A sustainable solution
We can end clubfoot as a lifetime disability
There is a treatment for clubfoot that is easy and inexpensive to implement. It is called the Ponseti method, and it was developed by Dr. Ignacio Ponseti. CURE has developed a sustainable clubfoot treatment program strategy that:
- trains local medical professionals in the Ponseti method,
- organizes and promotes clinics to bring that treatment to the children who need it, and
- provides counselors to help families see treatment through to completion.
Since beginning in 2006, CURE has become a global leader in the treatment of clubfoot. We are presently enrolling more than 17,000 children each year in treatment, and our program has had more than 100,000 children enroll in our clubfoot programs around the world so far. With numbers like these, we see the real potential to end clubfoot as a disability around the world in our lifetime.
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Treatment with the Ponseti method
The Ponseti method is a minimally invasive technique that includes gentle manipulation of the feet followed by the application of plaster casts, a tenotomy, and temporary bracing. It is extremely effective when implemented in the first 3 months of life and ideally will start before a child reaches 1 year of age. The casting process lasts 6-8 weeks. A tenotomy, an outpatient surgical procedure performed under local anesthetic to sever a tight Achilles tendon, is often needed as well. Following the tenotomy, the final cast is applied for three weeks to help ensure flexion of the foot as the tendon regrows. Following casting, the feet are in a corrected position and the treatment phase is complete. To maintain correction, the child will go through the maintenance phase, wearing a foot abduction brace until reaching 5 years of age. For the first 3 months, the brace will be worn 23 hours a day; after that, it is only worn while sleeping.
Because this method does not involve hospitalization or invasive surgery, the cost is very low. To provide complete treatment using the Ponseti method, CURE estimates the average global cost to be only $400 per child.
Implementing a sustainable program
CURE has developed a sustainable program for making effective Ponseti treatment available in underserved areas. The key elements of the program are training, counseling, and clinics. CURE provides training in the Ponseti method for local medical personnel. Depending on the context and legal requirements of the country, these may be doctors or nurses or other paramedical professionals. The will learn the casting and bracing process.
CURE also hires and trains local counselors to work with the patients and their families. Effective correction through the Ponseti method is facilitated when the family faithfully brings their child for weekly castings and follows up with consistent use of the foot abduction brace. CURE has found that having a counselor actively in communication with the family significantly increases compliance, which in turn produces consistent outcomes of fully corrected feet.
Our counselors do something more, too; they bring emotional and spiritual healing. They share God’s love with the families in their care. They tell them that their child is not cursed (a common belief) and that the disability is not the result of anything they did. Often for the first time, the child and their family are met by someone who accepts them just as they are and sees them with nothing but love.
Once medical personnel are trained and counselors are in place, clinics are established in cooperation with existing government hospital and clinic facilities. Then we begin spreading the word through posters, local media, and word-of-mouth: clubfoot can be corrected!