'$250 can change a child's life forever'

For about $250, a child’s life can be changed. A sure trajectory toward isolation and poverty can be turned toward education and independence. That’s a pretty good return on investment. A Chapel Hill organization called MiracleFeet makes it happen.

Around the world, about one child in 800 is born with clubfoot, a condition in which one or both feet are turned inward and upward, making normal ambulation impossible. In the United States, treatment is readily available and the deformity is usually corrected very early in a child’s life.

Not so in poorer countries, where many families have little or no access to medical care.

“Left untreated, kids born with clubfoot are not able to walk properly,” said Chesca Colloredo-Mansfeld, founder and executive director of MiracleFeet. “Because there’s so much stigma around disability in low-income countries, they tend not to go school. The kids tend to be hidden away. Often, they end up begging on the street.”

For a time in the mid-20th century, the preferred treatment for clubfoot was surgery. Then a University of Iowa orthopedist, Ignacio Ponseti, developed a nonsurgical treatment that involves manipulating the child’s feet and encasing the legs in a series of long casts. After about two months of castings, the feet are fully corrected.

Colloredo-Mansfeld encountered Ponseti when her husband was teaching at Iowa. It happened that she was looking for a way to work in international development, a desire that grew out of her childhood memories of living in Africa.

“My father was in the British diplomatic service,” she said, “so I’d grown up seeing this incredible disparity between the privilege that I had and the lives and futures of most of the people around me.” When the prospect arose of making the Ponseti treatment available in low-income countries, it sparked her sense of mission. Within a few years she had moved to Chapel Hill and founded MiracleFeet.

The organization partners with nearly 200 clinics in 24 countries in Africa, Latin America and Asia. MiracleFeet provides training and support within the existing health care infrastructure, working with a country’s ministry of health whenever possible.

“We work with local doctors,“ Colloredo-Mansfeld explained. “We never put American doctors on airplanes and fly them around. This is all about building local capacity.”

A key piece of the Ponseti method is keeping the child’s feet in a special brace – analogous to a retainer in orthodontic care – for several years after all the casts come off. MiracleFeet trains and pays clinic assistants who will follow up with parents and make sure they understand the importance of compliance to prevent a relapse.

The braces commonly used in the U.S. cost hundreds of dollars, a price far too steep for poor parents. MiracleFeet has addressed that problem too, commissioning the design of a sturdy plastic brace that can be made for about $20. Since its introduction a few years ago, the brace has been provided in 12 countries.

MiracleFeet started out treating about 50 kids a year. Last year, that number was 7,700, and Colloredo-Mansfeld expects to reach about 10,000 next year. This with a global staff of only about 20 full-time employees plus a “huge network of partners.”

Most miraculous of all, perhaps, is the cost.

“Everything that we do,” she said, “training doctors, setting up referral pathways, treating the kids, following up with the families – when you add it all up, it’s $250 a kid. That’s nothing.”

Fundraisers

Though the organization does not use volunteers locally, Triangle residents can contribute by holding peer-to-peer fundraisers, says Natalia Siegel, donor engagement manager. She’s found that local parents of children born with clubfoot often do “a lot of reflection,” realizing how easy treatment was for their child and wanting to help families elsewhere. Children will ask for donations to MiracleFeet instead of gifts for their birthdays or bar mitzvahs, for example, or fund-raise with a lemonade stand.

Thomas Cooper of Raleigh recognizes how lucky he is to have access to good medical care for his son. Fifteen-month-old Keith, who was born with clubfoot in both feet, is nearing the end of treatment and wears his brace – “boots and bar,” as Cooper calls it – only while he sleeps.

Cooper, an assistant principal at Reedy Creek Magnet Middle School in Cary, uses his hobby of running to raise money for MiracleFeet. In a recent relay called the Tuna Run 200, he garnered donations of almost $400 – more than enough to pay for one child’s complete treatment from beginning to end.

“It’s such an easy fix,” he said of the Ponseti method. “And it’s cheap to do. When you think about the big scheme of things, $250 can change a kid’s life forever.”

Colloredo-Mansfeld says MiracleFeet expects in the coming year to bring the new brace to more countries, including India, Sri Lanka, Paraguay and Senegal. She is also launching programs in Congo, Bolivia, Guatemala and Myanmar. Another new initiative will be a mobile-based app for data collection, supported by a grant from Google, so that clinicians can record and track patients’ care and outcomes.

“We really look for our partners to lead us in what we’re doing,” Colloredo-Mansfeld said. “We don’t tell them what to do. We let them tell us what they need us to do. … It’s all about capacity building. We have to build the capability so that, long term, this country can solve the problem on its own.”　

This story was originally published November 22, 2017 at 6:21 PM with the headline "'$250 can change a child's life forever'."