Bunions, hammertoes and flat feet might not sound like life-or-death conditions. But when left untreated, as is often the case in India, they can have devastating consequences.
Dr. Selene Parekh, a foot and ankle surgeon at Duke Health, saw this problem firsthand on a visit to the country a decade ago. The untreated foot problems can rob people of their ability to walk – and work.
“You can’t provide for your family because you can’t work,” he says. “It now affects the quality of your life and the quality of your family’s life.”
After that trip, Parekh and his wife, a physical therapist, created a foundation devoted to foot health in India, both by operating on those with severe problems and training medical professionals in the foot and ankle specialty.
Over the past eight years, the Parekh Family Foundation has performed more than 1,200 surgeries, and trained more than 1,400 surgeons and 500 physical therapists. They’ve also donated more than 1,000 pairs of shoes to India and published a foot and ankle textbook for Asia.
For Dr. Julie Neumann, who did her residency under Parekh at Duke, the trip to India affected her enough that she changed her specialty to foot and ankle from sports medicine. She says Parekh’s compassion and dedication to the foundation is making a mark there.
“He’s an extremely hard-working and very talented surgeon, and he takes a lot of time and money out of his life to give back to this community,” says Neumann, who is doing a fellowship in Los Angeles. “This can make a life or death difference for some of these people. You’re doing surgery that is allowing them to get back to being a productive member of society.”
In the middle of the action
Parekh was born in Chicago but grew up mainly in northern New Jersey. His parents had come to the United States in the 1970s, looking for greater opportunities to study and work. Parekh says he returned to the country about every five years growing up.
His classmates were unimpressed with this exotic background. One particularly bad spurt of teasing came when an Indiana Jones movie came out that featured an Indian man eating a monkey’s head.
“It was a faraway land that people didn’t know much about and what they knew was strange,” he says. “Thankfully we live in a time now when the world is much smaller.”
He wanted to be doctor from the time he was a child, when the first artificial heart replacement was in the news.
“I was fascinated with that,” he says.
Parekh earned his undergraduate and medical degrees at Boston University and did his residency in Pennsylvania.
He earned an MBA, as well. At a time when the pace of mergers among health care providers was picking up, he wanted to understand the business end of medicine as well as the surgical end.
“I’m the kind of person who wants to be in the middle of the action,” says Parekh. “Understanding health systems was part of that.”
He chose his specialty in part on the advice of a mentor, who counseled him to choose work that would leave time for family and other pursuits.
“Foot and ankle as a career choice give you flexibility on where you practice,” he says. “Anywhere you do there’s a need.”
He moved to North Carolina for a position with UNC Hospitals, where he helped develop the foot and ankle division. As in much of orthopedics, he also focused on athletic injuries and often cared for student athletes.
He’s been at Duke since 2009. He specializes in ankle replacements and in the developing practice of using 3D printing in orthopedic surgeries. In one early surgery, he used a printed metal piece to replace infected bone that had to be removed. It was an unusual approach that had rarely been taken at the time, and it worked.
“His wife told me that instead of taking care of him, they were planning vacations,” he says. “These are the things that become the height of your career when you have changed someone’s life dramatically.”
A family effort
Yet on a visit to India for a conference, he saw a much different experience for people with foot problems. Many were crippled with pain from untreated injuries, while other problems arose from conditions such as polio and diabetes.
“We thought, ‘We have to change this,’ ” says Parekh, who discussed the issue with his wife. “That’s 1.2 billion people and over 2 billion feet being ignored.”
At the time, he says, only a handful of surgeons were starting to do foot and ankle surgeries, so part of the goal of the foundation was to train more doctors and physical therapists to deal with foot issues.
They made their first foundation trip in 2010 and now make three trips a year, bringing 35 partner surgeons from around the world to perform surgeries. They go to different regions on each trip so that their impact spreads.
“If you look at the evolution of foot and ankle, it was the last thing to evolve as a specialty,” says Parekh. “We’re seeing globally that it’s one of the last sub-specialties of orthopedics to develop, and we’re trying to shorten that timeline.”
Parekh conducts many of the training sessions himself, in addition to performing surgeries. He returned from his 13th such trip last month.
Parekh conducted the first total ankle replacement in India, on a doctor there.
“He was in so much pain he couldn’t do rounds,” Parekh says. “We got him pain relief so he could help other people.”
The shoe drive arose as a way for the couple’s children to participate.
“We really wanted to engage our kids, who are young, into giving back,” he says, “and we wanted to tie into what we were doing.”
And it helps their cause. Many of India’s poorest residents will never own a pair of shoes, he says, which can lead to or exacerbate foot problems. They have donated shoes to orphanages and schools, and to an amputee clinic.
He was asked to go to Mauritius, an island off East Africa, to do a similar program, and other countries have reached out as well, he says.
The couple started the foundation with their own donations. Friends and family wanted to get involved, and they started an annual fundraiser with a silent auction. Parekh has also recruited orthopedic implant companies to donate supplies.
In all, Parekh estimates they spend more than $200,000 annually on the effort, including donated supplies. The foundation funds two $1,000 college scholarships a year.
“It’s a lot of time and effort, and we get a lot of joy out of it,” he says.
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Career: Professor of orthopedic surgery, Duke University; founder, Parekh Family Foundation
Education: Bachelor’s in medical clinical sciences, MD and MBA, Boston University; Fellowship in Healthcare Entrepreneurship, University of Pennsylvania
Family: Wife Zankhna; three children
Fun fact: Parekh is an avid tracker of injuries among top-tier athletes. Known as the “Fantasy Doctor,” his online blog explaining these injuries is used as a resource for fantasy sports enthusiasts.
Want to help? Visit www.parekhfamilyfoundation.org to learn more.