At 24 years old, twin sisters Silvia and Celva are just as inseparable as when they were little girls growing up in the rural area of Kurusu de Hierro, Paraguay. As two of eight siblings, the intimate connection between the girls existed from infancy.

“Ever since they were born, it was as if they were the same person,” says their father, Ricardo, “They wanted to nurse at the same time, they were always together. They slept together, they went to the bathroom together. We had to buy the same things for both of them.” But even apart from their innate bond as twins, there is another binding factor: both were born with clubfoot.

When they were born, the midwife told their parents the two babies had a problem with their feet but didn’t offer information about treatment.

When they began learning to walk at nine months old, their mother heard about a corrective surgery that could help, but she was unsure of the details and feared it would prohibit them from walking altogether. And so, the sisters grew up with the condition untreated – Celva with unilateral clubfoot in her left foot and Silvia in both feet.

“Ever since I can remember, I would look at my siblings’ feet and they looked fine. Then I would look at my feet, and wonder, why are mine like this?”

– Celva

Untreated clubfoot is inherently isolating. More often than not, the physical limitations cause exclusion from normal activities like walking, playing sports, going to school, and getting a job. Plus, in many countries, the stigma and misinformed cultural beliefs propels the exclusion and isolation. Yet Silvia and Celva had a unique bond of likeness even in their “difference,” an understanding and an empathy deeper than most can comprehend. “She’s my twin, my soulmate, and for me it was the most beautiful thing because we both were born like this,” says Silvia. “We both grew up and lived like this and it was great – she’s like that and so am I.”

Even with the benefit of comradery, the girls faced their share of obstacles. Neither could wear shoes, burning their feet on the hottest days and freezing them on the coldest. Walking any distance was painful, and running was out of the question. All these hurdles took a toll on their confidence. “Honestly, I was embarrassed to go out and do things. I didn’t want to leave the house because I saw everyone else was normal,” Silvia shares. Celva felt similarly, growing up shy and reluctant to interact with others.

As adolescents, the girls dreamed of wearing sneakers, strappy sandals, and high heels. As the girls grew older though, another dream began to form: treatment.

“’One day, we won’t be like this,’ we’d say, ‘We’re going to get treatment, me and you.’”

– Silvia

Their dream, however, seemed impossible. Their father, an agricultural worker, and their mother, a homemaker raising eight children, had no means to pay for the expensive surgery they believed was necessary. “They would tell me, ‘I want to get the surgery,’” their father remembers, “But we didn’t have the resources. I cried many times because I felt powerless. They asked me to get them surgery and we had no way to do it.”

Still Dreaming, A Decade Later

The summer of 2022 found Silvia and Celva, now 23, far from home in the city of Concepción in their second year of university both studying to become elementary school teachers–chasing their professional dreams and navigating adult life as they had their childhood: together. One day in August, the girls received a call from one of their professors with news that would change their lives forever. Their teacher told them to drop what they were doing and head to the hospital for an event focusing on clubfoot.  

The event, called a Brigade, was part of a larger program aimed at increasing clubfoot awareness and treatment referrals. Silvia and Celva had unknowingly landed in the middle of a meeting of local health leaders and chief physicians discussing clubfoot treatment. Their chance to fulfill their shared dream had arrived.

Dr. Mirna Valenzuela, a traumatologist and head of the MiracleFeet-supported clubfoot clinic at the Regional Hospital of Concepción examined the twins feet. She knew treatment would be complicated given their age, but ultimately decided they could be treated using the Ponseti Method – not the expensive corrective surgery the girls had always assumed would be necessary. Although they would become the oldest patients the clinic had ever treated by 10 years, Silvia, Celva, and Dr. Valenzuela were up for the challenge.

“The ideal is to treat clubfoot as a newborn when it’s a lot easier to treat because the foot can be more easily manipulated by the cast and the brace. The older a patient is, the ligaments are shortened, the muscles are hypertrophied, and the bones are much more rigid,” explains Dr. Valenzuela. Treatment for the twins would be a long, tough process compared to clubfoot treatment for newborns – but not impossible. The plan extended beyond the medical and drew from the twins’ greatest strength: each other. Silvia and Celva were living far from their family and would continue their studies throughout treatment, which meant they would rely once again on one another for the support, care, and encouragement needed to make their dream a reality.

Celva underwent treatment first since her case was unilateral. Silvia helped her throughout the process, and once Celva recuperated, Silvia began treatment, one foot at a time. With the application of her first cast, navigating classes, and student teaching, Celva began to feel overwhelmed. She also had to walk with crutches, bathe without getting her cast wet, and avoid putting weight on her left foot. Through it all Silvia was the ever-present support. “She’s my guide.” recalls Celva “Without her, I wouldn’t even be able to walk to the street corner. When I wanted to go do something, we both went, because I didn’t want to go without her.”

Catch part 2 of Silvia and Celva’s treatment journey here