OUR PROGRAMS

EARLY INTERVENTION CLUBFOOT PROGRAM

This program provides for the non-surgical treatment of clubfoot in newborns and infants from ages 0 to 4 years with clinics currently operating in 6 public hospitals. The program uses the Ponseti Method of manipulation, casting and bracing the feet over time as the child grows. This method has been endorsed by Cambodia Orthapediac Association and the Cambodian Ministry of Health.

This treatment provides children born with clubfoot a chance of a normal life. Key to the program are paid local coordinators who help identify and encourage clubfoot patients to receive initial and ongoing treatment.

The program has an established connection with Ponseti Institute at University of Iowa and the Rotary Action Group for Clubfoot who are working together to promote the non-surgical Ponseti method for the treatment of clubfoot across the globe.

The current priorities of the program are:

• Intensive training of selected surgeons in the Ponseti Method

• Supporting the establishment of the Cambodia Clubfoot Care program incorporating affiliation with clubfoot clinics operated by other International NGOs

• The roll out of the Ponseti International Clubfoot register to all clubfoot clinics to establish, for the first time, an online database of the number and treatment of clubfoot across Cambodia.

MEDICAL TRAINING

This program provides intensive training to Cambodian doctors and allied health professionals in the identification and treatment of clubfoot using the internationally recognised Ponseti method of correction. The trained medical officers will work in provincial hospitals in NGO funded clinics to deliver free Ponseti clubfoot treatment to children in need.

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The Ponseti Method

Phase 1: Casting

• The foot is carefully manipulated and casted with plaster. This will happen once per week for 4 to 8 weeks.

Phase 2: Tenotomy

• Most children will need a simple cut of the Achilles tendon which helps the foot move up and down. Once this is done, the foot is in plaster again for 3 weeks. After this the child is usually ready to start using the brace.

Phase 3: Bracing

• A brace is used to keep the feet in the correct position and has to be worn immediately after the last cast is taken off. The brace should be worn all night and day for 3 months. After 2 months, the brace should be work during any naps and through the entire night. The child will need to wear the brace until he/she is 4 or 5 to prevent relapse.

SURGICAL MISSIONS

At least once a year Dr Chhoeurn and his team travel to a provincial hospital to perform surgeries local hospitals do not have the skills to treat, including cleft lip/palate, clubfoot, burn contractures and other acquired/congenital physical deformity. Each mission costs between US$5,000 and 6,000.

Hospitals are selected based on the estimated number of cases requiring treatment and the hospital’s capacity to prepare the patients and provide post-operative care.

9 missions have been undertaken since 2011. Typically missions are conducted over a four day period, including travel, consultation, surgery (usually two days) and handover. There can be between 100 and 200 consultations with up to 60 surgeries performed during the mission.

PERIOPERATIVE SUPPORT

This program provides assistance where the cost of travel or equipment may be a prohibitive factor in a child receiving necessary treatment. Through this program NextSteps supplies bottles and teats for infants recovering from cleft lip/palate surgery and subsidises travel costs for families travelling from remote areas to the National Children's Hospital in Phnom Penh.