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Jan 30, 2009

Free medical treatment for children with club foot

Story PictureThere is hope for children that have born with a defect called Club Foot. About twenty infants are born every year with this problem and now for the first time, two organizations have joined efforts with the Ministry of Health to provide free medical care to the toddlers. Marion Ali was at CARE Belize this morning and viewed the new procedure used to treat four kids treated today.

Marion Ali, Reporting
It is called, Club foot, and it is a birth defect of the feet that if untreated, can cause persons afflicted to appear to walk on their ankles, or on the sides of their feet. It can be caused by one of many abnormalities in the final trimester of pregnancy.

But with the signing of an agreement among CARE Belize, the International Hospital for Children and the Ministry of Health, free treatment is now available for children born with the condition and today the first amount of kids received phase one of the treatment. The Ministry of Health will provide the supplies necessary for the procedures to be done in Belize using a newly developed treatment method called the Ponseti Method.

Dr. Peter Allen, C.E.O., Min. of Health
“The Ministry’s role is particularly in helping for the early detection and then providing materials and support through our staff.”

Marion Ali
“For those children who have not been able to access the treatment, they were born long before now and they never received the treatment because they can’t afford it, whatever happened to them, the quality of their lives, their contribution to society and so forth?”

Dr. Peter Allen
“Well it’s a great question because it’s such a debilitating syndrome because it essentially means you can’t walk around, you play with the other kids, you can’t play football and climb trees and do whatever every other kid does… at least not without a great deal of difficulty. So it severely inhibits your normal development process.”

Marion Ali
“Do you have to be a doctor or somebody with a medical background in order to be able to practice to actually correct this situation in children?”

Dr. Jose Morcuende, Professor, University of Iowa
“Well, we have information from many countries in which there are not enough doctors to cover all the cases and therapists or orthopedic officers and nurses that have a knowledge of the anatomy and how the frame moves in general, they can do it and learn how to put the cast because it’s essentially just a casting technique.”

Marion Ali
“The technique itself, can you elaborate on what it is, how it’s different from others and if it can be used for broken legs, broken arms, broken bones?”

Dr. Jose Morcuende
“Well, the technique is specific for club foot. The casting in general can be used on broken legs and arms, but for club foot the technique is specific. For many, many years doctors have been treating club foot by casting, but the problem is you have to follow a very specific way or protocol to do the casting. And if you don’t follow that protocol then the results are not very good and then what happens is the person will require surgery to fully recover their formity. These surgeries are very extensive surgeries. You have to cut the ankle of the foot all the way around, in order to turn a foot that is club foot that is like that to a foot that is normal setting. The problem with that is that they will develop stiffness because of the scar tissue. So with this technique is actually very strong understanding the normal foot function.”

The first stage entails wrapping cotton around both legs to protect the skin from the cast after which the process begins. Doctor Jose Morcuende, who is an Associate Professor at the University of Iowa, trained the local team that will administer castings for club foot. He walked us through the procedure as it took place this morning on baby Mary Reyes.

Dr. Jose Morcuende
“It goes from there, with the first cast it goes up to about there. When I’m doing—and this is the part that is difficult to explain—when I’m doing like this I’m going up a little bit to stretch over here. You can see that if you do it with one hand in the first cast it’s a little bit more difficult. So the first cast actually it’s better to go with this hand until you get the foot straight. So now that the cast has been placed, the doctor is going to start molding the foot and he will be stretching it a little bit today to put it in the most stretched position and he will be holding the cast until it sets and is hard. That way it will keep the foot in that position. What we’re gonna do now is to cut a little bit to trim the cast so they can see the toes which is good to check circulation to make sure that there’s no problem with the casting.”

The baby’s father, Alfred told us after the procedure that he’s happy for more reasons than one.

Alfred Reyes, father of Club Foot Baby
“They assured me that there wasn’t going to be any kind of operation on her, it was just casting and they went in there and the baby behaved herself and they put it on and as you notice it wasn’t painful.”

But because there aren’t sufficient doctors to administer the treatment, the Ministry of Health and the partners involved trained a team of field officers, like Andrea Coc, who will perform the procedure.

Andrea Coc, Field Officer, CARE Belize, Toledo
“I went to Honduras in January to get a training on Ponseti method and yesterday again, I got another refresher course and that is why we’re doing the first clinic today on a patient. Actually, we did the first hands on practice with clients in Honduras.”

Marion Ali
“Is it difficult to do?”

Andrea Coc
“For me it’s not difficult. At first, because I was using the thermoplast first, which is a plastic that you have to heat in hot water and then mold it on the children’s foot and I corrected one already using the thermoplast but it’s a lot of work. It’s very difficult for parent to keep it on because the children—I just use Velcro—and the children would just take them off. But with this method it’s very easy.”

For babies Like Little Mary Reyes, Sister Beverly Hoffman of CARE Belize says the system is set up that all the children who will need the treatment, will receive it free of cost.

Sr. Beverly Hoffman, Physical Therapist, CARE Belize
“CARE Belize will manage and administer the Ponseti Club Foot program here in Belize in collaboration with lots of stake holders. But we will be asking for the public to refer to us and to Milagro Garel from the International Hospital for Children, who is a Belize representative so that we can get these children on a and as we are able we will be working with treating these children.”

But even though the procedure is free to Belizeans it comes at a price to the providers of the program.

Milagro Garel, Rep., I.H.C.
“We are the ones who found the partners and made this collaborative effort possible.”

Marion Ali
“What cost is it to you to provide such a treatment?”

Milagro Garel
“It’s costing us like about five hundred dollars US for each child but it’s because of the collaborative effort between the ministry and the Karl Heusner who have come together and formed this partnership and really have waived so many fees so we can be able to make this possible and there’s no cost to the parents.”

Marion Ali
“Right, how many children will you be able to see per year through this funding?”

Milagro Garel
“We’re hoping that, because Belize is blessed and we only have a small population and there’s an approximation of twenty kids that are being born with club foot every year so we are hoping to be able to take care of all the children that have club foot.”

With the procedure complete, the baby was sent home and next week her parents will bring her back for a new casting. They will do that for a total of five weeks until her feet are normal. Marion Ali for News Five.

Dr. Morcuende says children whose club foot syndromes are corrected grow up and walk normal. Their only requirement is that they’ll have to wear a brace at night to sleep for four years after the treatment is administered. If you have or know of a child with club foot you can call Milagro Garel at 610-2606 or Sister Beverly Hoffman at CARE Belize at 223-5986.

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Viewers please note: This Internet newscast is a verbatim transcript of our evening television newscast. Where speakers use Kriol, we attempt to faithfully reproduce the quotes using a standard spelling system.

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