Nola PaterniAssociate Director, Marketing & Communications (USA)
“Well, from the beginning it was hard for us. We saw that her feet had problems.”
When Mariela was born her mother cried. “Look at the girl’s feet,” she told her husband, Ramiro. But Ramiro did not cry. He sat and thought, and prayed, and then sought help for his tiny baby girl.
Mariela was born with bilateral clubfoot in a health facility in a small town outside Managua, Nicaragua. Her treatment journey was not linear or easy, but it was ultimately successful thanks to her parents’ tenacious love.
Mariela was nine months old when she started treatment. It was emotional for both parents. Her mother was afraid the casts would hurt, the tenotomy wouldn’t work, and sure that the brace and shoes would be unaffordable. Ramiro, fueled by his faith and determination, assured his wife it would be ok.
When they first arrived at the clinic in Managua, Mariela’s mother didn’t want to go inside, so Ramiro entered alone to observe. He was surprised and comforted to see children finishing treatment and taking their first steps.
“First steps are always hard,” he said, but taking the first step to visit the clinic and seeing the possibilities for his daughter propelled him to enroll Mariela in treatment.
Mariela made good progress with her casts, and soon it was time for her tenotomy. “My wife was crying so I forced myself to be strong,” said Ramiro. After the operation Mariela’s parents were overjoyed.
“We saw the foot better, normal at last, just like any other child.” After the tenotomy, Mariela wore her brace continuously for a month and then only at night, as instructed. She was to return to the clinic for regular checkups and to eventually retrieve the next size shoes and brace.
However, just after Mariela turned four, one follow-up appointment was delayed due to a scheduling mix-up, and then a second due to a political crisis in Nicaragua that affected travel and security across the country. It was 2018 and deteriorating conditions prevented the family from traveling along the main roads from their rural home to Managua.
Her parents worried. They continued using the brace, but soon it no longer fit.
“The whole year, we saw that her feet were turning back in and regressing,” said Ramiro looking downcast. It was heartbreaking. They had made 34 trips to and from the clinic and now, instead of nearing the end of bracing, Mariela would again need casts.
Seeking treatment the second time was more difficult. Mariela was older and money was tight. The trips to and from the clinic caused significant financial hardship. But Ramiro never faltered. He saw it as his duty to complete the process so that his daughter could have a normal life.
To arrive at the clinic in time for their appointments, the family had to wake at 3:30 AM to bathe and dress, corral a horse, and collect the certificates they needed to safely and legally travel the main roads.
They packed food to avoid the extra expense of buying meals, and often Ramiro and his wife went without and gave the provisions to Mariela. “Sometimes we did not want to eat to avoid more expenses. I made sacrifices because we had a job to do for our daughter.”
Even knowing treatment was possible, Mariela’s parents worried, and the journey was laden with challenges. “The horse ride was very hard for us because of Mariela’s casts; bus transports, too. There were times when there were no seats. There were very nice people who gave us their seats, but not always.”
Despite the physical and financial hardship, they persisted, returning to the clinic again and again for appointments and ensuring she diligently wore the brace. “Today we are very attentive to bracing – my wife sees to that,” said Ramiro smiling.
Mariela is now seven years old and is an active and helpful child. “She helps with everything, even small things, like washing clothes. She says, ‘leave it to me.’ ‘No daughter, we are in a hurry, you take a long time,’ but she does what she can do,” said Ramiro laughing and his eyes smile like any proud father talking about his daughter.
“Thanks to God, plaster, and braces, Mariela is doing very well,” Ramiro said smiling.
When asked what advice he would give another father whose child was born with clubfoot, Ramiro says, “I would advise him to look for the doctor, to look for the hospital, to look for treatment as soon as possible. We did not know that there were other children who had the same problem who had been healed. There was no doctor, for example, where the girl was born, there was no one to give us light.”
“Now, what an incredible moment. Our daughter is healthy. It is a blessing.”
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