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2016 ROTARY INTERNATIONAL CONVENTION HOW ROTARIANS CAN HELP END DISABILITY FROM CLUBFOOT
| Date post: | 29-Jan-2018 |
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2016 ROTARY INTERNATIONAL CONVENTION
HOW ROTARIANS CAN HELP END
DISABILITY FROM CLUBFOOT
Presenters:
Jim Coloff, DGE 5970
Chris Knapp, DGE 6000
Herb Wilson, PDG 6000
Tomeka Petersen, RAG4Clubfoot Program Development Administrator,
Program Coordinator for Ponseti International Association and
Member of Rotary Club of West Liberty, Iowa
May 30, 2016
What is Clubfoot?
Congenital
Talipes
Equino-
Varus
1324 BC
What causes Clubfoot?
Muscle & tendon
imbalance in the lower leg
leading to skeletal
deformity in the foot-ankle.
NOT due to:
Fetal positioning
Lunar eclipse
Ancestral curse
Birth control pills
Poor nutrition
Polio
Witchcraft
Twin births, etc.
• Approximately 1 in every 750 live births
• Twice as common in males as in females
• Occurs in both feet half of the time
• A very slight correlation of family history and ethnicity
• 200,000 children born with clubfoot annually
• 100,000’s of “neglected” cases (~1 Million)
• No social or economic influences
Who is affected?
Countries Needing Training of Ponseti Method Providers
Visit RAG4ClubfootHoF Exhibit #3138 for details
Why be concerned?
• An 8-year-old Nigerian boy with primary neglected clubfoot.
• Abandoned to live with his grandmother.
• Discovered crawling around in a rural village by medical students on an outreach visit.
Ray*
*Name changed
What does not fix Clubfoot?
Taping
Thomas Wrench
Solar Eclipse
Surgery
Swathering
Herbs &
Potients
The Ponseti Method Treatment of Clubfoot
The PONSETI METHOD• Gentle manipulation and stretching• Series of precisely applied plaster casts• Percutaneous tenotomy (most cases)• Wear brace while sleeping to age fourIgnacio V. Ponseti
(1914-2009)
Endorsed and supported by
Dr. Ignacio V. Ponseti (1914 – 2009)
• Born in Menorca, Spain.
• Graduate of Barcelona University Medical School.
• He fled Spain during the Spanish Civil War (late 1930’s), then moved to Mexico where for two years he practiced family medicine.
• A physician in Mexico helped Ponseti get to Iowa in 1941 to study orthopaedics under Arthur Steindler, M.D. Ponseti completed a residency at Iowa in 1944 and became a member of the orthopaedic faculty at UIHC.
Ignacio V. Ponseti(1914-2009)
Early Research Leads to Ponseti Method
• In the early 1940s, Dr. Ponseti’s research showed that surgery, the most common treatment of clubfoot, could leave a child with stiff ankles and a limp.
• Ponseti Method involves “gentle manipulations” by slowly and gradually straightening and rotating each twisted foot toward its normal position.
Parents Request Ponseti Method
• Ponseti Method became popular in the 1990’s when parents began to spread the word through the Internet.
• Orthopedists found parents requesting them to perform PonsetiMethod to treat children.
Ponseti Method video
What is the Global Challenge?
The Global Challenge is
That thousands of children born with clubfoot lack access to well trained Ponseti Method providers.
Logistical Challenges
Due to logistical obstacles, too many children drop out of treatment
• Cost of casting materials• Cost of the brace to maintain the correction• Cost of meals• Cost of lodging• Distance to get to appointments• Cost for transportation to get to appointments
We must overcome these challenges to prevent return of the deformity.
Bracing Is a Global ProblemEspecially in low-resource countries
Bracing is critical for maintaining the correction.
• Costs of current “state-of-the-art” clubfoot braces range from $500 per year to more than $2,500.
• These braces are used almost exclusively in higher-income countries.
• In low-resource countries, most braces: Are made using low-quality, locally available materials. Lack important design features. Often cause skin problems and disuse, resulting in
return of the deformity.
Rotarians Take Action
Discussions initiated in 2007 and then restarted in March 2014
Visit with C.K. Gary HuangPresident, 2014-15
RAG4Clubfoot Approved in 2015
Rotarians in Iowa teamed up with Ponseti International Association (PIA) based at the University of Iowa to create a Rotarian Action Group, RAG4Clubfoot.
We are proud of our logo!
Charter districts: 5970, 6000, 5020, 5240, 5950 and 9640.
