Transcript
PETER CUNDY: Clubfeet is a disorder where children are born with deformed feet, which are often quite stiff, and traditionally have been treated by open surgery, with making incisions, lengthening tendons and opening up joints. With this Ponseti method, it's mainly non-surgical and we do casting for the first six to eight weeks of life, with a plaster cast on, like you have for a broken arm, and the different way of moulding it allows the feet to be corrected and keeps them supple and flexible, which is really good for people who might be walking on uneven surfaces or don't wear shoes very much.
SALLY ROUND: What is the need for this surgery in Samoa?
PC: The Polynesian people, and of course the people in Samoa have a much higher instance of clubfeet than the rest of the world, particularly the western Caucasian world, so in the Caucasian world probably one in 1000 children have, here the rates are somewhere between ten to 40 per 1000, so a much higher instance.
SR: And what's the reason for that? Is it genetic?
PC: We think it is genetic. It's not well known yet but there are some studies going on about the genetics of it. If you have untreated clubfeet it does affect the rest of your life, because you tend to walk with your feet turned in, you develop ulcers on your feet because normally the hard skin underneath your foot protects you from injury, whereas if you're walking with your foot turned in you tend to walk on the softer skin which then ulcerates, you look deformed and can often lead to you not being employable as well. There are other social effects that people with clubfeet are deemed to be less marriageable, and so it has social consequences as well. So with the Ponseti method, that we're teaching here in Samoa, we can stop some of that happening.
SR: And the beauty of this method, for this country, is what?
PC: It's cheap. It's very cheap. As long as it's taught properly, all you need is a bit of wool and a roll of plaster and you can treat children very successfully by that method. You don't need to do very much open surgery, you don't need an operating theatre, you don't need to have expensive nurses or risk of infection, so we can treat these by simple plastering method and avoid all those risks of surgery.
SR: Is this going to be sustainable in the long term?
PC: We're here to educate and teach and we identify key people in the local community to keep this driving forward. The programmes we've run in Timor and the Solomons are now self sustaining. We've got local people there who are driving it themselves, so in that way we probably don't need to be here for long, we've need a teacher, probably have a refresher course, and then hopefully they're self-sustaining with the Ponseti method for children with clubfeet.
