Congregation at Duke Chapel

miraclefeet: Treating Clubfoot One Step at a Time

For the ears, you can listen to an audio recording of this presentation. [high fidelity audio playable under all personal computer operating systems via VLC media player, Microsoft Windows Media Player with the Xiph.org codecs for FLAC et al, OS X QuickTime with the XiphQT plugin, etc., on many Android-based mobile devices, and on iOS-based mobile devices via apps such as FLAC Player or Golden Ear]

miraclefeet: Treating Clubfoot One Step at a Time

presentation at Adult Forum by
Leslie Loyd, Operations Manager
October 27, 2013

logo and images of three young patients

image of doctor with hands on feet of young patient



Treating clubfoot one step at a time.
 

This is clubfoot: untreated

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images of three young patients

One out of every 750 children is born with clubfoot worldwide;
untreated clubfoot is a leading cause of physical disability in the developing world.


Untreated Clubfoot

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image of man who walks on the sides/tops of his feet


Yasmin

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images of Yasmin before and after treatment


This is clubfoot: treated

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image of Yasmin after treatment

Yasmin from Brazil, seen previous page - treated for clubfoot

Mia Hamm, US Olympic soccer star – treated for clubfoot at birth

With treatment, children born with clubfoot can run, walk and play – and live fully productive, active lives.


The solution – low cost, very effective, non-surgical treatment

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In the last 5-10 years, there has been a major shift in clubfoot treatment.

From Surgery ...

  • Ineffective (20-30% success)
  • Invasive, hard on child
  • Expensive

To the Ponseti Method

  • Effective in 95% cases
  • Non-surgical, easy on child
  • Inexpensive, low tech
 

images of surgical stitches on feet, and of plaster cast on feet

Unlike surgery, the Ponseti Method is ideally suited to developing country environments.


The Ponseti Method now makes it feasible to treat kids born with clubfoot in all countries

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images of ankle massage, plaster cast on feet and legs, shoes on brace

Gentle manipulation and casting (5-8 weeks)                Bracing (4 years) images of feet progressively aligned more normally

Full correction - without surgery


However, very few children are receiving the treatment they need

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bar graph of annual cases of clubfoot per continent / region

miraclefeet annual estimates based on data from different clubfoot organizations


Living conditions in developing countries heighten the need for disability prevention

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photo of street in India

Disability in developing countries often leads to:

  • neglect and discrimination
  • increased rates of abuse
  • illiteracy and unemployment
  • and a life of extreme poverty
laundry outside living quarters in India
 

miraclefeet is seeking to change this

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  • miraclefeet increases access to proper treatment for children born with clubfoot in developing countries through partnerships with local healthcare providers.
  • miraclefeet helps our local partners transform children lives for about $250 a child
photo of boy kicking one foot high
 

The miraclefeet model: efficient, sustainable

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flow of local Ponseti-trained doctors + local infrastructure + funding

More children treated - less unnecessary disability in the world


Over 2,700 children in treatment in 9 countries

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global map showing count of children in miraclefeet's treatment


Bracing is a big obstacle, especially in developing countries

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  • Currently available braces are uncomfortable or prohibitively expensive
  • miraclefeet is working with Stanford University, Clarks Shoes and Suncast to design a new, easy-to-use brace for less than $20

photos of traditional and miraclefeet's braces

Current model used in most countries     New miraclefeet brace.

The miraclefeet brace will go into production in early 2014.


Yasmin, 2 years old, fully corrected after 3 months – Brazil

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photos Yasmin before, during, and after treatment


Jorgito, started treatment at age 5 and is now playing soccer - Nicaragua

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photos of Jorgito before, during, and after treatment


Maima and Youkoi, 12-year-old twins - Liberia

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photo of Maima and Youkoi


Three months later, Maimoi and Youkoi are both attending school for the first time

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photos of Maima and Youkoi at school


Pournima, 2 months old, fully corrected within 7 weeks - India

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photos of Pournima


Thank you so much for your interest and support!

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photos of children in mother's arms


Videos of patient stories and more are available on miralcefeet's website.


Appendices

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miraclefeet has proven that our approach works and that it is scalable

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graph of new children enrolled over years 2011, 2012, and 2013


miraclefeet plan is to reach 10,000+ new children a year by 2016

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Country FY 2013 FY 2014 FY 2015 FY 2016 FY 2017
Mexico 301 600 700 800 900
Brazil 95 285 475 740 1,050
Nicaragua 126 150 150 100 100
India (Existing) 1,162 1,330 1,410 1,500 1,650
India (New) 0 940 1,350 1,510 1,670
Zimbabwe 88 189 259 364 470
Liberia 173 250 250 225 200
Southern Africa 105 335 445 480 575
Ecuador 3 210 250 300 330
Tanzania 0 300 575 800 1,000
Philippines 0 100 200 500 800
Peru 0 100 150 200 250
Other Latin America 0 70 260 380 490
Other Africa 0 40 280 525 800
Other Asia 0 0 300 750 1,200
Total 2,053 4,899 7,054 9,174 11,485
           
% from Existing Countries 82% 94% 83% 74% 69%
% from New Countries 18% 6% 17% 26% 31%
Annual Growth 326% 179% 144% 130% 125%

Two sources of growth: depth and breadth


A growing base of donors has enabled expansion to date

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graph of donations of various sizes 2010-2013


Diverse funding sources, with emphasis on individuals and foundations

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pie chart of percentage of funding from small donors, ..., major gifts

Foundations

  • Oak Foundation
  • Ronald McDonald House Charities
  • Stanford University
  • Passport Foundation
  • Matthew 25 Ministries
  • Starfish Care and Relief
  • Staenberg Family Foundation
  • Heyman Family Fund
  • Llura and Gordon Gund Foundation
  • Cranford Rotary Charitable Fund
  • William Hendricks Family Foundation
  • Women’s Syndicate Association
  • STEPS UK

Corporations

  • Clarks
  • MD Orthopedics
  • Suncast
  • King and Spalding
  • Eurosport
  • Wasserman Media
 

miraclefeet Partnerships

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  • Global partners:
    • Governing member of the Global Clubfoot Initiative (GCI), based in the UK with global membership, Chesca is also a Trustee of GCI
    • Work closely with Ponseti International Association, University of Iowa
    • Key partner in the development of the Global Clubfoot Registry, working with the Bioinformatics Department, University of Iowa
    • miraclefeet brace project: Stanford University, Clarks Shoes, Suncast, King & Spalding
  • Local partners:
    • Brazil: University of São Paulo, Hospital Martagao Gesteira
    • Mexico: Mexico Clubfoot Foundation, Mexican Pediatric Orthopedic Society
    • Ecuador: Fundacion Herman Miguel, plus four public hospitals
    • Nicaragua: Three public hospitals, Rotary International-Managua
    • India: Cure India Trust
    • Liberia: FACORC
    • Zimbabwe: Zimbabwe Sustainable Clubfoot Organization
    • Southern Africa: STEPS-South Africa
    • Tanzania: Bugando Hospital and Lakes Region Clubfoot Programme