Why should I care?

Footnote is a documentary about clubfoot — a birth defect in which one or both feet are misaligned, often turned inward to resemble the shape of a golf club.  Clubfoot is an isolated problem, meaning it’s not directly related to other health problems with which a child is born.  Therefore, it is probable that a child with clubfoot will be otherwise physically, cognitively, and psychologically healthy.  Despite this fact, if left untreated, clubfoot can severely limit a person’s mobility and subsequently hinder their ability to lead a productive life. According to the Global Clubfoot Worldwide website, it is estimated that between 150,000 and 200,000 babies are born each year with clubfoot. It is the most common physical defect which limits locomotion, referring to the ability to move from one place to another and carry out routine tasks.

Now, if you are reading this and are living in the United States, you might be thinking, “Okay, I’ve heard of clubfoot, but why haven’t I ever seen it?” Don’t worry, you’re not alone: the majority of people with clubfoot living in developed countries receive the treatment they need at an early age. As we all know, most of the world’s population lives in developing countries, with inadequate income, less access to hospitals and clinics, and unsatisfactory transportation.  In fact, about 80% of those living with clubfoot live in poorer nations.  In these countries, financial success is very much dependent on one’s ability to partake in physical labor.  A person with untreated clubfoot will have difficulties participating in any activity which requires them to stand or walk for any amount of time, whether that means harvesting crops in a field or walking a short distance to school to receive an education.

Hopefully, by now, it is clear that clubfoot is a condition which can utterly determine a child’s future.  What might be most surprising is that it is relatively inexpensive to treat. The Ponseti Method is the most current and preferred way to treat clubfoot.  It is non-surgical, placing infant’s feet into a series of casts, slowly guiding natural bone growth to a more correct foot position.  The foot is regularly re-adjusted by replacing the casts, and after just a few months, a baby’s feet will appear to be completely corrected.  To try and ensure that the feet do not revert back to their original position, children wear a brace uninterrupted for a few months, and then just at night for the remainder of their toddler years.  By the time children are 4 years old, they are likely to be able to run and play with all their peers without pain.  Historically, surgery has been used to treat clubfoot. However, surgery reconstructs the bones of the foot instead of utilizing the natural bone growth and formation as the Ponseti method does. Additionally, surgery is not conducive to low resource settings, can be extremely costly, and patients are more likely to experience pain throughout their lives.

Congratulations! Now you are a clubfoot expert! You might be thinking, “I only read three paragraphs on this condition, how am I an expert?”  Well, if an expert is somewhat of an informational elitist compared to the general population, then you, the reader are now an expert.  The truth is that most people know very little about clubfoot, even if they have heard of the condition or know someone personally who was born with it. For this reason, we need to make this project a reality.  Clubfoot is a footnote on the global health agenda. It’s a detail that does not receive much international attention, although its developmental impact in poor settings can be widespread.   Through this documentary, we aim to raise awareness on clubfoot in general, how it is treated, and what countries, both poor and rich, are doing to address clubfoot. Our documentary follows lives of different individuals living with clubfoot in different countries, from different cultures, and with different means to seek out treatment. It’s our hope that this documentary will be used as a way for non-experts to become experts on this incredibly important issue that unnecessarily burdens people all over the world.