CONGENITAL Talipes Equinovarus (CTEV), more commonly known as clubfoot, is one of the most commonly occurring congenital disorders, occurring at an estimated 1:800 live births. If left untreated, children grow up walking with an in turned foot and an awkward gait which can lead to pain, a disabling limp, and a decreased self-image. In the Philippines, there are an estimated 3,000 clubfoot cases born yearly.
Fortunately, good and effective treatments exist for this condition. The Ponsetti Method (pioneered by Dr. Ignatio Ponsetti, an Italian-American Orthopedic Surgeon), involved treatment with a series of weekly corrective casts applied to the feet to gradually correct the deformity, a percutaneous tenotomy procedure, and a period of bracing until the child is 4 to 5 years old.
If done properly, the treatment is successful in up to 70 to 90 percent of cases. However, poor compliance with the treatment can lead to recurrence. This is usually affected by financial constraints, distance from treatment centers, and socio-cultural resistance to treatment. There are an estimated 9.75 million clubfoot patients living in the world today, of which 8 million have never received treatment.
The Miracle Feet foundation, founded in 2010 in the US by parents of clubfoot patients, is a non-profit organization whose goal is to treat clubfoot targeting Low to Middle Income Countries and partnering with local organizations and health networks to achieve this goal. They have been able to secure donor assistance from Clark’s, Google, and other large and small donors. Since they have started, they have benefitted close to 50,000 clubfoot patients in 28 countries. In the Philippines, Miracle Feet started partnering with programs in 2014, and in 2018 officially partnered with the PNGOC Network.
The Benguet General Hospital Miracle Feet (BeGHMF) partnership was signed on January of 2019, and the Clinic opened its doors formally on April 1, 2019. The clinic provides, casting, tenotomy and bracing treatment free of charge to its patients. Since the clinic opened, there have been over 50 patients who have enrolled and availed of treatment. The BeGHMF model involved tapping into the Service Delivery Network, which involved coordinating our services with the Provincial and Municipal Health Networks, as well as Non-Government Organizations to help disseminate information about the clinic.
The Covid-19 pandemic has affected the clinic adversely. As hospitals become covid centers we have been forced to focus on delivery of emergency care. Quarantine restrictions and the prevailing culture of fear have made it difficult for patients to come to clinic regularly for follow-up.
The BeGHMF clinic remained open throughout the pandemic, but had to shift strategies to meet the needs of its patients. Newborn patients are seen and attended to, and casting done weekly. The bigger problem is in attending to babies born outside the hospital, who have to travel to reach BeGH, as well as following up our patients in brace who have been unable to come for follow-up.
The clinic has been conducting online follow up of our patients through our Miracle Feet Benguet Facebook page, where parents are encouraged to post regular updates on their children’s feet. We had identified several of our patients, however, who had outgrown their shoes and braces.
Meet-ups with Parents and in Baguio and La Trinidad were arranged to follow up and exchange shoes and brace bars as needed. There were several, however, who lived farther out.
The clubfoot clinic staff and volunteers decided to reach out to these patients, arranging to visit them and doing brace exchanges if needed, during our weekend bicycle rides.
Week 1: We visited baby Ezra Pandosen in Sitio Banao, Ambuklao after a 30 kilometer bike trip to the Ambuklao area. After giving her gifts of chocolate crackers, she let us check her feet and fit her with new brace shoes. The bike ride along the beautiful Ambuklao and Adonot riverside.
Week 2: We visited two patients who lived along the Halsema trail, baby Everlyn Wankey and Kyro Wil Herman and did clubfoot follow ups and brace fitting for both. This was in a 50 km out and back bike ride along Halsema, again with difficult climbs but beautiful views. The tiring bike ride was lessened by the hearty pinikpikan lunch prepared by the family of our patients.
Week 3: Due to the inclement weather we drove to Kayapa, Nueva VIscaya, to visit Jhon Mark Balakay, who was eager to see us and fit his new shoes. After the brace fit we decided to drive further and with better (but still rainy) weather did a 60km bike ride in the Kayapa-Aritao-Bambang loop.
The bicycle brace delivery program allows us to combine the service and care of our clubfoot patients with the passion we have to bike with friends.
For more information please visit the MiracleFeet-Benguet Facebook site or call/text 09190725440. Please visit miraclefeet.org.