Dr. Vuthy, pioneer for clubfoot treatment in Cambodia
Like his patients, orthopedic surgeon Dr. Vuthy Chhoeurn knows what it takes to overcome adversity. He was only twelve years old when the brutal communist rebels of the Khmer Rouge overran Cambodia’s capital, Phnom Penh, dispatching its citizens to work on farms around the country.
Vuthy and his family were sent to work in a distant province, while the regime began a genocidal campaign against the nation’s educated classes. By the time the Khmer Rouge were deposed, barely twenty doctors were left alive, and only a handful of surgeons.
“There was no medicine during that time,” recalls Vuthy, sitting at his desk at his practice in Phnom Penh. “And most hospitals only had herbal and traditional medicine.” Even when Vuthy himself fractured his right forearm, the best and only option was a traditional remedy—wrapping it in a contraption of soil and bamboo.
It was against this backdrop that Dr. Vuthy began his career in medicine, a profession he chose partly because of the overwhelming need, and partly at the request of his family. The only other doctor in the family, a cousin, had been killed by the regime, and Vuthy was chosen to fill that role.
No sooner had he graduated from medical school in 1988 than he was sent straight to work on a frontline hospital in Pursat Province, and with such a shortage of medical staff available, just two months later he was promoted to the head of the surgical department.
“There was no residency program, no training after finishing, you had to get to work quickly,” he remembers. “Imagine a fresh doctor straight out of school becoming head of the surgical department of a frontline hospital two months later. Talk about on-the-job training.”
“We did not have much choice except to work hard, learn from all people we met, and build up our professional capacity as best we could. Even some of professors who taught us were freshly out of school themselves,” recalls Vuthy.
Vuthy considers himself lucky having had the opportunity to work with surgeons from International Committee of the Red Cross and Medicines San Frontiers who came to Cambodia as part of a post Khmer Rouge rebuilding effort. Through them, his surgical and English language skills grew.
It wasn’t until he had the chance to return to school for his specialization training in 1994, and to study abroad in a Belgium in 1999, that he was trained to be what he described as “a proper doctor.”
His first exposure to clubfoot was in 2003 when a group of clubfoot specialists visited from Uganda, where they had been assisting with a training. They introduced Vuthy and his colleagues to the Ponseti method of treatment. A few years later, he went to the USA, and to Australia for further training, before coming back home to launch the country’s first cohesive clubfoot program.
“At that time, I saw so many kids with birth defects, especially clubfoot. And not only young kids but also older kids, even adults” says Vuthy. “Nobody was taking care of them. And if they got treated, it was with methods that were not very effective.”
In Cambodia in those days, living with untreated clubfoot was not easy. Parents often kept children with clubfoot out of school, and those that did attend were often teased and bullied. Plus, when the time came to find a job, many found that employers discriminated against people with disabilities.
Vuthy, dressed in his blue scrubs, a cap emblazoned with cartoon characters, a pair of spectacles, and an irrepressible smile, explains that the nascent clubfoot program had to confront two major obstacles. The first was a shortage of staff and equipment. This they addressed through setting up a series of clubfoot clinics around the country and training a new generation of medical staff. Funding from overseas helped them provide the equipment essential to Ponseti treatment, such as foot abduction braces and plaster.
The second obstacle to surmount was overcoming the extreme lack of awareness of clubfoot. “There was no program advertising, parents didn’t know where to go, and there was no one to tell them that there’s a treatment for it” recalls Dr. Vuthy. This lack of awareness left a knowledge gap that was filled with superstitions and false beliefs. “Some people thought that maybe in their past life they did something wrong, and this is their fate,” Dr. Vuthy offers as an example.
Over time, Vuthy and his team set about trying to change that attitude by sharing information about clubfoot with whoever would listen.
“The information needs to spread, needs to be talked about every day, every hour, every minute,” he says. “We can’t convince them that it’s not a curse from a past life, but as a medical team, we can tell them that the deformity can be treated, and without surgery.”
The Revolution in Clubfoot Treatment
In Dr. Vuthy’s clinic today, the team uses educational posters and photos of successfully treated cases to aid them, and they have also benefitted from the digital revolution that has swept Cambodia in the past 15 years.
“The public is also more educated now. Plus, there’s news, TV, Facebook, and Youtube, so the information is spreading,” says Dr. Vuthy.
It also helps that each patient the team successfully treats acts as an unofficial ambassador touting the Ponseti method and continually voicing the fact that clubfoot can be treated. Even if people have never seen the condition themselves, it’s likely, these days, that they know someone who was born with clubfoot who has been successfully treated. And if not, many now turn to the internet to find information provided by the clubfoot program and other sources. Since the program launched in 2007, levels of clubfoot treatment have soared, to the point where Vuthy says it’s now incredibly rare to see a child older than two with untreated clubfoot.
He describes treating clubfoot not merely as a vocation, but as an act of love, and he derives endless motivation from witnessing the reaction of parents when they see their children’s feet straightening out in the early weeks of treatment.
“It makes me so happy,” says Vuthy. “It’s hard to express in just a few words.”
During his tenure as the Executive Director of NextSteps, MiracleFeet’s partner in Cambodia, which took over the running of the clubfoot program in 2015, he recruited and trained many staff and advocates to help safeguard the future of the program.
“Now I’m old, but I see the young doctors working with passion and motivation,” he says. “And the good thing is that the program is already there. Clubfoot treatment will continue successfully in the future.”
Looking back on his career, Vuthy draws great satisfaction from the knowledge that with every clubfoot patient he has treated, not only has he transformed that child’s life, but he has also ignited a spark that glows far and wide.
“You can’t look just at one kid, it’s also about the society,” he says. “If the child is not treated, their clubfoot becomes a burden not only for them but for the family, the community, and the whole society. But after treatment, who knows, maybe they could be prime minister one day.”