Monica Nogueira

Ponseti International

4420 – Sudeste Brazil

How Rotarians can help

erradicate disability from clubfoot

Congenital

Talipes

Equino-

Varus

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

• 200,000 clubfoot children born annually

• 100,000’s of “neglected” cases (~1 Million)

• No social or economic influences

Never married, depend on government help for living

problem

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.

RILWAN

OTAVIO, 7 year old boy from Peixe Boi – PA , Brazil

Did not go to school

Because colleagues called

him

“crippled” and other names

The PONSETI METHOD

• Gentle manipulation and stretching

• Series of precisely applied plaster casts

• Percutaneous tenotomy (most cases)

• Wear brace while sleeping to age four

Ignacio V. Ponseti (1914-2009)

The Ponseti Method is unquestionably the “Gold

Standard” for correcting clubfoot deformity.

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.

Ponseti

Method

Partner with/support clubs in low-resource areas:

• Help form the Rotarian Action Group and recruit Rotarians around the world

to band together.

• Support training of local health professionals.

• Assist families and caregivers with logistical support, including

transportation, housing, food, and other needs.

• Assist families with the provision of night-time braces to complete Ponseti

treatment.

• Assist with public awareness to reduce the stigma, to spread the message

that “Clubfoot is treatable”, and to promote early referral to appropriate

treatment centers.

• Advocate with governments and health officials to provide the facilities and

resources to treat clubfoot deformity.

•Help form the Rotarian Action Group and

recruit Rotarians around the world to work

together.

Support training of local health professionals

Assist families and caregivers with logistical support,

including transportation and housing

Support bracing to complete treatment

Raise Public

Awareness

THE UGANDA CLUBFOOT PROJECT

The Children’s Orthopaedic Rehabilitation Project, The Rotary Foundation, Canadian

International Development Agency , Ugandan Ministry of Health, Makerere University

Medical School Department of Orthopaedics

A 4 Year Rotary project to enable Ugandan healthcare

professionals to treat Ugandan children with clubfeet

All children in Uganda born with

Clubfeet will

• be identified at birth

• have access to Ponseti treatment

Guatemala

• Starting in 2010, 7 clubs in Districts 5970 & 6000 raised $25,000.

• Partnered with Club Rotario La Ermita in Guatemala City.

• In-country workshop for 15 MDs.

• In 2012, 3 doctors attended the International Symposium & had additional training in Iowa.

Workshop on

Clubfoot

Exhibit Booth 65

December 2014

RILWAN

Treated with Ponseti method using five casts.

Now walks independently without pain and is enrolled in school for the first time.

His mother first came to the clinic on the day the last cast was removed.

HOW A CHILD CAN CHANGE...

Rotarian Action Group

RAG4clubfoot

Global support for Awareness, training and Treatment

World free from clubfoot disability

www.RAG4CLUBFOOT.org

www.RAG4CLUBFOOT.org

Establishing a Rotarian Action Group

to eliminate clubfoot disability.

Email: info@rag4clubfoot.org

You can sign-up to join the effort to

create RAG4CLUBFOOT by visiting

the website.

Charter District members:

6000, 5970, 5240, 5020, 9640

and 5950