May 22, 2017 – Musculo/Skeletal Health

  1.  Describe the day-to-day routine of someone in the developing & how would it be impacted by amputation?

The day to day life of someone in the developing world would vary from country to country and from city to city. For example, someone in rural china may do farming for a living and walk around everyday to tend to their fields and crops. An example shown in class was a man who farmed rice for a living but then had his legs removed due to a landmine explosion. Because of the loss of his legs he was no longer able to farm rice and make a living for himself or his family so their family face great financial, social, and emotional burden. Through a non-profit organization they set him up with mushroom farming where he could reach from the ground and easily manage and maintain. Though the loss of his legs hindered his previous life’s work he was able to find a new calling in his life to make money. Other people may not be as lucky however. If this man had not been set up with a mushroom farm, he, like many other have, would end up failing to deliver on their crops and would no longer be able to sell or transport materials. Soon they would go into poverty and may lose their farm and house and end up going to the street to panhandle as the last remaining option for them to make money. In a different developing country like India may people have to walk up to ten miles to get things like food and water to survive. Additionally, they may have to walk similar lengths to get to school or work everyday. If they lost their legs they would no longer be able to get to school or work on their own or without another form of transport. They would also become a burden on the family as they would no longer be able to get things like water or food for their family to survive and so a lot of strain would be placed on the remaining members of the family who are still able to walk. These two countries and scenarios are just a few of many cases of people losing their limbs in developing countries. For many the loss of a limb is debilitating and prevents them from getting a job or making a place for themselves in society. For everyone there is great emotional burden due to feeling of failure and lack of self worth. Companies like Jaipur foot can help reduce this emotional and physical burden by providing prosthetics to any one who needs them. This program will help make them useful in society, and it will help reduce stigma surrounding people with these disabilities (Mohan et al.). It is also important to increase education about organizations like these so that everyone can have the chance to walk again.

  1.  How could you use education to fight the stigma of congenital diseases such as clubfoot?  What are the challenges of educating in the developing world?

Educational practices especially in the field of medicine in greatly lacking in the developing world. From a young age and growing up many children never get the education they need to understand why diseases exist or why they may be present in a person, thus they are less accepting of others who may be plagued with an uncommon disease. As seen in the CURE international video (Healing for clubfoot) it is mentioned that kids born with clubfoot are seen as an act of God to punish the parents for some sort of wrongdoing they have done in the past. As a result, the parents and the society around them may see the baby as a curse and may kill the baby or leave the baby to die. To try to prevent this stigma and labeling that may occur it is imperative that children and adults be taught from a young age about why certain diseases, deformities, and traumas may occur so as to lower to future stigma. Additionally, it is important to educate all people on foundations like CURE who will be able to fix clubfoot early on and prevent it from affecting the child through its life. Children with neglected clubfoot especially go through a lot of emotional burdens, are unable to complete their education or get jobs, and become dependent on their family to survive. In order to increase the livelihood of someone born with clubfoot, the Ponseti method has been invented to correct the disorder early on. Smythe et al. talks about the process of the method which includes the corrective stage, where the feet undergo casting, and then the maintenance phase, where the feet are put under a bracing regime. As a result of this study it was found that the Ponseti method was successful 85% of the time and lowered the Pirani score to an average below 1, which indicates a successful functional outcome. (Smythe et al.) Because of the success of the treatment of congenital diseases like clubfoot it is important to not only educate people on why the disease has occurred, but on how to treat and live with a disease like it. It may be hard to change the ingrained societal opinions people have about people with congenital diseases, but what we can do is change the stigma and make the disease seen as less of a burden in general.

  1. If you were the CEO if Jaipur/CURE, how could you improve/resolve the challenges they face?

If I was the CEO of CURE or Jaipur foot, I would put a lot of emphasis in advertising and raising local and national awareness over the existence of these organizations. Many people may live in rural areas and never know of the existence of organizations like these and so many people never get the treatment they need in life. To advertise, I would send a mobile clinic around the region and share the message and provide treatment to people or do things like sizing and fitting of things like prosthetic limbs. I would then take the measurements back to the manufacturing facility and once they were finished the limbs would be brought back to the villages for pick up. This idea is likely very costly which is another challenge faced in these organizations. A cheaper idea would be to have a bus which goes around to local villages to pick up people and bring them to the clinics so that transportation is not an issue in them getting treatment. With the busses they can get back home and then be able to return for follow up appointments. To help with funding it would be useful to increase online awareness so that people from first world nations could help donate and also learn about these problems and be able to research them further. If that was not a viable option, I would probably go to the government and share all the information about what we do as an organization and why we need funding so that we could try to get more government support and help get better infrastructure for the clinics and hospitals. In a perfect world we would set up smaller satellite clinics all over the area so that people would not have to worry about transportation and finding money to stay in the area. We would also have enough doctors to cover the clinics and have the doctors go out in the villages and talk to people and spread the word about the organization and get people to come for treatment. However, with a lack of funding this may not be possible until the government finds a way to subsidize these programs.


“Healing for clubfoot: A solution for a global problem.” CURE. N.p., n.d. Web. 23 May 2017.

Mohan, D., P. K. Sethi, and R. Ravi. “Mathematical modelling and field trials of an inexpensive endoskeletal above-knee prosthesis.” Prosthetics and Orthotics International 16 (1992): 118-23. Web.

Smythe, Tracey, Daniel Chandramohan, Jane Bruce, Hannah Kuper, Christopher Lavy, and Allen Foster. “Results of clubfoot treatment after manipulation and casting using the Ponseti method: experience in Harare, Zimbabwe.” Tropical Medicine & International Health 21.10 (2016): 1311-318. Web.





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