Londoni

'Walk for Life' initiative

In 2008 Colin Macfarlane, an Australian businessman, founded the ‘Walk for Life’ organisation in Bangladesh with the objective of providing sustainable clubfoot program in the country. Walk for Life provide free treatment to children under the age of three by the Ponseti Method. Currently, the organisation has over 40 clinics spread all over Bangladesh and has treated more than 8,759 feet since its formation. Walk for Life is continuing to expand its network with the objective of making sure no child has to travel more than 60 km (40 miles) to get treatment .

Besides providing free treatment, we are focused in supporting various important Government Medical facilities by providing appropriate training with international trainers and also by providing with material and manpower for running clinic.

Walk for Life

Australian professional drives clubfeet and cleft treatment in Bangladesh

In 2001 Colin Macfarlane became a member of ROMAC (Rotary Oceania Medical Aid for Children), a rotary club in Melbourne, Australia. Rotary Clubs bring businesses and professional leaders together to provide humanitarian services to others. They are established throughout the world. Members of Rotary Clubs, known as Rotarians, usually meet weekly for breakfast, lunch or dinner and use the social event to organize work on their service goals.

ROMAC in Australia provides medical treatment for children from developing countries in the form of life saving and/or dignity restoring surgery not accessible to them in their home country. Since forming in 1988 it has helped over 350 child patients with treatment. During one such campaign Colin Macfarlane funded a little girl from East Timor with a "hole in the heart" and later made several visits to her country to track her progress. This incident inspired Colin to become a Rotarian and he joined ROMAC.

In 2004 Colin part funded an Interplast visit of plastic surgeons to Dhaka Medical College Hospital Bangladesh and also visited Bangladesh for the first time. Interplast is a partnership between Rotary Australia and The Australian College of Surgeons. It’s a not-for-profit organisation which helps people disabled as a result of congenital or acquired medical conditions such as cleft lip and palate and burn scar contractures. They do this by sending fully qualified Australian and New Zealand volunteer plastic and reconstructive surgeons, anaesthetists, nurses and allied health professionals to the Asia Pacific region to provide free surgical treatment for patients who would otherwise not be able to afford access to such services.

Colin’s visit to Bangladesh had a profound impact on him. He was inspired to form "Operation Cleft" in 2005. Following his first visit, Colin travelled to Bangladesh a total of 17 times in 5 years.

A wise teacher said:"Be sincere, be brief, be seated." I will be following that advice today!

Why is an Australian businessman talking to a group of medical professionals in Bangladesh? I came to Bangladesh for the first time in 2004 as an observer with a team of Australian Plastic surgeons. This is now my 17th visit.

I saw untreated cleft lips and palates. I saw what it means to be poor and have a disability in this country. The realization: What we spend on a meal in a restaurant in the west will change a child’s life here...forever...and then I read a quotation by Mark Twain: "Twenty years from now you will be more disappointed by the things that you didn't do than by the ones you did do. So throw off the bowlines. Sail away from the safe harbour. Catch the trade winds in your sails. Explore. Dream. Discover."

In 2005 I founded Operation Cleft which was then adopted by the Rotary Club of Box Hill Central in Australia. We have now passed 4,000 operations.

[You] Don’t have to be a big NGO to make a difference!

The new challenge in my life is Walk for Life – the Bangladesh Club Foot Project.

...Am very lucky to have Mr Zakirul Haque as country director and Mr Jahangir Alum as country coordinator – a few weeks ago I called Jahangir from overseas he said: "There is so much to do: we are putting our heart and soul into this project". That is what we need to grow Ponseti in Bangladesh: Energy and Passion.

Mine is not a medical discussion...I am not qualified for that…but successful Ponseti treatment is a team effort...it is not top down. The role of the physiotherapist is every bit equal to that of the surgeon in Ponseti treatment.

...All of us here today have a special opportunity to make a difference...The time is right for a focused effort to treat club foot children in this country.

Lao Tzu the Chinese philosopher said: "A journey of a thousand miles must begin with a single step". We have taken the first steps with Ponseti treatment in Bangladesh – now we have the journey to complete.

Extract from Colin Macfarlane’s speech as special guest at a CRP seminar on treating club feet (25 October 2009)

Colin Macfarlane has received multiple prestigious awards for his amazing contribution. In 2006 he became only the second Australian to be awarded the Education Medal by the Vietnamese Government for his contribution to education in that country. Two years later he made a Member of the Order of Australia for service to international relations, and to the community, through philanthropic support for a range of education and health care initiatives.

