership Scheme, and is a collaboration between NDORMS at the University of Oxford, CURE Ethiopia Children's Hospital, CURE Clubfoot and Global Clubfoot Initiative.

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