Drs. Morcuende, Zhao, and Khan respond to audience questions at the AAOS Annual Conference in Chicago, IL.
Medical Advisory Board Chair, Dr. Shafique Pirani
Ponseti International meeting with Special Secretay Health, Government of Sindh, Pakistan on December 7th, 2012 at Karachi: Left – Right:: Dr. Morcuende, Dr. Suresh Kumar, Prof. Shafiq Pirani, Prof. Anisuddin Bhatti, Prof. Asadullah Maher.
2012 Ponseti Method Training in Peru
Dr OO Adegbehingbe in follow–up visit at Wesley Guilds Hospital clubfoot clinic in Ilesa, Nigeria
News and Events
4-year old Girl from Honduras Receives the Gift of Mobility
A young girl named Reina has made the long trip from Honduras to Grand Rapids, Michigan to receive what we in the clubfoot community refer to as the "gift of mobility." She was born with bilateral clubfoot on a small mountain farm in Caserio El Cacao, near Catacamas, Honduras where her parents raise corn, coffee and beans. Due to a lack of trained providers in her area, Reina does not have access to the Ponseti method to treat her condition. She was brought to the U.S. by Healing the Children Michigan/Ohio Chapter and is being treated by Dr. Michael David, a Grand Rapids podiatrist and a PIA provider. Ponseti International Association is currently working to establish a national clubfoot program in Honduras by partnering with their Orthopedic Society - we hope one day little ones like Reina will not have to travel to the U.S. for proper treatment for clubfoot.
Collaboration with AAOS International Scholars Program
Ponseti International Association is collaborating with the American Academy of Orthopaedic Surgeons (AAOS) to establish an AAOS-Ponseti International Association (PIA) Scholarship, which will be awarded to one recipient per year in the years 2014 and 2015. The $5,000 scholarship award will fund the recipient's visit to the University of Iowa to train for two weeks under the direction of Dr. Jose Morucende and his colleagues. The AAOS-PIA scholarship recipients will be selected by PIA based on selection procedures and candiate qualification crietria to be determined by PIA in the next few months. Together, AAOS and PIA will review and select the best candidate. The selected scholarship recipient will be announced in the last quarter of the preceding year or in the first quarter of the scholarship year. To ensure each international scholar is performing the Ponseti method for the treatment of clubfoot to highest standards, there will be a six month post-program evaluation of the recipients in-country progress. We are very excited about this opportunity to co-sponsor this scholarship with AAOS and to train two promising orthopaedic surgeons from around the globe!
International Training Workshops - Summer 2013
The 3rd Advanced Nordic Ponseti Clubfoot Course was held on June 13th-14th in Odense, a region of southern Denmark. The course was hosted by the Department of Orthopedics and Traumatology at Odense University Hospital. There were 70 participants (doctors, nurses and physiotherapists) representing 10 different countries. The final program can be found here.
On His Path sponsored the Ponseti Method Training for Clubfoot Treatment held at the Hospital Nacional San Rafael in El Salvador on July 21st and 22nd, 2013. Dr. Martin Enrique Rosales and Dr. Mario Sequiera Somoza led the course, which trained over 40 surgeons, physiotherapists, nurses and residents throughout the two days of lecture and hands-on practice.
The Thai Ponseti Clubfoot Group held the first ever Ponseti clubfoot workshop on August 12th, 2013. The training was held at Siriraj Hospital in Bangkok, Thailand and had 32 participants from several different country hospitals. PIA Chief Medical Director was able to Skype in during the morning sessions to give several lectures and discuss case studies.
Worldwide Celebrations for 1st Annual World Clubfoot Day
Ponseti International Association (PIA) designated June 3rd as World Clubfoot Day. The date was chosen to commemorate the birthdate of Dr. Ignacio Ponseti, (1914-2009) the developer of the Ponseti Method to treat clubfoot. The goal of World Clubfoot Day is to raise awareness about clubfoot disability and its prevention using the Ponseti Method, a non-surgical treatment that includes gentle manipulation of the feet followed by the application of plaster casts and temporary bracing.
Various events and programs that were organized around the world to celebrate the first annual World Clubfoot Day. In addition to these events, several individuals, parents, advocates, and healthcare providers observed the day by spreading awareness through social media outlets, running, and sharing pictures and stories of their clubfoot journey.