First clinic opens in Jessore, Khulna Division

In 2008 Walk for Life teamed up with Lamb Hospital and opened its first clinic in Jessore, Khulna Division. Bangladesh's Minister for Health, Professor Haque, who is also an eminent orthopedic surgeon and a "convert" of the Ponseti Method - he has been successfully treating clubfoot babies in Dhaka for a number of years - contributed hugely in helping to establish the clinic.

Our philosophy is to move towards sustainability. We are doing this by working alongside the government health system.

Professor Haque has issued a government order to all civil surgeons in Khulna Division to fully co operate with the program. The clinics we are establishing are predominantly in government hospitals.

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Working on a first year budget of $100,000 (USD) which was donated by POF in Seattle and Glencoe Foundation in Australia, it was possible to establish the clinic and allow for administration and training. Two trained physiotherapists worked alongside government employees to train the staff. Walk for Life also provided free braces, plaster and accessories. The clinic successfully treated 400-500 children suffering from clubfeet in the first year.

Walk for Life subsequently grew and invited experienced trainers from Uganda, UK and Australia to provide training to their fellow Bengali colleagues.

Clinics throughout Bangladesh

Currently, Walk for Life has 40 clinics operating all over the country which has provided treatment to more than 8,759 feet. They have also established clinics in many health organisations such as NITOR (National Institute of Traumatology & Orthopaedic Rehabilitation), BSMMU (Bangabandhu Sheikh Mujib Medical University), CRP (Centre for Rehabilitation & Paralysed) and medical college hospitals in Dhaka, Rajshahi, Khulna, Barisal, Sylhet and elsewhere.

A full list of the clinics with opening time and contact number is available on their website.

Training

Walk for Life provide training and support to various important Government Medical facilities. The training is ran by international trainers whilst material and manpower are provided to help run the clinic successfully.

Walk for Life has an enthusiastic and talented team working in clinics throughout the country.

Together with our Bangladesh staff we are very fortunate to have very skilled volunteer medical professionals from UK, Australia, USA and Canada coming to teach the Ponseti technique.

Regrettably, in Bangladesh as well as in many other developing countries, there is little public awareness about clubfoot as a medical condition, or the Ponseti Method as a proven treatment option. Consequently, the gradual limb deformation is typically ignored until it becomes a truly disabling condition. We are confident that with quality trained medical staff and a public awareness campaign to identify clubfoot, treatment for all clubfoot children is achievable in Bangladesh.

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Volunteers from home and abroad

Thankfully for clubfoot sufferers in Bangladesh, highly reputable and leading clubfoot practitioners around the world visit Bangladesh regularly to provide their invaluable service free of charge. They carry out operation and also conduct training workshop to popularise the Ponseti Method.

The first of these volunteers to come to Bangladesh was Gonzaga Waiswa, an Orthopedic Surgeon in Mulago, Uganda, who has also made great contribution to the Ugandan Clubfoot Program.

The Honorary Medical Adviser for Walk for Life is Bengali Dr. A. H. M. Abdur Rouf, Assistant Professor of Orthopedic Surgery in Jessore Medical College Hospital in Jessore.

Many of the leading Ponseti practitioners from around the world have given their time free of cost to help Walk for Life become established in Bangladesh.

Without them the programme would never have happened. The wonderful thing is that everybody who has visited wants to come back again!

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I wish to congratulate Walk for Life on their programme to treat children with club feet.

As an orthopedic surgeon I have a special interest in the use of the Ponseti method of non-invasive surgery to treat this condition.

As Minister of Health and Family Welfare I welcome the opening of clinics and mutual cooperation in government hospitals. This program is much more than treating feet - it involves comprehensive training of doctors, physiotherapists and other medical professionals. Very experienced overseas surgeons and physiotherapists are voluntarily giving of their time to become involved with Walk for Life.

As a long time Rotarian I am delighted to see the interest worldwide from Rotary Clubs, including many in Bangladesh. I offer my support and encouragement to Walk for Life.

Professor A. F. M. Ruhal Haque FRCS (Edin) FICS, Minister of Health and Family Welfare for Bangladesh

Partnership

Outside of Bangladesh, Walk for Life is partnered by Glencoe Foundation and Prosthetics Outreach Foundation.

