* Any views expressed in this article are those of the author and not of Thomson Reuters Foundation.
“The text messages make me feel cared for,” says Hema, mother of Aniket, age three. We’re sitting in the waiting room of Wadia Hospital, in Mumbai, India. She shows me the fingerprint-covered screen of her small Nokia phone, and my colleague translates the messages from Hindi:
“The brace is not painful for your child. It prevents the clubfoot from returning. You are doing the best thing for them!”
And this one:
“Sometimes it is easier for two people to put on the brace. One person can play with the child while the other person can ensure that the feet are in the brace correctly.”
Aniket has clubfoot, a fairly common congenital deformity that is completely treatable if caught early enough. Clubfoot affects one out of every 750 children, making it one of the most common birth defects.
Aniket and a dozen other kids are squirming. The waiting room is calm and almost festive—it doesn’t feel like a place people come when they’re sick. The walls are brightly colored, there’s no antiseptic smell, and everyone is friendly.
Staff create warm atmosphere
There is a chatter that fills the room as parents share stories and advice. Most of them have traveled for several hours to come for their children’s check-ups. Other parents have moved all their belongings from far-away villages so they can be near the clinic for the duration of the treatment, which lasts three to five years.
This is a place for healthy kids to obtain an outwardly healthy appearance, so they can get into the same mischief as their counterparts, and be able to work as adults. The State Program Manager, Sachin Pole, and Lead Counselor, Vipulata Agale, are responsible for the warm feeling that permeates the clinic. Vipulata sits with parents right on the waiting room bench. She has an expansive, calming presence and the families flit around her like moths to a flame.
“She knows all of the children’s names,” says Sachin, as the parents show Vipulata their children’s tiny pink feet. One little girl’s feet have turned so the soles are facing each other. She gurgles and cries a little as Vipulata shows the mom how to stretch the foot with the heel of her hand.
A miracle brace to eradicate clubfoot
Sachin and Vipulata use a treatment developed by miraclefeet, a non-profit working to eradicate clubfoot in the developing world. In developing countries like India, where treatment is not readily available, this disability often leads to a life of poverty, abuse, and shame. In India, close to 50,000 children are born with clubfoot every year, and many will suffer stigma and economic deprivation because they can’t access treatment.
Miraclefeet’s “miracle” is a brace that works the way dental braces do, by pulling and pushing over long periods of time. The brace consists of a bar with strap-on shoes on either end that hold the feet in a dorsiflexed position, about a shoulder width apart.
Here’s what a miraclefeet child experiences:
Starting at one to two weeks of age, the tendons and ligaments in the foot are gently manipulated. This does not hurt the child. The foot is then casted for five to seven days. This procedure is repeated over a six to eight week period.
In most cases, the child will then need an Achilles tenotomy (cutting of the tendon) to release the heel. This procedure, usually done using local anesthesia, requires no stitches and takes about 10 minutes.
After the tenotomy, a final cast is kept on for three weeks. At this point the position of the feet is completely corrected. The child will wear a foot abduction brace 23 hours a day for three months, then only while sleeping for the next five years. The brace prevents the corrected feet from relapsing and is a critical phase of successful treatment.
After five years, the child should be left with supple, pain-free feet that look and function completely normally. Treatment is successful in 95 percent of cases.
Father finds new hope
“One of my favorite stories,” says Sachin over a lunch of spicy vegetable korma, “was a father who has clubfoot. He brings his son in with the same tell-tale turn of the foot as the father has. The father was poor and his village used to jeer at him for his different canter. Some people thought that clubfoot was payback for ills done in a previous life.
“So when he was told by Vipulata that his son’s feet weren’t a sign of anything but a genetic roll of the dice, that may have been a bit weighted because of his own deformity, the father was given new hope. His son is now in his second year of treatment, and his father is letting go of the future he was sure his son would share.”
The miraclefeet brace and the Wadia staff are bringing the same hope to many families. But with treatments that last three to four years, the staff and miraclefeet realized that they had to find a way to encourage the parents after they left the clinic. In the red-painted waiting room full of playing kids where moms swap stories about fussing and itchy casts, there’s a support system. But back at home they faced opinionated in-laws and all of the work of raising a kid that doesn’t include keeping his or her legs completely immobile. It’s easy to feel confident around Vipulata’s comforting hands and knowledge. But back at home reality seemed to beg: “just take off the cast and give up.”
Medic Mobile delivers encouragement
That’s where Medic Mobile comes in. Hema and her son don’t know about Medic Mobile’s part in Aniket’s treatment. They believe that the nurse herself is sending them personal messages of encouragement, knowledge, and proof of the treatment’s effectiveness to share with their in-laws. They can show their concerned family the phone, and fears and opinions bow before the doctor’s orders.
Medic Mobile and miraclefeet developed 120 texts for all of the phases of treatment, with more messages during the first phases where diligence is crucial. The messages are personable, direct and leave a helpful tidbit of information with the parents. In case they forget one of the many things told to them during a hectic run to the clinic, they can get a simple reminder during the calm hours of their day. In this way, they have Vipulata in their pocket.
“The messages reinforce the treatment when your life gets busy. What I tell you here,” says Vipulata, “is what you’ll get reminded about at home.”
Katie Kelly is Director of Communications with Medic Mobile.
