Making the initial CCW presentation to hospital executives in Niger

I spent a week in Niger traveling more than 2,500 kilometers (about 1,550 miles) visiting clubfoot clinics and prospective clinics. Some are mission run, but most are government hospitals which are partnering with CURE Clubfoot Worldwide (CCW). Orthopedic surgeons, physiotherapists, cast technicians, and some nurses have been trained in the Ponseti method by CCW at the CURE Hospital in Niamey. Each partner clubfoot clinic has a CCW-trained counselor assisting the medical staff.

In the prospective partner sites, we met with the Medical and Executive Directors and explained what CCW does in our partnership clinics. In most cases, this was the first time they had heard of the CURE Clubfoot Worldwide Niger program. In every case, they were excited and asked about next steps.

We stopped at the regional hospital in Dosso, one of CCW’s current clinic sites, during their normal Saturday clubfoot clinic. It was very encouraging to see the physio assessing the feet and properly applying the casts. We talked with the orthopedic surgeon who had dropped in to perform a tenotomy. Most of the patients had already been seen and treated. The staff said there were still two patients who should have been there but had not yet arrived. After discussing with the staff about the clinic progress in general, I left the CCW coordinator with them and went outside. A young woman was walking into the clinic yard with her infant, who was wearing a cast.

Since I knew she would have 10 minutes or so before going into the clinic, I grabbed a translator and started a conversation. I asked about her beautiful baby girl, her Islamic faith, how she was doing with the casting process, and other general questions. The final part of the conversation follows:

Malaika and Halimu

Me: Is this your first child?

“Yes.”

How old is she?

“Several months old.”

What did your husband and your mother and others say when they saw you had given birth to child with clubfoot?

“My husband was in the field working, but I heard my mother and other women say that it was God’s will that I have a disabled child.”

And what about your husband when he got home? What did he say?

“He said the same thing. This was God’s will for me to have a deformed child and for the child to be disabled. He said to even seek treatment would be to go against God’s will.”

What did you think? Did anyone say that it was your fault to birth a child like this?

“No. I know that these things occur. I knew it was not my fault. It was God.”

What motivated you to come for treatment then?

“I heard a radio program by the government saying that this condition could be treated and healed. It said it was a common condition, but that a child born like this did not need to be disabled. I didn’t want my child to grow up disabled. I want her to live normally and get an education and have a good husband.”

So after the radio program your husband and family helped you to get here to the clinic?

“No. They said I should not go, and they would not give me any money for the transportation to get treatment because it was God’s will for this child to be disabled.”

So how did you manage to come to the clinic?

“I went to all my friends and borrowed money for the fare to come.”

So after several visits, with them seeing that the foot is improving and having heard that the doctor said it could be healed, do they give you money for the next week’s fare?

“No. I have to borrow each week. I will work extra in the fields later to pay it back.”

Your daughter is very blessed to have a mother like you. What is her name?

“Malaika.”

(To my translator – Malaika means Angel doesn’t it? “Yes”, he said.)

What is your name?

“Halima Abdou, and my husband is Bahamu Tsahirou.”

Is it OK if I pray for Malaika and you and your husband?

“Yes, please.”

So I prayed for Angel (Malaika), her extraordinary mom, and her father and extended family. I prayed that the Ponseti treatment would be 100% successful and that she would grow up without the stigma of being disabled. I prayed that the God who loves and redeems and heals would reveal Himself to Angel and her family.

I also praise God for the many hundreds of mothers like Halima who go to extraordinary lengths to seek help for their children. She motivates me to do more to make the treatment and healing assessable.

It is easy to think that the harsh view of ‘God’s will’ is found only in the Muslim community. But while on this visit to Niger, I met with a group of pastors to teach, encourage, and listen to them. I asked them why children are born with clubfoot and had them share with the person sitting beside them. Then we had each group tell us their answer. Their answers fell into roughly three categories. The first and most common answer was, “It is God’s will for the child to be born deformed.” This was followed by “Spirits, demons, or ancestors,” and finally “environmental issues or something the mother did.”  When I have asked the same questions to people from nearby countries who are neither Muslim nor Christian, but who follow traditional religions their responses are similar, with “Spirits, Curses, Ancestors” being the most commonly held belief.

Bad theology seems to transcend the object of the belief and exists in all faith communities. One of the roles of the counselors in the CCW programs is to counter bad theology/cosmology and help alleviate fear and hopelessness. Only faith in Christ provides an ultimate path to freedom from fear.  An understanding that clubfoot occurs in all societies and in all places with roughly the same ratios to live births does motivate parents to seek treatment and move beyond the self-blame and fear.