Glencoe Foundation is a private NGO based in Melbourne, Australia, which was formed on 21 February 2002 by Colin Macfarlane. Its goal is to give motivated young people an opportunity to realise their potential through medical and educational support. With this in mind, the Foundation has been involved in projects in East Timor, Zambia, Vietnam, Bangladesh and Australia. Glencoe Foundation also funds local university education for students in Vietnam, Bangladesh, and Zambia.

Under Australia law private NGO’s are required to partner with an AusAid accredited NGO for overseas projects.

Glencoe Foundation formed Operation Cleft in Bangladesh and funded local surgeons to perform cleft and palate operations. This project is now operated by Rotary Clubs in Australia and has completed over 5,000 operations.

Over the years Glencoe Foundation has also renovated the pediatric ward, and built accommodation for visiting overseas doctors at Lamb Hospital in Parbatpur, Dinajpur – one of Walk for Life’s partner in Bangladesh. Glencoe Foundation also funds the fistula and burns operations at this hospital.

Prosthetics Outreach Foundation (POF) is a non-profit organisation headquartered in Seattle, USA and formed in 1989. Its goal is to create opportunities for children and adults who live in developing countries and suffer from limb loss and limb deformities to lead more fulfilling lives.

It has helped over 14,000 children and adults in developing countries, including Vietnam, Bangladesh, Sierra Leone and Liberia. It establishes and equips orthopedic centers which are subsequently staffed by local prosthetists and medical personnel who are trained by POF. These centers provide access to a range of orthopedic services, including orthopedic surgery, physical therapy services, the manufacturing and fitting of custom-made artificial limbs, and the Ponseti treatment of clubfoot.

Within Bangladesh Walk for Life partners with various organisations throughout the country. In Chittagong Division it partners with Zero Clubfoot and has its main clinic at the Lions Hospital in Chittagong. Zero Clubfoot was established on 12 February 2010 as part of a project of Lion Mukhlesur Rahman Foundation.

In Dinajpur Walk for Life has a 6-year association with Lamb Hospital which was set up in 1955 by John Otteson, a Christian missionary of the American Santal Mission. During this time they have funded a children’s Pediatric Ward, guest house accommodation, cleft operations, women’s fistulas and burns. Lamb Hospital treats more than 60,000 outpatients in a year and nearly 10,000 in-patients for surgery or medical treatment. It also has an active Ponseti clinic for the treatment of clubfoot.

In Mirpur and Savar (near Dhaka) Walk for Life partners with Centre for Rehabilitation & Paralysed (CRP) and has signed an MoU with CRP to provide enhance clubfoot treatment in these areas. CRP was founded in 1979 by British physiotherapist Valerie Taylor and a small group of Bengalis. It provides a holistic approach to the rehabilitation process and covers physical, psychological, and economic rehabilitation of the patient.

In Netrokona Walk for Life has partnered up with Sabalamby Unnayan Samity (SUS), an NGO formally established in 1986 by Begum Rokeya. Covering Netrakona, Sunamganj, and Mymensingh districts, SUS has a multi-disciplinary approach to helping the deprived. It has various micro finance, education, food security and livelihood development, rights and governance, environment and climate program amongst others. As part of its health and disability program, SUS provides operation, pathology, ultrasonography, physiotherapy, cleft, palate and clubfoot operation, vaccination, and ECG service amongst others. It also provides advice and treatment on sexual health, family planning, nutrition and sanitation.

Since partnering with Walk for Life, SUS has helped 98 clubfoot patient and provided special shoes (for bracing) for 63 patients after operation.

'Zero Clubfoot' initiative in Chittagong Division

Zero Clubfoot (ZCF) is a non-profit health project based in Chittagong. It targets and treats children under the age of 5 free of charge using the Ponseti Method and aims to detect clubfoot within the first month of the child's birth. It serves the whole Chittagong Division including Chittagong, Comilla, Noakhali, Brahmanbaria, Chandpur, Cox's Bazar, Lakshmipur, Feni, Khagrachhari, Rangamati and Bandarban where it estimates more than 4,500 children in that age group suffer from clubfoot and a shocking more than 900 children a year are born with the defect.

The vision is to see no child walking with clubfoot. That’s why the aim is to offer treatment to every child with clubfoot within the 1st month of life and achieve full correction before they start walking.

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Like Walk for Life, Zero Clubfoot establishes Ponseti clinics in government hospitals, trains up doctors and physiotherapists in the Ponseti method and builds up awareness among local doctors, hospitals, government agencies and NGO’s to emphasis early diagnosed and treatment of clubfoot.

