Global Strategy to End Clubfoot Disability

CBM has been a founding and governing member of the Global Clubfoot Initiative (GCI), an umbrella organisation of non-governmental organisations involved in clubfoot treatment worldwide. Via GCI, CBM has helped develop a standardised training package for clinicians treating children with clubfoot and a global database of cases treated.

Up to 85% of children born with the condition worldwide are unable to access treatment. CBM has thus collaborated with GCI on the drafting of a Global Strategy to End Clubfoot Disability, which is published today, 3 June 2017,on World Clubfoot Day and the birthday of the late Professor Ignacio Ponseti who pioneered the successful treatment technique. This strategy has prioritised countries in which programmes need to be established and developed, as well as estimating the costs involved in doing so. Under this strategy we hope that, by 2030, 70% of children born with clubfeet in low and middle income countries will have access to the treatment they need in order to walk and run free for the rest of their lives. CBM, via our partners worldwide are already a major provider of clubfoot treatment internationally and intend to take a leading role in the implementation of the global clubfoot strategy published today.

What is clubfoot?

Congenital talipes equino-varus, or clubfoot, is the most common significant musculoskeletal congenital abnormality, affecting between 1 and 2 babies in every thousand live births. The deformity presents as a “twisted” foot, with the sole of the foot turned upwards and the ankle twisted inwards. The condition is twice as common in boys as in girls and in two thirds of cases both feet are affected.

Without treatment, the child will begin to try to walk on the deformed foot, which with time will become stiff and painful. Also the bones of the foot will secondarily deform making correction more difficult and often only possible by means of extensive and costly surgical procedures. Without correction mobility is impaired, leading to children having difficulty attending school and being unable to participate in the normal activities of childhood.  Normal shoes cannot be worn and as adults employment opportunities are limited.

Clubfoot deformity is entirely correctable by a very inexpensive and simple technique known as the Ponseti method. This involves a weekly manipulation and plaster casting of the foot, which typically corrects over a period of 5-6 weeks. The majority of cases need a minor surgical procedure.

Globally, nearly 200,000 children are born with clubfoot deformity each year and the majority of these are in low and middle income countries where it is difficult for them to access treatment; of those born today only 15% are likely to be corrected, condemning the remainder to lifelong pain and disability. CBM has been in the vanguard of the drive to establish Ponseti based clubfoot treatment programmes across the less developed world.

Via our partners CBM has gone on to set up Ponseti based clubfoot treatment programmes in many of the less developed countries in which we work and as a result we have transformed the lives of children born with this condition. CBM has also been at the forefront of teaching and training local doctors in the specialized surgical techniques necessary to treat older children and adults who present with “neglected” clubfoot.