CARRBORO — Growing up in Africa, Chesca Colloredo-Mansfeld often encountered street-corner beggars whose turned-in feet had callused into awkward lumps.
Years later, when she learned that the condition called clubfoot was being treated cheaply and easily throughout the developed world, she found a new career.
Colloredo-Mansfeld, 49, co-founded and now runs a nonprofit organization devoted to treating children with clubfoot worldwide. Miraclefeet, based in Carrboro, works with local partners at clinics in 11 countries such as Brazil, India and Liberia, helping them build their capacity to treat the birth defect.
Her organization has rapidly expanded since its founding four years ago, helping to treat more than 2,000 children last year alone, up from 50 its first year. Its budget has grown from $26,000 to $1.4 million, and the group now has eight employees.
For the past two years, the organization has led the development of low-cost braces that will make treatment for clubfoot even more accessible.
Colloredo-Mansfeld says her organization does much more than fix feet; the treatments allow children to attend school, work and escape the stigma that often stems from their condition.
For me, this isnt about clubfoot as much as it is about preventing poverty in a particularly vulnerable group of children that can be easily identified and helped, she says. If you get there early and provide the treatment, you can put their lives on a different trajectory.
Millie Brobston saw Miraclefeets impact firsthand on a recent visit to two Nicaraguan hospitals, where the training and materials the group provides have dramatically improved doctors ability to combat a disability that affects one in 750 children worldwide.
Brobston oversees a $600,000, four-year grant to Miraclefeet for the Oak Foundation. She says Colloredo-Mansfelds leadership has been key to her organizations success.
Shes very energetic and passionate, and she works hard to leverage her resources in the most efficient way, says Brobston, who works in the Chapel Hill office of the Geneva-based Oak Foundation. You can just sense how committed she is to all the kids all over the world who are not getting access to this treatment due to the poverty where they live.
A dying wish
Colloredo-Mansfelds father was a British diplomat, and she grew up following his work to several African nations as well as Turkey.
Spending much of her youth in the developing world gave her an upfront look at poverty, and she always planned to help somehow in alleviating it.
She came to the United States to attend UNC-Chapel Hill as a Morehead scholar and earned a degree in political science and economics.
Her career took some surprising turns over the years. She worked at Goldman Sachs, and then went to Pakistan with the International Rescue Group, documenting its efforts near the border of Afghanistan.
She earned an MBA and went on to work for the Boston Consulting Group and several Internet startups.
She had a job at the University of Iowa, helping students land jobs on Wall Street, when she met Dr. Ignacio Ponseti, who had pioneered a nonsurgical method of treating clubfoot that was rapidly replacing more invasive methods used in the past.
The treatment involves gradually turning a childs feet into a normal position using a series of casts over two months. In most cases, the Achilles tendon will be cut toward the end of the treatment, allowing it to stretch. Afterward, children wear a brace at night for several years.
By the late 1990s, Ponsetis method had become the norm in the developed world, where nearly all babies born with clubfoot are treated as infants. But as Ponseti neared the end of his life, he lamented that it was not available to more children in developing countries.
Ponseti died in 2009. Colloredo-Mansfeld saw his wish as her chance to fulfill her long-held goal of helping others.
His dying wish was to make sure that all the kids in the world get this treatment, she says. I had been looking for a way to have an impact, and suddenly I was told that for $250 I could change a childs life dramatically.
She returned to Chapel Hill with her husband, an anthropology professor at UNC-CH, but the clubfoot idea stuck with her.
She teamed up with a group of parents whose children had been treated with the Ponseti method, and together they founded Miraclefeet. Colloredo-Mansfeld started as a volunteer and eventually took over as director.
Developing a new brace
Clubfoot in the developed world is a non-issue; athletes such as Troy Aikman and Mia Hamm were born with it and were treated as children.
But in poorer countries, the birth defect can set off a downward spiral in a childs life.
Clubfoot, like many disabilities, carries a stigma in many countries, so children born with it are often abused or neglected. In families with scant resources, food goes to children who can work, so children with clubfoot are underfed. They cant walk to school, so they are often illiterate.
Its absolutely terrible to live with a disability where there are no buses, no wheelchairs, no public supports, says Colloredo-Mansfeld. You are completely ostracized and marginalized.
Miraclefeet starts by helping interested doctors set up clinics where clubfoot is treated. Once the clinic is established, a public campaign kicks in to bring in more children who need treatment.
Each child is tracked on a central database, where photos are posted at every visit, a visual chronicle of tiny feet slowly turning from backward to normal.
The Ponseti method requires little infrastructure: plaster of Paris and cotton padding for casts, training for the doctors and staff.
Colloredo-Mansfeld discovered early on that the biggest challenges were securing the costly braces that children must wear, and educating parents on how to use them.
A good brace could cost as much as $200, and cheaper ones were often too difficult or flimsy for parents to use effectively.
So starting two years ago, Colloredo-Mansfeld worked with designers at Stanford University to develop a low-cost plastic brace. Clarks, the shoe company, helped design the shoes for the brace, and a manufacturer agreed to make the plastic parts at cost.
While still under development, the current prototype is promising and can be made for less than $20 each. Colloredo-Mansfeld hopes to sell the braces in the United States and Europe, with proceeds used to treat clubfoot abroad.
She travels frequently to the groups partner countries, where she still encounters the stunning poverty that first compelled her to a service career. She says she feel lucky to have found a way to help.
Sometimes when you look at poverty, its so overwhelming, she says. This problem is very solvable compared to a lot of the problems out there.
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