THE Ministry of Health and Child Care (MoHCC) has called for the speedy decentralisation of Club Feet treatment services to district and community health centres so as to take ease pressure from provincial hospitals.
By Michael Gwarisa
The developments come after indications that most Provincial hospitals were being overwhelmed by referrals from afar places, hence exerting pressure on financially beleaguered parents ending in affected children not adhering to treatment leading to long term disabilities and death in children.
Addressing delegates during a Club Foot seminar in Harare, MoHCC director Pharmacy Services, Mrs Ropa Hove said Clubfoot was a treatable condition and adhering to proper treatment and care.
“We need to raise a flag and disseminate information to make sure that every child gets an opportunity to leave normal lives even after being diagnosed with Club foot. Club food is a deformity that can be treated.
“Training of volunteers and introducing of world standard club foot clinics. The aim of the ministry is to continue rolling out this program until every hospital and healthy centre has capacity to manage Club Foot at their levels. We need to decentralise treatment of Club Foot so as to ease pressure on bigger health institutions,” said Mrs Hove.
According to statistics, Harare Hospital this year alone received 146 new cases of Club foot of which 63 percent were referrals from other parts of the country such as Chegutu, Masvingo, Chiredzi among others.
Clubfoot refers to a condition in which a newborn’s foot or feet appear to be rotated internally at the ankle. The foot points down and inwards, and the soles of the feet face each other. It is known as talipes equinovarus (TEV) or congenital talipes equinovarus (CTEV). In 50 percent of cases, both feet are affected.
According to the National Institutes of Health (NIH), just over 1 in every 1,000 infants are born with clubfoot. In clubfoot, the tendons on the inside of the leg are shortened, the bones have an unusual shape, and the Achilles tendon is tightened.
If left untreated, the person may appear to walk on their ankles or the sides of their feet. In an infant born with clubfoot: the top of the foot twists downwards and inwards, the arch is more pronounced and the heel turns inward, in severe cases, the foot may look as if it is upside-down, the calf muscles tend to be underdeveloped, if only one foot is affected, it is usually slightly shorter than the other, especially at the heel A person with a clubfoot does not usually feel discomfort or pain when walking.
A clubfoot will not improve without treatment. Leaving the foot untreated increases the risk of complications later in life. Treatment occurs during the weeks after birth. The aim is to render the feet functional feet and free of pain.
The primary way of treatment is the Ponseti method, in which a specialist manipulates the baby’s foot with their hands. The aim is to correct the bend in the foot. Then a plaster cast is applied from the toes to the thigh, to hold the foot in position.
There is normally one session a week. The manipulation and casting are done very gently, and the patient should experience no pain. At each session, the plaster cast is changed, and each time the foot is corrected a little more. The whole process may be done 4 to 10 times, using 4 to 10 new casts.