Founder

Zero Clubfoot was founded by Bengali businessman Nader Khan. Nader had established the "Lion Mukhlesur Rahman Foundation" which started a project named "Operation cleft lift" and treated cleft lip and cleft palate patients from 1995. In 2010 Nader Khan's youngest son Dr. Shamim Khan began work on "Clubfoot Project". The result had impressed Nader Khan who began a second project on clubfoot treatment under the Lion Mukhlesur Rahman Foundation. Subsequently "Zero Clubfoot" was started on 1 February 2010 with the slogan "No more walking clubfoot". Colin Macfarlane from Walk for Life had extended his support to the project.

Since its relatively new beginning Zero Clubfoot has already corrected 1,500 clubfoot in the first 30 months of her journey.

Services

Zero Clubfoot works with health professionals to set up screening program for foot deformity. Amongst these professionals are doctors, nurses, female health assistance, health inspectors, community health assistants from each district hospitals, Upazilla health complexes, maternity care centers and different NGO health care centers in Chittagong Division. Their field officers also distribute educational brochures, leaflets and provide in-service training in various aspect of the treatment including how to follow up with patients to ensure ongoing care.

Zero Clubfoot also trains doctors, physiotherapists and medical assistants how to treat clubfoot in young children using the Ponseti Method followed by setting up Zero Clubfoot clinics in different areas of Chittagong division.

Several Medical Teams formed, each with two of the trained physicians or physiotherapists, are working in different clinics of ZCF in separate week days. This would ensure throughout the week service in all over Chittagong division.

We have a great medical team of young energetic health professionals, consists of Orthopedic surgeons, Orthopedic residents, Physiotherapists and medical assistants. All of them are trained and experienced in Ponseti Technique of Clubfoot management. To ensure quality of treatment and progressive improvement of skill and efficiency of the practitioners, ZCF has following plans to execute link with overseas practitioners through Walk for life, for the problem solving and advice and to arrange at least 2 Ponseti workshops a year in Chittagong with home and overseas Ponseti experts.

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Zero Clubfoot also distribute posters, PVC banners, and stickers in various important public places such as railway stations, bus terminals, and markets to increase public awareness. These posters and banners include the name, address and contact information of the nearest of treatment facilities.

The organisation also publishes a monthly tabloid named "ZCF Newsletter" covering the full range of its activities, aims and objectives. It also publishes press releases on day-to-day events in local and national dailies.

Training

Clubfoot practitioners and other staff undergo routine training program to enhance their skillset. In addition, there are regular scientific seminars, trainings and workshops on clubfoot management for the Ponseti team which encompass world renowned medical and Ponseti experts. Ponseti specialist Dr. Paul W. Wade is the main person for most of the workshop.

Our Ponseti Practitioners as well as representatives from SARPV were present in all of our previous workshops. We also arrange a question and answer session for the clarification of any queries from the participants and Keynote speaker clarifies them all. We hope to keep this flow of workshop constant to enrich our Ponseti Practitioners skill to ensure better clubfoot management. All on going activities of the project are being monitored round the clock, so that no anomaly as well as irresponsibility is exposed.

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In addition to its large range of training resources, Zero Clubfoot is also aiming to invite private hospitals to sign agreements with participating NGOs to offer Ponseti treatment. It is expected that the private hospitals will discount costs for needy patients as part of their contribution to Clubfoot treatment. Leading corporate, business and industrial groups and wealthy citizens of our country are also being encouraged to "step up and provide necessary economic and logistic support, so that free clubfoot management service becomes sustainable in Bangladesh and future generation gets better chance to stand strong and build the country".

Supporters

Besides Colin Macfarlane and Jahangir Alam of Walk for Life, Zero Clubfoot also receives the active support of many nationally and internationally renowned personalities such as Dr. Paul W. Wade who lends their support to clubfoot clinics around the world (including Walk for Life) .

Partners

Besides the cooperation of local area health authorities and relevant government departments, Zero Clubfoot also enjoys the active support of corporate and private companies such as ROBI telecom, Pedrollo, Uttara Group of Companies, Endolite. It also works in partnership wih NGOs like Grameen Bank, SARPV, Rotary Club of Darlington (UK), Khulshi Lions Club of Chittagong and naturally Global Clubfoot Initiative and Walk for Life.

You can find out a lot about people by the company they keep. The same is true of organizations. CURE is thankful to have a host of organizations with impeccable integrity to help make our vision come true.

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