For more than a decade, Shafique P. Pirani, MD, has been passionate about improving the function and quality of life of Ugandan children afflicted with clubfoot. The AAOS recognized this devotion by presenting Dr. Pirani with the Humanitarian Award during the 2012 AAOS 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 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.

A pediatric orthopaedic surgeon specializing in the treatment of clubfoot, Dr. Pirani helped establish the Uganda Sustainable Clubfoot Care Project (USCCP), a nonprofit organization dedicated to raising awareness of the deformity and reducing the disabilities associated with neglected clubfoot. The project has been instrumental in teaching and institutionalizing the Ponseti method of clubfoot treatment throughout Uganda’s healthcare and higher education systems.

An opportunity to make a difference
Dr. Pirani was born in Uganda and immigrated to England with his family in 1972, where he qualified as a doctor. He moved to Canada where he completed his orthopaedic residency and pediatric orthopaedic fellowship at the Hospital for Sick Children in Toronto and joined the department of orthopaedics at the University of British Columbia, establishing a practice at the Royal Columbian Hospital in Vancouver.

In 1998, during a visit to his boyhood home, Dr. Pirani met with Norgrove Penny, MD, an orthopaedic surgeon who was in Uganda on a medical mission. At the time, according to Dr. Penny, an estimated 10,000 children in Uganda were living with neglected clubfoot, and 1,500 children each year were born with congenital clubfoot. However, only eight orthopaedists in Uganda were surgically treating the deformity.

“It immediately struck me that the Ponseti method needed to be brought to Uganda,” said Dr. Pirani. “When left untreated, children in Uganda with clubfoot are a burden to themselves, their families, and society. They are less likely to attend school, get a job, or get married, and more likely to suffer from poverty.”

Developed by Ignacio V. Ponseti, MD (1914–2009), the Ponseti method is an inexpensive, minimally invasive method for correcting clubfoot that is now considered the standard of care for the condition. Drs. Pirani and Penny quickly set to work formulating a strategy for establishing the method in Uganda. Due to the lack of local orthopaedic surgeons, they enlisted the help of “orthopaedic officers”—Ugandan nurses and other allied health professionals—to oversee the treatment. Training was funded by Rotary International and the Canadian International Development Agency, and conducted at Mulago, the major teaching hospital in Kampala, Uganda. Once they completed their training, the “officers” began treating children with clubfoot with locally made braces and plaster.

In nominating Dr. Pirani for the Humanitarian Award, Peter O. Newton, MD, wrote: “Dr. Pirani has spread the knowledge that has allowed many with limited means to literally put thousands of children back on their feet. What better way to represent our specialty than to teach and lead an effort that has changed the lives of so many children for pennies’ worth of plaster?”

Changing lives
Over the next several years, Dr. Pirani, Dr. Penny, and the USCCP continued to hold Ponseti method training sessions in Uganda. Thanks to their efforts, the Ponseti method for treating clubfoot is now successfully integrated into Uganda’s healthcare and higher education systems. To date, more than 4,000 healthcare professionals and students have been trained in the Ponseti method and it is used in more than 40 clinics throughout the country. Recently the World Health Organization recognized the success of the USCCP and recommended its model as a way of helping the disabled worldwide.

Dr. Pirani returns regularly to Uganda to evaluate the USCCP’s success.

“The outcomes are very good,” said Dr. Pirani. “It shows that the Ponseti method can be successful in the hands of paramedicals. Now children in Uganda with clubfeet aren’t waiting for surgery—they are being treated nonsurgically with the Ponseti method.”

He added, “The most important thing about receiving this award is that it raises the awareness of the problems experienced by children in developing nations affected with orthopaedic problems such as clubfeet, and that orthopaedic surgeons are instrumental in developing solutions.”

Video presentation of the Humanitarian Award presentation at the 2012 Annual Meeting

Maureen Leahy is assistant managing editor of AAOS Now. She can be reached at leahy@aaos.org