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Kuhle’s ready to take on the world

28-09-2017

Kuhle gets help for her club feet

Kuhle is a gorgeous little girl, aged 4, who lives in a rural area of the Eastern Cape. She was born with a condition called clubfoot.
 
Clubfoot (or talipes equinovarus) is a general term used to describe a range of unusual positions of the foot.  Most types of clubfoot are present at birth and are referred to as being congenital. It may present in either one or both feet. In almost half of affected children, both feet are involved and this is the case with Kuhle.
 
Clubfoot is painless for young babies, but it can eventually cause discomfort and cause noticeable disability. Left untreated, clubfoot does not straighten itself out. The foot will remain twisted out of shape, and the affected leg (in the case of only one leg being affected) may be shorter and smaller than the other. These symptoms become more obvious and more of a problem as the child grows, including finding shoes that fit and being able to participate in normal play.
 
In some cases, clubfoot is just the result of the position of the baby while it is developing in the mother's womb, called postural clubfoot. But more often clubfoot is caused by a combination of genetic and environmental factors. If someone in your family has clubfoot, then it is more likely to occur in your child. If your family has one child with clubfoot, the chances of having another with the condition increase.
 
Currently, a non-surgical technique known as the Ponseti method is the main treatment for clubfoot. The foot is manipulated into the most normal position possible and immobilised in that position using plaster casting (as you would for a broken leg) until the next treatment. Using this method corrects two problems with foot position (the front part of the foot being turned in and up) at the same time. 
 
This manipulation and immobilisation procedure is repeated every one to two weeks for two to four months, and each time,  the foot is moved a little closer toward a normal position.
 
Most children treated with the Ponseti method will have pain-free, normal-looking feet and will be able to walk. They can also participate in activities such as sports when they're older.
 
Kuhle’s clubfoot had affected both feet and the doctors and rehabilitation team at the nearby Zithulele Hospital decided to use the Ponseti method to correct the condition – even though she is a little bit older than the typical patient.
 
But there was a problem. Her mother did not understand why the plaster cast was necessary, and she kept removing them, slowing Kuhle’s progress and recovery. When the Rural Ability Programme’s community disability worker, Nomabali Mtshange found Kuhle, she had stopped going for therapy.
 
With Nomabali’s help, Kuhle’s mother was able to access a care dependence grant, which gave her the resources to visit the hospital again. Nomabali also explained why the plaster cast was needed, and helped Kuhle’s mom to use the special shoes that Kuhle had to wear at night.
 
“She didn’t want to wear them,” said Nomabali. “But together we found a solution that resulted in Kuhle wearing the shoes she needed at night.”
 
Nomabali’s commitment to helping this family has also resulted in Kuhle starting Grade R at a local school, following ‘catch-up’ sessions that included learning colours and naming the parts of the body. Nomabali said that Kuhle’s mother was afraid that the other children would laugh at her because she was not able to walk properly and had plaster casts on both legs.
 
Kuhle is happy to go to school each day – and Nomabali tells us that she is very clever!


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