Interview with Jen Everhart

You’ve been at MiracleFeet for almost 9 years and working in physical rehabilitation for 26 years. Can you share what motivated you to do this work?

My interest in physical rehabilitation came when I lived in a small village in rural Cote d’Ivoire as a Peace Corps Volunteer in the mid-1990s.  I saw many cases of preventable disabilities that were not being addressed by the health system.  Several friends and neighbors from my community were impacted by physical disabilities such as clubfoot, polio, tuberculosis or other undiagnosed conditions that were blamed on destiny, witchcraft, or otherwise written off as untreatable.  Knowing that their quality of life could dramatically improve if they had access to rehabilitation, drove me to focus my career on physical therapy in low-and middle-income countries.

Since then, I’ve treated or coordinated rehab services for many conditions including cerebral palsy, clubfoot, angular deformities of the lower limbs, polio, amputations from landmines, and rare congenital anomalies. Of these, clubfoot is the condition that if treated early will most successfully prevent physical disability.  The first case of clubfoot that I saw was in 1996.  We weren’t able to do much for her since there were no clubfoot providers and I often wonder how she is after all these years.  I’m so pleased with the progress made since then and in knowing that babies born today have a stronger likelihood of finding the right treatment.

Are there key achievements that stick out the most from your time at MiracleFeet?

When I first started at MiracleFeet, we were working in only a handful of countries with about 2,500 children enrolled in treatment. Today, our partners have treated almost 60,000 children in 29 countries! There has been incredible growth over the past 8+ years and I consider myself fortunate to have had the opportunity to contribute to this global movement to end clubfoot disability.

I’m especially proud of the partner relationships we’ve grown and nourished over the past 8+ years. WhileMiracleFeet is a financial partner, we also provide technical assistance and through this, we’re constantly learning from the experiences of healthcare providers and our partners. Investing in local leadership of programs has been a priority, whether it’s through building clinical expertise or working with partner organizations to strengthen governance or management procedures. This is evidenced by the number of healthcare providers trained annually by skilled trainers from their home countries, resulting in an increased number of children treated. We partner with some of the most experienced clinicians in the world—their advocacy, training efforts, and commitment to treating children despite working in challenging settings are the foundation of MiracleFeet’s global work today.

Jen with TCCO

 An example of strengthening partner organizations of which I am so proud to have been a part of  is the creation of the Tanzania Clubfoot Care Organization (TCCO). We started our partnership in one region of the country in 2013 with a few committed healthcare providers treating a few hundred children. In 2016, this group of healthcare providers created an organization with a mission to provide country-wide treatment coverage. Today they support over 40 clinics where 55 percent of children born with clubfoot in Tanzania receive treatment and their vision to treat all children born with clubfoot in their country. They have high quality programming, an incredibly strong team of trainers, an M&E officer, and skilled clinicians within their network of clinics. What an honor to be part of that process from the very beginning and to contribute to this vision that is close to becoming a reality!

Finally, the implementation of tools like CAST, which has transformed our ability to monitor clinic quality and introduce strategies for quality improvement. It has helped us understand the obstacles parents facekeeping their children in treatment. CAST was just an idea seven years ago; today it is a model that other organizations regard for how technology can be used in the rehabilitation sector, and most importantly—it provides evidence to the high quality of treatment that children receive through our partner clinics.

You’ve visited every region and met many of the providers and partners. Are there any visits that left an impression?

Time spent with partners has been the most fulfilling parts of my work at MiracleFeet and every visit was rewarding and full of adventure. I’ve hopped on the back of a motorcycles to visit clinics, crossed lakes by passenger boats or ferries, and taken 4×4 vehicles to access remote communities where the patients live. An invaluable part of our learning involves spending time in clinics to experience what day to day work and life is like for partners, healthcare workers and families. In the Philippines, I spent time with PNGOC staff and watched them in action as they organized trainings and met families who had been searching for years for the right treatment. In Guatemala, we travelled to remote communities in the mountains where parents of children with clubfoot shared their struggles to access treatment, as well as their deep gratitude for our partners guidance and dedication.

One of my most memorable trips was to Liberia in 2017 when I accompanied a journalist from a prominent American newspaper to tell the story of a family who had been affected by clubfoot for three generations.  It was unlike my typical visit during which I would address a long list of program objectives and issues.  Instead, I was in storytelling mode and I spent most of the week listening to parents and healthcare providers. The stories I heard from parents were ones that I could easily relate to as a mother– hopes and dreams for a future in which our children are healthy, happy, and enjoying their childhood. The difference in our parenting experiences came not from cultural differences but rather was reflected in how the stigma, superstition, and economic hardship had temporarily put obstacles in their path to realizing those hopes for their children.  Fortunately, our partners at the Liberia Clubfoot Program are working tirelessly to change that situation.

During the same visit, I saw evidence of the past Ebola crisis at every hospital that I visited, and I heard stories of  resilience and perseverance as providers recounted the ways they helped children complete treatment during the Ebola epidemic.   Little did we know at the time that  the measures and lengths they went to during that crisis would serve as a model and inspiration for the global pandemic we would face in 2020.

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Are there times that have been particularly challenging?

The last 18 months of the Covid-19 pandemic have been the most challenging without a doubt. We are an ambitious organization and always strategize with partners to treat more children. As the pandemic initially unfolded, safety was our top priority and the guidelines we shared called for suspension of treatment provision. We were asking partners and providers to do the opposite of what we had encouraged for years.  It was surreal– and devastating.  I had the same late night conversation over and over, where I found myself saying things I couldn’t have imagined in my wildest dreams, “That’s good– all clinics in the country are closed.” “No children are coming in for treatment.” “Please advise parents on how to remove casts at home.”

The relationships with partners, health care providers, and parents are the most rewarding parts of my work and not being able to spend time at clinics or visiting in-person has been challenging. We’ve had health care providers from programs pass away from COVID, lose family members, and experience the stress and anxiety related to strict quarantines and multiple waves of the virus and we’ve felt limited on how we can best help. 

Throughout the pandemic, however, we’ve found creative and better ways to keep in touch through technology, and I’ve repeatedly been humbled by our partners’ determination to serve children with clubfoot even when the odds are against them.  In the Philippines, a team of an orthopedic surgeon and physios deliver braces by bicycle to patients who can’t get to clinic. In Uganda, a mother walked over 20 miles so that her child could complete treatment before the pandemic shut down the clinic. These are only a few from hundreds of examples of parents and providers who put themselves at risk to provide a better life for children with clubfoot.  It’s not often in life that one has the opportunity to work with such incredible heroes—and I have been privileged to work with hundreds!

What’s next for you?

I plan to apply the experiences from my time at MiracleFeet to  increase access to treatment of other underrepresented health conditions that I have navigated as a parent. MiracleFeet’s approach to advocacy, awareness raising, workforce development and quality treatment are key elements for any successful intervention to increase access to health care. 

Are there any parting words you’d like to share with partners?

I have tremendous admiration for your commitment and for the work you do daily under challenging circumstances— especially over the past year and a half. I have learned so much from you and will carry this with me always. Thank you for the trust you’ve had in me and my colleagues.  Being part of this incredible community and contributing to the vision where all children born with clubfoot receive treatment, enabling them to live active and healthy lives has been one of the greatest honors and privileges of my career.  I’ll be cheering you on in the fight to end clubfoot disability and I’ll always be proud member of the MiracleFeet family!