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November 15, 2018

Mum of two Peta Douglas was so grateful for the treatment her son received for Clubfoot that she wants to help families all over the Pacific who may not be so lucky...

It was at the 20-week scan for our second child James, that the technician scanning me spotted something unusual about how his legs and feet were positioned. After consulting with the specialist (a prolonged wait that seemed like hours and a very stressful one at that) they told us they thought he had bilateral Clubfoot, or Talipes as it's often called. This was quickly followed by "not to worry" as it is treatable and that everything else, including his brain scans showed that it was just his feet that were abnormal. Clubfoot? Sounds like something from the Dark Ages, right? That was the start of our journey, and one we quickly found was more common than we knew. 

What is Clubfoot?

Clubfoot is a birth defect where one or both feet are turned inward and downward. The calf muscle and leg can be affected, and the severity of the foot position can vary significantly. We had a lot of questions. What was the treatment like and would it be painful? How was this going to affect our baby’s life and would he achieve all the ‘normal’ milestones like other kids do? And, of course, there was that parental guilt that somehow we had caused this.  

In New Zealand we have a very high instance of Clubfoot. Maori and Pacific groups see a much higher rate (6 to 7 per 1000 births) than in European/Pakeha populations (1 per 1000). It is twice as likely to happen in boys. The cause of Clubfoot is still unknown, but a family history of it (as in my case), increases the chances of passing it on.

We live in Auckland near Starship Childrens’ Hospital, which has a Ponseti clinic (the name of the treatment given here in NZ), and they treat a large number of Clubfoot kids. We met with the head physiotherapist before James was born and she gave us an idea of what to expect and how treatment would likely be carried out. It was great to be given the information beforehand and some reassurance that it was ok to be nervous and worried. We walked away with full confidence we were in good hands.

Treatment

When James was eight days old he had his first full set of casts put on. This was quite confronting for us. We were very concerned about how he (and we!) would cope. This tiny little baby with casts from his groin to his toes! It was initially very stressful learning how to hold him again, position him to feed and making sure that no poo or wee got under his casts. Every week we went to the hospital and had new casts put on and they slowly changed the position of his feet until they were in the correct position. After four sets of casts he had his Achilles tendons snipped (so he could have full movement) and then he had a set of casts on for three weeks while his tendons healed. After these casts were removed he went into boots that are held in place with a bar (called ‘boots and bar’!). The bar is like a thin snowboard and the boots have a plastic sole with soft leather straps. They are positioned so that the feet are splayed open. He wore these night and day for 12 weeks and only had them off for bathing.

This was a particularly hard stage. Babies tend to be very unsettled after they have the casts off while they get used to wearing the boots and bars. They can’t move their legs freely like they have done and it takes time to get used to sleeping in a new position etc. We found putting James’s boots on really stressful in the beginning as their skin can be super sensitive and you don’t want blistering or rubbing to happen. So much to contend with especially when you are running on little sleep! Fortunately for us his treatment has been textbook and he now only wears his boots and bar during his nap and at night, which he will continue to do until he is four.

James is now 16 months and as I watch him walk around the backyard and climb the slide, I feel so incredibly grateful for the treatment and care we have received. The treatment he has received so early in life means he should not experience any difficulty with walking later on. Here in New Zealand, treatment is free and we are provided with the expensive boots and bars that in some other Western countries families have to pay for. There are thousands of children born in developing countries, especially in neighbouring Pacific Islands, who are not as fortunate as James and being born with Clubfoot means hardship for them and their families. It breaks my heart to think that beautiful children who cannot get treatment are left deformed or have to endure incredibly painful treatment later in life if they can get access to it. There are some amazing New Zealand-run charities that collect used medical equipment (like James’s boots) and send them to developing countries that desperately need it. Anything from a used Moonboot to a hearing aid can be reused and could change another person’s life.

If you have any equipment that you would like to recycle please contact one of these charities

(MEND)

 (Medical Aid Abroad)

Take My Hands


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