1. By Mathew Shayo MPhil.CL.PT (Orthopedics and Rheumatology)
KCMC CLUBFOOT CLINIC
By Mathew Shayo
MPhil.CL.PT (Orthopedics and Rheumatology)

3. Background Use of Ponseti Method started back in 2008
Few staff were trained on the method
Less interdisciplinary approach
Students were receiving Ponseti training during their clinical rotations

4. Studies
Ponseti knowledge gap was established among Physiotherapists in 8 regions of Tanzania (Shayo & Van dn Bergh, 2013)
In 2014 more Ponseti knowledge gap and lack of interdiscplinarity was observed among health workers working with clubfoot children in Kilimanjaro region
Need of immediate collaboration and training

5. Steps Collaboration with Usa River Rehabilitation Centre
Agreed to provide training to participants from six district hospitals in Kilimanjaro Hospital
Agreed to provide training to physiotherapist finalist students twice a year
Fellowship training to health workers
Connected our clinic to Miracle feet

7. Training at school of Phys

8. Fellowship attachment

9. Staff are empowered to treat neglected cases

10. Joining Miracle feet Since July 2015 Supply of material
Continuous education
Fellowship attachment
Equipment supply
Improved data collection

12. Statistics 1st July - 31st Dec 2015
Category
Number of cases
# of patient enrolled 25
# of patients served
males
females 34 9
Laterality: Bilateral
Left
Right 22 8 4
Affected relative: affected
Not affected 5

13. Statistic ct. Treatment stage: Casting Tenotomy Bracing 28 1 5
Dropouts: Casting 7
Bracing: Good
Fair
Poor 3
# of patients with 8+ casts
# of visits
165
# of casting
110

14. Impression Communication need to be improved
Follow-up in a near by clinics may be necessary
Parent support and education is necessary

15. Age of First Visit

16. Age of First Visit Majority visits at the first three months;
there are still some cases captured at the late stage.
Community awareness may reduce/alleviate the problem in future.

17. Age of First Cast

18. Age of First Visit
There are still some neglected cases in the society, although few.
Further studies may be necessary.
Midwife education on early detection is necessary.

19. Future plans
More training to service providers in the periphery i.e. district hospitals
Regular training on advanced Ponseti
Outreach to provide early detection and referral education to midwives and traditional birth attendants.
Network with NGOs, DPOs, FBOs

20. Thanks Tanzania without adult disability due to clubfoot is possible