Steve Mannion

By Steve Mannion

May 31st 2012

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Ponseti training in Madagascar

Categories: CBM, Child, Clubfoot, Madagascar, Training

I’m Steve Mannion, a Consultant Orthopaedic Surgeon with CBM.

Madagascar, a country of 24 million people is estimated to have over 15,000 children and adults suffering the disability of neglected clubfoot, with nearly 1000 babies being born with the clubfoot each year. Currently there is no coordinated national project for clubfoot treatment, there are very few trained practitioners trained in the Ponseti method (the most effective method of treatment in babies), and only one surgeon in the entire country with the skills to operate on neglected cases.

Ponseti training Madagascar

Training the team in the Ponseti method. It's messy work making plaster casts, but it's so important to train local staff in this technique. Photo © Steve Mannion

I have been invited to conduct training courses and demonstrate neglected clubfoot surgery at two centres in Madagascar, as CBM is determined to eliminate clubfoot disability in Madagascar.

On this trip we conducted a Ponseti training course at CAM, the Centre d’Appairallage de Madagascar, the major rehabilitation clinic in the nation’s capital Antananarivo.

25 practitioners attended the course, a combination of surgeons, rehabilitation doctors, physiotherapists and orthotic (brace) technicians. I had faculty assistance from Michiel Steenbeeck, a CBM advisor and expert in brace production and Dr Leonard Banza, a CBM orthopaedic surgeon working in Malawi.

As part of the course, 20 babies with clubfoot were assessed and casted.  Their continued treatment will be undertaken at CAM, funded by CBM.
15 cases of neglected clubfoot were also assessed with 5 cases (9 feet) being selected for operations which were undertaken later.
In theatre I was able to instruct a Malagasy paediatric surgeon, Dr Raherison, in the techniques of neglected clubfoot surgery and he undertook the later cases under my supervision.

We’ve been busy in Antananarivo, but it’s been so worthwhile. Next, we’ll be heading to Antsirabe…

Clubfoot surgery team, Antananarivo, Madagascar

Clubfoot surgery team, Antananarivo, Madagascar. Photo © Steve Mannion

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