Grant to UI-based association will expand international reach of clubfoot treatment

$2 million grant will increase access to treatment for thousands of children in Peru, Pakistan, and Nigeria

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IOWA CITY - The Ponseti method of treating clubfoot will increase its worldwide expansion with the help of its organization's largest grant to date.

"It's very exciting and we're glad Iowa can help the world," said Dr. Jose Morcuende, associate professor of orthopaedic surgery at University of Iowa Hospitals and Clinics and Chief Medical Director of Ponseti International Association.

The association received a two-year, nearly $2 million project to increase access to treatment of clubfoot deformity for thousands of children in Peru, Pakistan, and Nigeria, in partnership with Management Sciences for Health.

Morcuende said the work will go beyond the training the organization typically conducts, oftentimes by having medical professionals trained in Iowa, where the group is based.

The grant will allow the association to not only conduct training, but to help establish clinics and create an awareness campaign, he said.

Each year, 200,000 children worldwide are born with clubfoot, one every 3 minutes. There is no known cause for the condition and nearly 80 percent of children born with clubfoot live in impoverished countries.

Left untreated, children affected by this condition often grow up unable to walk, go to school, or significantly participate in their communities. They are often cast aside and regarded as useless members of society.

The grant from the U.S. Agency for International Development, provided through Management Science's Leadership, Management, and Governance Project, will broaden the use and understanding of the low-cost, non-invasive method for treating clubfoot known as the Ponseti Method.

This method – created by the late Ignacio Ponseti – involves a series of about five plaster casts and a simple snipping of the heel cord to “train” the foot into normal alignment. Before the Ponseti Method was introduced, surgery was the only alternative, an option which has been unavailable or financially out of reach for most families in underdeveloped countries.

In contrast, the Ponseti Method is performed as a series of outpatient visits that do not require a hospital stay.  It costs only a fraction as much as surgical treatment and has a much higher success rate (95 percent).

By increasing access to the Ponseti Method in Peru, Pakistan, and Nigeria, Morcuende estimates that this highly effective treatment method will be accessible to an additional 2,400 children in two years – more than four times the number of children in those countries who are currently being treated.  The goals of this ongoing project include not only improving the quality of clubfoot treatment but putting the ownership of the Ponseti treatment approach into the hands of each local healthcare team.

In his 22 years with UI Hospitals and Clinics, Morcuende has taken the Ponseti Method to more than 60 countries in an effort to reach more children and teach the method to medical personnel around the world.


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