SCH team helps Tongan babies with club foot
Sydney Children’s Hospitals Network staff are dedicated to helping every child live their healthiest life. This is true not just of the patients in our hospitals like baby Sahib (pictured), but of children across Australia and beyond. For past 40 years, a dedicated team of clinicians from Sydney Children’s Hospital, Randwick (SCH) has visited Tonga, to operate on babies born with club foot.
SCH Orthopaedic Surgeon Dr Andrew Leicester has led the team for the last 25 years. Congenital Talipes Equinovarus – or club foot – is when a baby is born with a foot (or feet) that points down and turns inward. It is a very treatable condition, but without treatment it can be debilitating.
It is treated with the Ponseti Method, a series of plaster casts, which gradually improves and corrects the foot position with each cast. Usually, getting the foot to the final correct position is done by a tenotomy, a small surgical procedure to release the Achilles tendon. The baby is then fitted with a temporary pair of boots joined together with a bar. Sahib had this surgery at SCH last year and has recovered well.
In Tonga, 1 in 100 babies are born with club foot, 10 times the number of babies born with the condition in Australia. SCH has a link with Vaiola Hospital in Nuku’alofa, Tonga, through Orthopaedic Outreach. Physiotherapist Natalie Tannos has made the trip Vaiola Hospital, three times.
Families come from all over Tonga, including different islands. Last year the team operated on 25 babies in three days, Natalie says.
The ideal time to operate on infants with club foot is six weeks, but as the SCH team visit Tonga only once a year, they operate on babies from newborn to one year old. During their time there, the team trains the local doctors and physiotherapists.
Due to COVID-19 restrictions, the most recent trip was cancelled. Instead our orthopaedic surgeons and physiotherapist discussed cases and shared their expertise with the Tongan doctors via Zoom. Using video conferencing, the SCH team described the tenotomy and casting procedures as they were being conducted. The procedures were also recorded so that they could be sent to Tonga as an educational resource.
The positive of moving to Zoom is that the Tongan doctors will be empowered to operate on babies with our support via video conferencing, but will not have to wait for the physical support of our team. This means that the treatment can be performed at a younger and more optimal age as babies will not have to wait for our annual visit.
Once COVID-19 restrictions are no longer in place, the team will resume their annual visits to Tonga to assist with the more complicated cases. In the meantime, the team will continue to provide support via video conferencing and by sending equipment, such as second-hand boots.
“We can still help people overseas, even though we are not there physically. The Tongan team has adapted to the challenges presented by the pandemic, and has been empowered to carry out this treatment so that their patients continue to receive the care they need.”