A few days ago, I had the opportunity to go and visit one of the CURE Clubfoot Wordwide clinics in the town of Dosso, 140 km. away from Niamey. It was in the regional hospital of Dosso, and we met with the surgeon, the physical therapist, and the counselor (as well as a few others). It was really great to talk with them a bit, hear some of the challenges they face, and see them in action.
I met them before, when they came to the CURE hospital in Niamey for a training, but that was when we first got here, so it was good to see them again. They told us that before the training they had no way of treating clubfoot, so whenever they saw clubfoot cases they always referred them to the National hospital in Niamey. Obviously, this was not an option for many families because of the distance and the cost(s) of the trip. But now, they can treat them right there in Dosso, and it is paid for.
One of the patient we saw being treated was Al-Moustapha. He is only three months old. He came in for a recasting, his third one. With the Ponseti Method of treating clubfoot, a series of casts are used to set the feet back in place, which is great because it avoids surgery (at least most of the time; sometimes small surgical procedures are needed). But it is a long and drawn out process, and it involves a lot of visits to the hospital. Al-Moustapha was at the hospital the week before, and now he was back again, getting new casts on both of his legs. It is hard for the families to come to the hospital so often, especially when they don’t live nearby. Some of the families are from villages that are far away, and they often come the night before and spend the night at the hospital so they can be there in the morning to see the doctor. It goes without saying that they don’t spend the night in a bed (most of the patients don’t even have beds). They sleep on a mat on the dirt floor. But that is enough for them; they are just happy to be able to get treatment for their children.
When it was time for the recasting to begin, they first soaked Al-Moustapha’s legs in a bucket of water to loosen up the plaster, and then they just peeled it off. They didn’t use an electric saw to cut off the casts (the power went out while we were at the hospital, so this probably wouldn’t be the best choice even if they did have a saw). All they needed was a bucket and water. I remember when I broke my leg as a kid and they used a saw to take the cast off. That was the most painful part of the process, and it was scary with the saw buzzing right next to my leg. Why didn’t they just do it this way?
Since the program started not too long ago, they still do not have a ton of patients coming in to Dosso. A lot of them still go to Niamey because they don’t know that they can be treated in Dosso. It takes time for that kind of information to really sink in, but while we were there a young couple came in with their baby. The future for this program looks bright, and it is exciting to see the progress.