June 3rd is World Clubfoot Day!
Ponseti International Association (PIA) has designated June 3rd as World Clubfoot Day. The date was chosen to commemorate the birthdate of Dr. Ignacio Ponseti, (1914-2009) the developer of the Ponseti Method to treat clubfoot.
The goal of World Clubfoot Day is to raise awareness about clubfoot disability and its prevention using the Ponseti Method, a non-surgical treatment that includes gentle manipulation of the feet followed by the application of plaster casts and temporary bracing.
Dr. Jose Morcuende, CEO and Medical Director of Ponseti International, says this day is an important step in furthering global awareness that clubfoot is a treatable deformity. “By designating June 3 as World Clubfoot Day, not only do we celebrate the life and contributions of Dr. Ponseti, but we help further his belief that every child born with clubfoot is entitled to treatment using this low-cost, non-surgical approach.”
Clubfoot is the most common musculoskeletal birth deformity, affecting 200,000 newborn children each year, 80 percent in developing countries. There are also hundreds of thousands of children and young adults who are living with this debilitating condition worldwide. The Ponseti Method is nearly 100 percent effective when properly applied by a trained health care provider and is considered the "gold standard" treatment, leading to a normal, productive life
PIA is the global leader in training and educating healthcare providers on the treatment of congenital clubfoot.
April 2013 Newsletter
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AAOS International Presidents’ Breakfast and World Opinion Forum Recognizes Value of Ponseti Method
At the International Presidents’ Breakfast and World Opinion Forum, held on Wednesday March 20th, 2013, attendees heard about the approaches to clubfoot treatment, particularly the application of the Ponseti method, in countries as diverse as Brazil, China, and Pakistan. In addition, José Morcuende, MD, of Ponseti International, reviewed how national orthopaedic organizations could become involved in establishing a high-quality, locally developed, sustainable clubfoot program.
The importance of training
Speaking on video from Brazil, Monica P. Nogueira, MD, discussed the impact of the Ponseti method in her country. She noted that the first 2-day training session was held in 2003, and within 2 years, those trained in the method were achieving positive results in 95 percent of cases. As of 2009, the Brazilian Ponseti Study Group had trained 567 professionals in 21 states. A recent review of results, however, showed that few surgeons were properly applying the method. As a result, a new instruction methodology is being implemented, one that relies more heavily on an intense mentorship and the establishment of clinics staffed by healthcare providers who have gone through a 2-week, rather than a 2-day, training program.
A public health approach
According to Li Zhao, MD, PhD, of Shanghai, China, taking a public health care approach may help overcome some of the barriers to widespread adoption of the Ponseti method in countries in which surgeons are accorded higher status than other healthcare professionals “because they cut.” In China, an estimated 18,000 children are born with clubfoot each year. In rural areas, especially, noted Dr. Zhao, some surgeons view the “hands-on” treatment required by the Ponseti approach as beneath them. They have gone through so much schooling and training to become surgeons and they fear that their status as surgeons will be diminished if they focus on nonsurgical treatments. To overcome this attitude, China has developed a national project, “Healthy Walk,” which focuses on the early recognition and treatment of clubfoot. The hope is that viewing clubfoot treatment as a public health effort will encourage the adoption of the Ponseti method across the country.
According to Mansoor A. Khan, MD, who practices in Karachi, Pakistan, one of the significant appeals of the Ponseti method in developing countries is its low cost. In many countries, patients must bear the costs of surgery themselves, even providing their own food. For these individuals, the lower costs of the Ponseti method can help encourage them to seek treatment. Dr. Khan, who works at a private hospital that provides free care, noted that the costs to patients undergoing treatment for clubfoot using the Ponseti method are substantially less than the costs incurred when surgical treatment is used ($349 versus $816). In addition, he said, “the Ponseti method has a higher success rate than surgery.”
