'Hejje Guruthu', making giant strides

One-month-old Geetha, born with club feet, is having her legs put in a cast by Dr Jayanth S Sampath, Consultant Paediatric Orthopaedic Surgeon at Sparsh Hospital.

This is part of the serial plastering in the Ponseti method, a non-surgical treatment for club foot––a congenital lower-limb anomaly wherein children are born with feet turned inwards. The infant is being held by her aunt. The mother J Radhika is too nervous and anxious to hold her child and looks on, standing a few feet away.

Dr Sampath informs us that this is the fourth plastering session which will be followed by very minor surgical procedure lasting a few minutes called tenotomy. Following this, for four years, the child will have to wear special custom-designed shoes and undergo regular medical checkups.

Strict compliance is needed during this period or the problem will resurface. If compliance is complete, four years on, the child will be walking perfectly normally. “No scar, no tell-tale signs, the child, once grown up, will not even know about the treatment––unless told. And even doctors may not recognise the person as a former club-foot patient, so complete is the cure!” Dr Sampath reveals.
 
Geetha is a lucky child. Her parents are educated, well-off and urbanites. So they had a pediatrician who recognised the problem at birth and sent them for treatment they could afford. And treatment at birth makes all the difference and ensures complete cure.

Not so fortunate are thousands of other children around the world, especially in India. There are about one to two such cases in every 1,000 live births worldwide, according to estimates. It is the most common congenital lower-birth anomaly. About 30 per cent are born with such problems in both feet while 70 per cent have a problem only in one.

While worldwide there are about two lakh cases coming up every year, Karnataka sees 1,500 new cases every year, reveals Dr Sharan S Patil, Chairman and Chief of Orthopaedic Services, Sparsh Hospital. Yes, the same doctor of the Lakshmi Tatma fame, the Dr Patil who operated successfully on an eight-limbed girl of that name!

Sadly, about 70 per cent of clubfoot cases are in rural India which means that many of them go untreated, because of the parents’ lack of the three vital As: awareness–– that the problem is easily treatable, access––to right medical help and affordability. Some uneducated parents regard the problem as a curse, and the children are left to limp their way through life with many ending up as beggars. Or it is regarded as the result of the evil eye.

The pity is that the problem is so easily treatable thanks to the Ponseti method, which is minimally invasive and the gold standard for treatment across the developed world. It ensures complete cure if the child is brought to the doctor at birth.

Twenty-five years ago, as a medical student, Dr Patil came across a patient but was not equipped to deal with the problem. But “that failure” as he puts it, sowed the seeds of desire to do something concrete about this problem.
‘Hejje Guruthu’ programme
Thus was born the ‘Hejje Guruthu’ programme, an initiative of Sparsh Foundation, the charitable wing of Sparsh Hospital wherein clubfoot patients are treated without being charged for it. This charitable initiative is the result of a public-private partnership among the Government of Karnataka, Sparsh Hospital and United Way of Bengaluru.

Every Monday and Wednesday, children with clubfoot deformity are brought to the Health City centre of Sparsh Hospital and all children are treated free of cost for the entire duration of treatment. Sparsh, incidentally, is the first hospital in India to begin a sustainable, long-term clubfoot programme based on the Ponseti method. ‘Hejje Guruthu’ means footprint in Kannada, and the name was chosen because the clubfoot-affected child is incapable of making the footprints which normal feet can. About 700 children have been treated so far, explains Dr Patil. But he is not satisfied with this. He dreams of a time when there will be no child with untreated clubfoot left in Karnataka.

He has a three-pronged plan for that by target year 2016. Building awareness through anganwadi and social workers, so the problem is identified in time as early intervention ensures complete and quick cure; building capacity, 35 centres across Karnataka each staffed with two doctors trained in the Ponseti method by Sparsh Hospital and building a review mechanism, so the senior specialists know that newly trained doctors at the different centres are on the right track and the patient is progressing properly and thereby achieve a 95 per cent success rate which is the global standard. Finally, one needs adequate funding.

The Sparsh Foundation is willing to help with training and review mechanisms, but needs financial inputs. The complete course of treatment for each patient takes about Rs 35,000. “So, if each of the 1,500 corporates in Karnataka adopts just one child, we can ensure that there is no child with untreated club foot left in our State by 2016,” says Dr Patil. The treatment method has a 95 per cent rate of success, he adds.

Other charitable activities
That is a big dream but then Sparsh Foundation has been building credibility through small steps. Besides ‘Hejje Guruthu’, it has other charitable activities.

‘Sparsh Vachana’ offers free surgery to economically underprivileged children suffering from complex musculoskeletal abnormalities including scoliosis and hand deformities. So far, 600 children have benefitted. As part of ‘Sparsh Guru Namana’, around 200 retired schoolteachers who have crippling arthritis but no access to sophisticated medical care have been given joint-replacement surgery free of cost.

For these programmes, individual and corporate donors may sponsor surgeries, each one can sponsor one or more. Fundraising cultural programmes such as a concert titled ‘Fusion Dreams’ held last week are another option.