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Earlier this week, the Centura team completed the first 2-day training session on the Ponseti casting method to correct club foot in children. The training began with introductions from Gian Piero Taricco, from the Centre de Chirurgie Orthopédique Pédiatrique et de Réhabilitation Ste Marie in Rilima, Rwanda; Dr. Peter Janes from Vail Summit Orthopedics;  and Dr. Emmanuel Nsengyimava, a pediatric orthopedic surgeon from The Centre. Following a video presentation on the Ponseti method, students from all over Rwanda were soon elbow deep in plaster, practicing the technique using models of club feet. The students represent a broad spectrum of Rwandan health care providers including physicians, physical therapists, and physicians in training. They were mentored in their efforts by Dr. Emmanuel and Dr. Bonaventure who represent two of only eight orthopedic surgeons serving the 10-12 million people in Rwanda.

Day two brought an opportunity to learn more about casting from Dr. Esperance Uwizeye, an expert on club foot disorder in Rwanda. The Center Ste Marie Rilima, a Center of Excellence in pediatric orthopedics, has several children in residence for treatment. Most of the children travel long distances to the Center and treatment programs can be lengthy. Because of this many stay at the center without the support of their parents and families. Students welcomed the opportunity to learn from Dr. Esperance and performed casting under her direction on several of these children.

One of the children, a 4 year old boy came to the Centre for treatment of his right foot. He was born with spina bifida that left him with little movement in his left leg and club foot on his right leg. Through the support of Centura Health Global Health Initiatives, this child has begun the process of casting to correct his club foot.  The goal is a flat foot that can support him as he learns to walk with braces and crutches.

We’ve heard many stories about the success of surgical intervention with children who didn’t benefit from the technique developed by Ponseti. The surgeons here in Rwanda help open a life of real possibility for the Rwandan children afflicted with club foot. Without treatment, they live their lives on the margins of society. A good outcome for these children is not only repair of their congenital disorder but marriage and children of their own. As Dr. Janes said, by learning an early intervention such as Ponseti’s that reduces the need for surgery later in life, the hope is to put the orthopedic surgeons in Rwanda “out of business”—at least as far as club foot disorder is concerned. How much better can it get than to help the doctors and therapists of Rwanda accomplish that goal!

Paula Enrietto

Paula is a veteran volunteer to Rwanda, Microbiologist, and has worked at the nearby orphanage in Rwanda. She is at Rilima helping teach treatment of clubfoot deformities and assisting in the OR at Mugonero. 

About the Rwanda Medical Missionary trip
Dr. Peter Janes of Vail-Summit Orthopaedics and a medical team will be traveling to Rwanda July 22-August 11 on a medical missionary trip. The group will be providing no-cost surgical, medical and community health programs, education, training and relief in an area where health care is often limited or difficult to obtain. Most surgeons fled the African country or were killed during the major genocide in 1994.

The group involves 20 participants, eight from Summit County, working on seven defined projects. Dr. Janes will be performing surgeries and conducting workshops to train local health care providers on how to correct club foot in newborns. This year he will be at three different hospitals; Rilima, Mugonero and CHUK, for a week each. In addition, there is a surgical team at King Faisal hospital in Kigali, working at the orphanage, and a team building a gazebo at Mugonero.

The group is sending home daily blog entries with photos and depictions of their daily experiences. Be sure to check this blog site for updates.