Caleb
Caleb having his first serial cast removed
Caleb was born with a club foot, a congenital birth defect which occurs all over world. In Canada, children with club feet are treated within the first week of life and most often receive a good outcome. Clubfoot treatment and awareness is growing in Nyanza, however parents and community clinicians still lack the knowledge and/or resources to address the deformity at birth. Caleb, like many children in low and middle income countries, develop what is called ‘neglected club foot’ and learn to walk on the affected foot resulting in permanent shortening of muscles and skeletal misalignment. In many cases, neglected clubfoot is managed with orthopedic surgery.
Caleb was 17 in March 2010 when he underwent corrective surgery for his clubfoot. He was discharged from hospital with surgical hardware in place and an open cast. The doctors instructed him to return for follow up in April, however he never attended due to his orphan status and lack of funds. In June, a DSP community health worker located him and arranged for him to come to the clinic in Opapo. When his cast was removed, his foot was soaked in clean water for an hour to remove the built up skin layers. During this scrubbing, several old heavy gauge stitches were found in addition to two 4-inch pins that were protruding from his skin. Caleb was educated on how to walk with his corrected foot position, and was then casted to provide further stretching of his muscles.
An example of bilateral neglected clubfoot