RAG4Clubfoot Partners with
Ponseti International Association
Ponseti International Association (PIA)
PIA’s VISION: Every child in every country
will receive effective treatment for clubfoot
using the Ponseti Method.• Established in 2006• 500+ healthcare professionals• hundreds of advocates• 75 countries
PIA’s ACTIVITIES:
• Media - World Clubfoot Day
• Interact with professional societies
• Best Practice Guidelines
• International Clubfoot Registry
• Global web-conferencing
• International symposia
• Organize training activities
• Advice & assistance about
capacity building
Memorandum of Understanding signed between RAG4Clubfoot and Ponseti International (PIA)
Ponseti International Association’s role:
• To lead the educational components of the Ponseti Method training of orthopaedicsurgeons.
• To identify in-country trainers who facilitate the Ponseti Method training.
• To provide clinical expertise.
Ponseti International (PIA) to Lead Countrywide and Multinational Training Programs
Introductory Course – scientific basis of clubfoot and the fundamentals of
clubfoot management.Mentorship - mentoring by an
experienced provider for one week.
Visiting Professorship - continued on-site mentoring by an experienced provider.
Distance Education – consult, share new information, and refine skills.
Building National Programs
A Short Course isOnly an Introduction
One-on-One Mentoring Is Required to Learn the Ponseti Method Correctly
What is a Rotarian Action Group (RAG)?
A Rotarian Action Group (RAG) is
• An association of Rotarians who provide assistance and support to Rotary clubs, districts, and multi-districts in planning and implementing large-scale, community development and humanitarian service projects.
• Approved by RI but functions independently from RI.
26 current Rotarian Action Groups
What is RAG4Clubfoot?
RAG4Clubfoot serves as a clearinghouse to:
• Promote contact between local
Rotary clubs and qualified local
Ponseti Method providers.
• Promote collaboration between local
Rotary clubs/districts to fund clubfoot
treatment related projects
• Vocational Training Teams
(VTT) to increase the number of
qualified Ponseti Method
treatment providers.
• Humanitarian grants addressing
housing, meals, transportation
and bracing.
• Assist with public awareness
• Social media, brochures, public
service announcements on radio
and television, etc.
• Collaborate with government
officials and health
administrators with information
about the long-term benefits of
Ponseti Method treatment.
• Maintain a website
(RAG4Clubfoot.org) of approved
and developing clubfoot projects.
RAG4Clubfoot Organizational Graphic
RAG4Clubfoot Connecting Rotarians
Vocational Training Team grants submitted to RI for review
• Brazil (funded by Brazil District 4420 and USA Districts 5300, 5970 & 6000)
• Mexico (funded by USA Districts 5970, 6000 and 6960 and clubs in USA & Mexico)
To train 50 ortho surgeons in Brazil. To train 29 ortho surgeons in Mexico.
Ponseti Method Training Projects in Development
International Rotarians are communicating with local Rotarians in:
• Argentina and Paraguay• Bolivia• Colombia• South Africa
RAG4Clubfoot Board
members present at:
• District conferences
• Club meetings
Call to Action
How Rotarians and Others Can Help
Partner with international clubs/districts to:
• Create public awareness that “Clubfoot is treatable.”
• Promote identification & referral of patients.
• Support training of local orthopaedic surgeons.
• Assist with provision of high-quality braces.
• Assist with logistical support: meals, housing, and transportation.
Join RAG4Clubfoot
RAG4Clubfoot.org
Join RAG4Clubfoot
RAG4Clubfoot Membership
How do we join?
• Is open to active Rotarians, family members, program participants and alumni.
• Individual membership is $25 / year.
• Charter membership is $100 the first year, $25 / year renewal.
Become a Member!
www.RAG4Clubfoot.org
Membership fees help support the operational costs of the RAG.
Ray’s Ponseti Method Treatment Journey
Treated with Ponseti Method using five casts.
His mother brings him to clinic on the day his last cast was removed.
Now walks independently and is enrolled in school for the first time.
Boy in Brazil pre and post Ponseti Method Treatment
WHAT WILL YOU DO TO HELP
CHILDREN LIKE RAY WALK?
Rate this session! Your feedback is valuable so remember to
complete the brief session evaluation in the convention
mobile app. To download the app, search for “Rotary Events”
in your Apple or Android app store.
This presentation and others from throughout the convention
are available through the convention mobile app and on
SlideShare at www.SlideShare.net/Rotary_International.