The role of professional associations
Dr. Morcuende encouraged members of the audience—all presidents of national, regional, or multinational orthopaedic associations—to get involved in supporting training and practice of the Ponseti method in their countries. He recognized the uphill battle that some might face, because the Ponseti method, like the polio vaccine, eliminates the need for surgeries. “It can have a tremendous impact,” he said, “but change doesn’t happen just because something works.” The care pathway for clubfoot treatment—identification, referral, diagnosis, treatment, and follow-up—depends not only on training providers and supplying materials and staff, but also on policy awareness. National orthopaedic associations, he pointed out, are key in creating that policy awareness. Adopting position statements that support the use of the Ponseti method, making the case to healthcare administrators, health ministries, and the media, and institutionalizing training of the Ponseti method in medical education are all ways in which national orthopaedic associations can make a difference. To become a Global Partner, please e-mail email@example.com.
For the full report from the American Academy of Orthopaedic Surgeons, please click here.
The Canadian International Development Agency (CIDA) will provide $4.3 million to support Sustainable Clubfoot Care in Bangladesh, led by Dr. Shafiqe Pirani, Medical Advisory Board Chair
Thousands of Bangladeshi infants born with clubfoot – in which the feet are turned inward and downward – will be cured of the debilitating condition, thanks to a project led by two University of British Columbia professors, and supported by the Canadian International Development Agency (CIDA). Project leaders Shafique Pirani, clinical professor of orthopaedics, and Richard Mathias, professor in the School of Population and Public Health, will seek to replicate their success in creating a network of 40 clubfoot clinics in Dr. Pirani’s native country of Uganda. In the past year alone, that effort – which also received a grant from CIDA – has treated 1,100 Ugandan children, saving them from a lifetime of hardship and isolation. “Despite being on another continent and having a vastly different culture, Bangladesh faces many of the same challenges as Uganda, and clubfoot is just as much of a burden, for individuals, families and society,” said Dr. Pirani, who is based at Royal Columbian Hospital in New Westminster. “Once we demonstrate the impact such a coordinated response can have, I expect more countries will follow, and within a generation, clubfoot will no longer be the global scourge it is today.”
For the full report from the University of British Columbia, please refer to the article here.
Breaking News Update: $2 million USAID grant to Ponseti International Association will improve access to clubfoot treatment
The Ponseti International Association will collaborate with partner organization Management Sciences for Health (MSH) on a two-year, nearly $2 million project to increase access to treatment of clubfoot deformity for thousands of children in Peru, Pakistan, and Nigeria.
Each year, 200,000 children worldwide are born with clubfoot, one every 3 minutes. There is no known cause for the condition and nearly 80 percent of children born with clubfoot live in impoverished countries, says Jose Morcuende, M.D., associate professor of orthopaedic surgery at University of Iowa Hospitals and Clinics and Chief Medical Director of Ponseti International Association. If untreated, children affected by this condition often grow up unable to walk, go to school, or significantly participate in their communities. They are often cast aside and regarded as useless members of society.
The grant from U.S. Agency for International Development, provided through MSH’s Leadership, Management, and Governance Project, will broaden the use and understanding of a low-cost, non-invasive, and highly effective method for treating clubfoot – the Ponseti Method.
This method – created by the late Ignacio Ponseti – involves a series of about five plaster casts and a simple snipping of the heel cord to “train” the foot into normal alignment. Before the Ponseti Method was introduced, surgery was the only alternative, an option which has been unavailable or financially out of reach for most families in underdeveloped countries. In contrast, the Ponseti Method is performed as a series of outpatient visits that do not require a hospital stay. It costs only a fraction as much as surgical treatment and has a much higher success rate (95 percent).
By increasing access to the Ponseti Method in Peru, Pakistan, and Nigeria, Morcuende estimates that this highly effective treatment method will be accessible to an additional 2,400 children in two years – more than four times the number of children in those countries who are currently being treated. The goals of this ongoing project include not only improving the quality of clubfoot treatment but putting the ownership of the Ponseti treatment approach into the hands of each local healthcare team.
In his 22 years with UI Hospitals and Clinics, Morcuende has taken the Ponseti Method to more than 60 countries in an effort to reach more children and teach the method to medical personnel around the world. “I’m still training people, and it helps to change one doctor and one clinic at a time,” he says. “But how do you change an entire country? You have to do that through a public health approach, which means institutionalizing high-quality, locally-owned and sustainable treatment within the country’s own health system. This project’s true contribution is to permanently strengthen public health systems for the treatment of clubfoot in these three countries.”