miraclefeet in Brazil

miraclefeet works in Brazil due to its large population, stability, and commitment to public health. Despite incredible economic growth, Brazil is still a country of great socioeconomic inequality with very high poverty rates and large numbers of untreated clubfoot.

miraclefeet has numerous local supporters in Brazil, including the Ponseti Brazil Study Group and a Ponseti Parent's Group in Sao Paulo who promote the Ponseti Method within Brazil. miraclefeet partners with these champions to advance their efforts, while focusing on major cities and public hospitals that serve low income populations.

Strategic partnership with Hospital Universitario da Universidade de Sao Paulo

miraclefeet launched its first program in October 2010, partnering with Dr. Laura Ferreira and her clubfoot clinic team at the Hospital Universitario de Universidade de Sao Paulo (HU-USP) in Sao Paulo, Brazil. This hospital serves university faculty and students, as well as a large low-income area of the city.

Dr. Ferreira is a long-time Ponseti doctor, and with the help of miraclefeet, recently received approval from hospital administration to build a dedicated team to treat clubfoot patients.

Dr. Ferreira expects to treat 50 children in the next year, with the ultimate goal of creating a Ponseti Center of Excellence for Sao Paulo. miraclefeet funding allows HU-USP to provide free braces to all families. In addition, Dr. Ferreira is also using miraclefeet funds to concentrate on education and outreach in maternity hospitals and clinics.

The Challenges of Treating Clubfoot in Brazil

The situation in Brazil is a good illustration of the complexities involved in addressing clubfoot worldwide. While Brazil is growing extraordinarily fast and has a very solid public health system in many parts of the country, clubfoot remains a forgotten stepchild, with high rates of neglected clubfoot in the poorer and more rural areas, and Dr. Monica Nogueira, a passionate and dedicated Brazilian orthopedic surgeon, has spent ten years tirelessly training doctors around Brazil in the Ponseti Method. She estimates to have reached over 200 doctors. However, despite her efforts to train there is still very limited use of Ponseti in Brazil, with many hospitals treating clubfoot with expensive and ineffective surgery, even where there is an understanding of the superior outcomes of the Ponseti Method. The Brazilian government reimburses hospitals for the number of surgeries they perform. Casting has very low reimbursement rates and so hospitals favor surgery over the simpler and more effective casting techniques.

Dedicated doctors like Dr. Nogueira and the small cadre of Ponseti champions she has developed The Brazilian Ponseti Study Group scattered around this huge country are deeply committed to providing the best care for the children they see, but are frustrated that their efforts are undermined by a system that pushes those who are less humanitarian to continue to operate.miraclefeet hopes that by supporting these "agents of change" or local Ponseti entrepreneurs, it can increase the number of children being treated, improve the quality of care and promote systemic change within the system so that the Ponseti Method becomes the gold standard treatment provided by all public hospitals in Brazil.