World Orthopaedic Concern UK

Report on 1st Ethiopian Ponseti clubfoot course

March 27th-29th  2006

The first Ethiopian Ponseti clubfoot course was held in Addis Ababa over a 3 day period at the end of March.  This was organised by Sally Tennant and Steve Mannion and funded jointly by CURE International, (an American Children’s charity), World Orthopaedic Concern UK, the BMA Humanitarian Fund and STEPS (a British Children’s charity).

The aim of the course was to bring surgeons in to Addis from around Ethiopia to teach and train them in the use of the Ponseti method for the treatment of clubfoot deformity. The ultimate intention was for them to then return home and set up their own clubfoot clinics.  24 delegates from around the country attended, with a doctor and an allied health care professional (such as a physiotherapist or a nurse) from each of 12 hospitals, representing several different regions.

There were 8 faculty from Ethioia, the Sudan, Norway, and the UK.  The three day course comprised lectures on clubfoot deformity and the Ponseti method, practical sessions using rubber feet, and talks on the practical aspects of brace manufacture and setting up a clubfoot clinic.  On the final day, delegates attended the clubfoot clinic at the Black Lion Hospital in Addis Ababa where they were able to get hands on experience manipulating and casting on babies.  They were also able to see and perform tenotomies on 5 of the babies. 

Each pair of delegates was then supplied with 15-10 braces of varying different sizes, to take home with them to enable them to start their clinics prior to setting up a brace making facility.  Very positive feedback was received from all delegates and they all left intending to set up their own clinics.

In the future a nationwide initiative is planned, to increase awareness of both the deformity and its treatment, to get the technique included in medical student and nursing courses, to run more courses and to run train the trainers courses, so that in future there will be less reliance on faculty from outside Ethiopia.  It is important to follow up on the delegates already taught, to offer encouragement, support and visits where necessary, to ensure that the skills so recently taught are not lost but are built upon. 

Sally Tennant

Consultant Orthopaedic Surgeon.