Thousands of Bangladeshi infants born with clubfoot – in which the feet are turned inward and downward – will be cured of the debilitating condition, thanks to a project led by two University of British Columbia professors, and supported by the Canadian International Development Agency (CIDA).
The Hon. Alice Wong, the federal Minister of State for Seniors, announced today that CIDA will provide $4.3 million to Sustainable Clubfoot Care in Bangladesh, an effort to train health workers to perform a low-cost, non-surgical treatment that involves placing a series of casts on the ankles of babies, and to create a permanent mechanism for providing this treatment for future generations.
Project leaders Shafique Pirani, clinical professor of orthopaedics, and Richard Mathias, professor in the School of Population and Public Health, will seek to replicate their success in creating a network of 40 clubfoot clinics in Dr. Pirani’s native country of Uganda. In the past year alone, that effort – which also received a grant from CIDA – has treated 1,100 Ugandan children, saving them from a lifetime of hardship and isolation.
Dr. Pirani was instrumental in drawing renewed attention to the clubfoot treatment, known as the Ponseti method. That technique, now the standard treatment in North America, is particularly suited to developing countries, which must contend with a chronic shortage of surgeons, and where traveling to a hospital can be a journey of several days.
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“Despite being on another continent and having a vastly different culture, Bangladesh faces many of the same challenges as Uganda, and clubfoot is just as much of a burden, for individuals, families and society,” said Dr. Pirani, who is based at Royal Columbian Hospital in New Westminster.
“Once we demonstrate the impact such a coordinated response can have, I expect more countries will follow, and within a generation, clubfoot will no longer be the global scourge it is today.”
BACKGROUND | Curing clubfoot
A global burden: Between one and three children per 1,000 are born with clubfoot. It poses a particular hardship on children in developing countries, because walking is usually the main means of transportation, and manual labour and farming are the main occupations. In Bangladesh, about 5,000 children are born with clubfoot each year, and historically have gone untreated.
The Ponseti method: Dr. Pirani helped popularize the clubfoot treatment invented by Dr. Ignacio Ponseti, of the University of Iowa, in the 1940s. It involves gentle manipulation of a baby’s foot, placing a cast on it, and then repeating the process over several weeks, so that the flexible cartilage is molded into the proper position and stays put as it becomes bone. Before the final cast, the Achilles tendon is cut, a minor outpatient procedure done under local anaesthesia. After the casting, the child wears a brace – full-time for a few weeks, then only at night for a few years.