TWO WORLDS
In developed countries, children with clubfoot receive treatment relatively quickly. Various healthcare systems — regardless of their efficiency — include the treatment and full recovery of such children as part of standard care. As a result, most of them complete the entire treatment before starting school. This is important because they grow up with normal, functional, and flexible feet — free from pain and without feeling different or inferior to their peers. They do not stand out in appearance or ability. They are accepted and have equal opportunities in life. The condition does not limit their functioning or make them disabled or excluded because of a physical deformity. However, this is not the case everywhere…
Globally, untreated clubfoot is considered the most serious cause of physical disability related to the musculoskeletal system. It remains a major problem in many developing countries, with approximately 80% of all cases occurring in these regions.
CAUSES
What is the reason for neglected clubfoot?
The answer to this question is both simple and hard. The reasons for this are multi-fold and may be hard do imagine in a well-developed and relatively well-functioning country. They can be trivial or simply absurd.
LACK OF KNOWLEDGE
MEDICAL CARE
BELIEVES
COSTS
A HELPING HAND
Fortunately, there are many non-governmental and non-profit organizations that support the treatment of clubfoot in developing countries. Some of them provide external assistance from developed nations, others are local initiatives, and some operate as national treatment programs implemented by the country’s Ministry of Health or its equivalent.
The main mission of all these organizations is to spread knowledge — both among parents and medical personnel — as well as to organize training programs for doctors, nurses, and physiotherapists. They also work to create treatment centers, provide medical supplies and equipment, publish educational materials and brochures, and offer comprehensive support to ensure effective and sustainable care.
SPECIFIC DIFFICULTIES
Untreated clubfoot leads to a range of complications that affect many areas of life. These consequences are not limited to the medical aspect, although that is the most critical one and directly influences the others. An untreated deformity results in social, economic, and psychological dysfunctions, deeply impacting the individual’s overall well-being and quality of life.
FROM A MEDICAL PERSPECTIVE
A deformed foot has an abnormal structure, which leads to pain, stiffness, and limited mobility. It affects everyday functioning — often making it impossible. Walking, jumping, and running become unachievable, and participating in any kind of sport is out of the question. The improper structure of the foot and the resulting abnormal gait force the rest of the body into unnatural positions. Anatomically, we function like a system of connected vessels — the knees, hips, and spine are forced into compensatory alignments, becoming overloaded, painful, and stiff. As a result, pain affects not only the foot but also other parts of the body.
FROM A SOCIOLOGICAL PERSPECTIVE
Children born with untreated clubfoot are often abandoned, marginalized, or condemned to a life of poverty. When families decide to care for such a child, the burden of care typically falls on the mother, who consequently has less time for other children, household duties, or income-generating work. This leads to a decline in the family’s standard of living, which also affects the broader community. Children and adults with visible disabilities are frequently stigmatized and excluded. Their physical difference becomes a source of social rejection and discrimination. Women affected by clubfoot face particularly harsh outcomes — they are less likely to marry and more often become victims of physical, emotional, or economic abuse. Although children with clubfoot are fully capable of participating in regular education and social life, they are often denied equal opportunities, as their needs are not prioritized. Their limited mobility prevents them from engaging in daily activities, sports, or play, further deepening their social isolation and sense of exclusion.
FROM AN ECONOMIC PERSPECTIVE
The condition of the foot and overall health are among the most common causes of poverty. A person living with an untreated deformity usually experiences a very low standard of living, and the same applies to their family. The disability generates ongoing financial and social losses. Unfortunately, individuals with physical deformities have limited employment opportunities and are often unable to perform basic daily tasks such as digging, plowing, harvesting crops, or carrying firewood and water. These essential activities become impossible for children, adolescents, and adults with impaired mobility. When treatment is delayed or when re-treatment becomes necessary, the associated costs often exceed a family’s financial and time resources. Expenses related to transportation, medical visits, and orthopedic equipment can be overwhelming. Early intervention, on the other hand, is far more cost-effective — treatment completed within about eight weeks in infancy significantly reduces the long-term burden on families. In developing countries, early and efficient treatment greatly reduces costs by minimizing travel expenses, clinic visits, and work absences. Otherwise, the economic impact extends beyond the family: individuals with disabilities often require state assistance, and their inability to work or contribute economically results in substantial financial losses for the entire society.
FROM A PSYCHOLOGICAL PERSPECTIVE
The psychological background of individuals affected by the deformity is extremely important. Very often, these individuals feel excluded, forgotten, and rejected because of their disability. They frequently struggle with self-acceptance, have low self-esteem, and may be unwilling or unable to form relationships. Many withdraw and isolate themselves, which fuels a vicious cycle of depression that can be difficult to escape. Their helplessness, sense of injustice, and feelings of rejection are often turned inward, leading to self-harm as a way of coping with their emotional pain.
UNBELIVABLE?
It seems unimaginable that such a relatively simple deformity could go untreated anywhere in the world. Truly unbelievable — and yet, it happens!
What’s more, the consequences of not treating clubfoot affect individuals on many levels, leaving them disabled, excluded from daily life, and often stripped of the will to live fully or participate in society.
THE PONSETI METHOD IS NOT KNOWN ALL AROUND THE WORLD. THERE ARE PLACES, WHERE PEOPLE DO NOT KNOW THAT CLUBFOOT CAN BE TREATED DIFFERENTLY.
YOU CAN CHANGE THAT!
HOW FAR THIS KNOWLEDGE SPREADS DEPENDS ON YOU, YOUR UNDERSTANDING, AND YOUR WILLINGNESS TO SHARE IT.
EVEN IF IT REACHES ONLY YOUR IMMEDIATE SURROUNDINGS — YOUR HOSPITAL, CLINIC, PRACTICE, OR FAMILY —
IT CAN STILL MAKE A REAL DIFFERENCE.
- Gupta A. et al.: „Evaluation of the utility of the Ponseti method of correction of clubfoot deformity in a developing nation.”
- Penny J.N.: „The Neglected Clubfoot.”
- Lourenço A.F., Morcuende J.A.: „Correction of neglected idiopathic club foot by the Ponseti method.”
- Stahelli L.: „Clubfoot: Ponseti Management. Third Edition.” (page 19)