Clubfoot clinic in India is a success and is being expanded

With one affected person per thousand newborns worldwide, clubfoot is one of the most common congenital malformations. While we no longer see people with untreated clubfoot in this country, this is unfortunately still a sad reality in India, which can also affect the fate of entire families. In addition to making everyday life difficult and painful, clubfoot, if not recognised and treated early, often results in poverty for those affected, as they are unable to pursue gainful employment due to the physical impairment. Clubfoot is a congenital, complex deformity of the entire foot. Those affected walk on the outer edge of the foot, in severe cases on the back of the foot.

With this in mind, the association Child Health Care Heidi (CHCH), based in Münchenstein, decided to support a project run by the Indian organisation CURE India with the SVNIRTAR rehabilitation centre in Olatpur in the Indian state of Orissa. The aim of the organisation is to promote health projects for children, adolescents and young adults in India. The focus is on the treatment of diseases for which there is insufficient local provision, as well as on the training of local specialists and the transfer of expertise.

In December 2016, the joint clubfoot clinic - with regular consultation hours and modern treatments - started. The initial results are positive: Since then, around 700 patients with clubfeet, mainly children, have already been treated. "That's an incredible number and definitely already a success," says Bernhard Maria Speth, Senior Consultant Orthopaedist and Head of the Foot Consultancy at UKBB. Together with Reinald Brunner, Head of Neuroorthopaedics, Speth visited the SVNIRTAR rehabilitation centre for the first time at the beginning of 2015. During this visit, the aim was to identify patient groups for whom a significant improvement in quality of life could be achieved with little effort. This resulted in the clubfoot project, which current and former UKBB employees now support with the transfer of expertise and regular visits to the centre. Conrad E. Müller, Chairman of the Board of Trustees of the Pro UKBB Foundation and former CEO of UKBB, is President of the CHCH association, which was founded in 2015, while Brunner, a neuro-orthopaedic surgeon, is Vice President. The commitment is voluntary, including that of Speth and Brunner.

Another success of the project in Olatpur, India, is that the number of operations has decreased and the majority of children are now being treated conservatively - and according to the same principles as at UKBB "This was our main focus when supporting our Indian colleagues," says Speth. Early detection is a particularly important aspect of this. "Early detection is still a major problem, which our educational work on the ground is dedicated to. Nevertheless, we are seeing significant treatment successes by starting treatment early." Whereas three children a day used to be operated on in the past, the figure is now three children a month. At UKBB, clubfoot is treated conservatively using the so-called Ponseti method - in a first step with several casts and in a second step with a splint that must be worn until the child is four years old. According to Speth, 20 cases per year are treated in this way at UKBB.

Another, third success of the project is that patients no longer only come to the SVNIRTAR rehabilitation centre for surgery or treatment as they used to, but also come for regular check-ups later on. "This is important for a good recovery," says Speth. The SVNIRTAR rehabilitation centre has a huge catchment area. According to Speth, it covers an area of over 40 million people.

Following the successful launch of the clubfoot project, the CHCH association now has further plans in Denkhanal, India. A new treatment centre for children with orthopaedic problems and impairments is also to be set up and financially supported. According to Speth, the foundation stone is due to be laid soon. Sponsors are currently still being sought for the project. It was a coincidence when he first visited the SVNIRTAR rehabilitation centre in Olatpur at the beginning of 2015, says Speth. In the meantime, however, the projects in India have become an "affair of the heart" for him. "I have already had many impressive experiences there and have also made personal connections," he says. Speth is convinced that UKBB and its employees will also benefit from the experience and knowledge gained there. "It's a win-win situation."

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