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           February 9, 2012
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Canadian Orthopaedic Surgeon, Shafique P. Pirani, MD, Honored for Creating Clubfoot Treatment Program in Uganda

SAN FRANCISCO – The American Academy of Orthopaedic Surgeons (AAOS) presented its 2012 Humanitarian Award to Shafique P. Pirani, MD, of British Columbia, Canada, during an awards ceremony at its 2012 Annual Meeting. The Humanitarian Award honors members of the Academy who have distinguished themselves through outstanding musculoskeletal-related humanitarian activities in the United States or abroad. This award also recognizes those orthopaedic surgeons who help to improve the human condition by alleviating suffering and supporting and contributing to the basic human dignity of those in need.

Dr. Pirani established the Uganda Sustainable Clubfoot Care Project (USCCP), a nonprofit organization dedicated to reducing widespread disability and poverty from neglected clubfoot. 

“Clubfoot is a birth defect where the foot is twisted inward and downward.” said Dr. Pirani. “Early on in life, the deformity causes few symptoms. But as you get bigger, it hurts when you stand and walk. Life then starts to become more difficult. Walking becomes increasingly painful. Children suffer social isolation and stigmatization. Children appear different to friends and village mates, and are given strange names.

“Children with clubfoot are less likely to attend school, less likely to have a job or get married, and more likely to suffer from poverty.” said Dr. Pirani. “They are a burden to themselves, their family and society.”

In 1972, when Dr. Pirani was just 15-years-old, he and his family were forced to leave Uganda by the country’s dictator, Idi Amin. They moved to England, where Dr. Pirani became a doctor. He later moved to Canada where he completed his residency in orthopaedic surgery and fellowship in pediatric orthopaedics, joined the Department of Orthopaedics at the University of British Columbia, and began a successful practice specializing in pediatric orthopaedics, and specifically the treatment of clubfoot at the Royal Columbian Hospital in Vancouver.

In 1998, Dr. Pirani returned to his native country on a social visit. While there, he met with Norgrove Penny, MD, a Canadian orthopaedic surgeon who was working in Uganda treating disabled children. Dr. Penny told Dr. Pirani that an estimated 10,000 children were living with neglected clubfoot in Uganda, and another 1,500 were born each year with the condition. In a country of 20 million people, there were only eight orthopaedic surgeons available to surgically correct the condition. More often than not, children failed to access treatment and grew up suffering the consequences of neglected clubfeet.

After hearing about the “terrible” clubfoot situation in Uganda, Dr. Pirani said that he “immediately thought that the Ponseti Method needed to be brought to the country.  This affordable, minimally invasive method corrects the deformity with gentle manipulation and casting, followed by cutting of the heel cord under local anesthetic (the tendon heals normally). Bracing prevents relapse. The method is very successful in young children, who then grow up no longer disabled and fully able to participate in society.”

“I told Dr. Penny, ‘you should do this.’ And he said, ‘no, you should do this,’” said Dr. Pirani. “That’s how it started. I was ready at that point in my life to try to do something altruistic.”

Dr. Pirani and Dr. Penny communicated over the next year via email, “and formulated a strategy to bring Ponseti clubfoot treatment to Uganda.  We had some obstacles that we had to get over. There were few orthopaedic surgeons. Who was going to do the treatment?”

They decided to train a “cadre of nurses and health care workers” called “orthopaedic officers” to oversee the treatment. Training began in November 1999 at the Mulago Hospital in the city of Kampala with funding from Rotary International and the Canadian International Development Agency.  The new “officers” immediately began treating children with clubfoot with locally made, inexpensive braces and plaster. Dr. Pirani and Dr. Penny held additional trainings each year, ultimately integrating the program into the country’s health system.

The USCCP has been instrumental in teaching and institutionalizing the nonsurgical Ponseti Method of treatment throughout Uganda’s health and higher educational systems. Today, there are 40 clubfoot clinics and more than 4,000 health care professionals and students trained in the Ponseti Method in Uganda. Over the past 15 years, more than 3,000 children have been successfully treated.  Dr. Pirani regularly returns to Uganda to evaluate the outcomes of the program.  He also presents the “Ugandan Model” of Ponseti clubfoot care in other under resourced countries and jurisdictions.  Recently the World Health Organization recognized the success of USCCP and recommended its model as a way of helping the disabled worldwide.

“Years ago, if you went to the orthopaedic ward at a major hospital in Uganda you would see many children with neglected clubfeet waiting for surgery,” said Dr. Pirani.  “Now there are very few children waiting for surgery. They are being treated by the Ponseti Method. That surgical time can now be utilized for other surgeries to treat other conditions.

The USCCP “is an incredible effort and a spectacular outcome that sits on the shoulders of one of the humblest men I know,” said Peter O. Newton, MD, who nominated Dr. Pirani for the Humanitarian Award. “I can think of no one more deserving and representative of this award than Dr. Shafique Pirani.”

“I am honored to receive this award. The most important thing about receiving this award is that it raises the awareness of problems experienced by children in developing nations affected with orthopaedic problems such as clubfeet, and that orthopaedic surgeons are instrumental in developing solutions. ” said Dr. Pirani.


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