04 May 2010

Ponseti Management Program

This year, orthopedics here on the Africa Mercy has had a new addition. We are trying out a 'new' program called Ponseti casting which allows young children with club feet to have the problem corrected with very little surgery - ideal for West Africa. The casting has been done on the dock the last few months, with the tent just under Deck 7 where we have outside play time. Many times we can see children or hear the angry cries of the little ones getting the casts off and on again. The following article was written by the Communications Department here onboard.


Little Kossi was born with clubfoot. This condition causes the foot to grow inward, retarding normal growth and leaving the side of the foot where the bottom should be - crippling the child.
In many African cultures, this abnormality is viewed as a curse and makes a child an outcast. But Kossi's mother, Akouwa, took action to prevent that. She brought the 10-month-old baby to a Mercy Ships screening in Togo. He became the first patient in West Africa to take part in the Ponseti Management Program, now being established onboard the Africa Mercy .
The Ponseti technique, developed by Dr. Ignacio Ponseti over fifty years ago, is a series of casts that manipulate the foot gently into a more normal position. It requires only minor surgery to lengthen the Achilles tendon as the child grows. The child may need to wear some type of foot brace. The entire process requires 20 visits over four years. Kossi had both legs cast and manipulated and will be recast in three weeks.
The Mercy Ships Ponseti team, under the direction of Dr. James McDaniel, includes Dr. Frank Haydon and Dr. Gary Douglas. Dr. McDaniel enthusiastically describes the program: " It 's the gold standard that has been used all over the world. But, unfortunately, all over the world does not include West Africa. So, we are starting this program in Togo - with the hope that one of the other groups will help to keep the program going. We will supply the cast materials and all the supplies for the six months we are here. We hope to manage at least 60 to 70 crippled children on this program. It will be taught, and those can teach it to others. So , we are delighted to be able to offer this opportunity to the children of West Africa."




Ten month old Kossi, the first child to receive the Ponseti Management techniquefor the correction of Clubfoot introduced in West Africa by Mercy Ships, gets hisfirst casting aboard the Africa Mercy during the Togo field service.




Akouwa holds her 10 month old son Kossi, as Dr. Gary Douglas, Physical Therapist Joanna Gates and Physician's Assistant Laura Stonestreet apply the first casting in the Ponseti Management Program for the correction of Clubfoot.


Ten month old Kossi enjoys a soak in a pail ofwater to loosen the plaster castings on his legsbefore they are removed and the second castingis applied.


Physical Therapist Joanna Gates loosens plaster casting in a tub of water to remove them before the application of a second casting.


Physical Therapist Joanna Gates wraps Kossi's leg during his second casting, as Kossi's mother, Akouwa, looks on.


Written by Elaine Winn
Edited by Nancy Predaina
Photos by Liz Cantu