When Clubfoot is Complex – A Guest Post by Chesca Colloredo-Mansfeld

Meeting Jazmilin

Jazmilin is a bubbly 5 year old with a huge, cheeky smile and bright eyes.  She lives in a small village in Ecuador with her parents and 5 siblings, a 2-hour bus ride from the capital city of Quito. When I visited Jazmilin’s home a few weeks ago she was very happy – looking at picture books and drawing. She was very excited about going to kindergarten with her friends.  

Jazmilin was born with bilateral clubfoot. Unfortunately, she was treated unsuccessfully with two surgeries at the provincial hospital. Jazmilin, a tough and determined little girl, has figured out how to walk on her feet but walking is difficult and painful. Life is very hard – their house sits off a steep dirt path on the edge of the hillside – and I couldn’t help thinking what the kids on the playground will say when she has to go to school outside her village.

An Attempt to Help

Fortunately for Jazmilin, she was spotted by an American volunteer who Googled “clubfoot in Ecuador” and found the new MiracleFeet-supported
clinic. One would hope that from this point on this would be a straightforward story – but sadly, it isn’t.

Jazmilin’s family were understandably intimidated by the idea of going to Quito to get treatment. Luckily for them, a local innkeeper offered to accompany them. Money for bus fares was also an issue, although they were helped with funding from the American volunteer. Once at the clinic, Jazmilin was seen by a
doctor who, although he is an experienced orthopedic surgeon, is newly trained in the Ponseti Method. It is very hard to treat older kids who have been treated previously with surgery.

The doctor casted Jazmilin’s feet, but they have been left very stiff and rigid by the two surgeries. The lack of progress after casting her for the first time was distressing for everyone involved. The doctor feels this case is too complex for him – and we agree. Unfortunately though there is no other doctor close by with more experience who works in a public hospital. Ecuador and MiracleFeet, despite all our work, is not in a position to help Jazmilin.

Changing the Story for Other Kids

The point of this account is not to highlight a failure, but to explain how complicated our work is. While a lot of things are in place to make sure that there will be fewer cases like this in the future, there are still enormous challenges. Many people are unaware that clubfoot is treatable; it took an American volunteer with
internet access to figure out where Jazmilin could see a properly trained doctor. An alarming amount of non-Ponseti method surgeries are still being done on children, resulting in terrible long-term consequences. There is a limited number of doctors with enough experience to tackle the tough complex cases. And last, travel times are off putting to very low income families that have many demands on their time.

It Takes a Village

MiracleFeet is working with all our partners in Ecuador to solve these problems – and others in Ecuador, such as PIA, have made progress by getting the orthopedic society to endorse the Ponseti Method and train doctors. Ronald McDonald House Charities has been providing funding to MiracleFeet so we can expand access and provide support to create a network of clinics.  We have a terrific local partner, Fundacion Hermano Miguel, who understands the disability and
rehabilitation landscape in Ecuador, as well as the shifting political situation which is quite complex at the moment. And yet, we still have a long way to go. There are probably lots of kids in Jazmilin’s position that we don’t know about, and more are being born every year that do not have access to treatment.

Even in countries where a lot has been done, we are a long way off solving the problem. With time, hard work, and collaboration it can happen.   In the meantime, we are working on how we can help Jazmilin get her feet corrected. She needs and deserves a solution – and we will find one.