CLUBFOOT IN THE PHILIPPINES 2018: HAND IN HAND WITH MIRACLE FEET AND PNGOC

Clubfoot is a common congenital birth defect with an average prevalence of 1 per 800  to 1000 live births. (1) 

According to Miracle Feet data, about 3,523 children with Clubfoot are born in the Philippines.(2)

Neglected clubfoot results in disability and as a child grows up, he is subjected to bullying  and being made fun of, thus, leading to low self esteem on the Clubfoot children. Others are deprived of the opportunities, whether the choice of educational field and also in the work place because of preformed ideas on the disability. Families are affected as well emotionally and financially.

Physically, the Clubfoot child has difficulty in walking and in wearing shoes

The important aspect of this birth defect is that Clubfoot is TREATABLE!!!

"Parents of infants born with clubfeet may be reassured that their baby, if otherwise normal, when treated by expert hands will have normal looking feet with normal function for all practical purposes. The well treated clubfoot is no handicap and is fully compatible with normal, active life." Ignacio Ponseti, M.D.(3)

Let us now look forward to a world where a Clubfoot child can walk and run free from disability, as envisioned by the consortium called the Global Clubfoot Initiative (GCI) with the battlecry  #runfree2030,

The best present we can give to the clubfoot kids is the OPPORTUNITY FOR A NORMAL AND ACTIVE LIFE just as Dr. Ignacio Ponseti found out as he developed the Ponseti Method resulting in a well treated clubfoot with no handicap.  (3)

Here is Nurbin who at 2 years old was already running around with his Clubfoot but after several months of treatment now has better positioned feet. He is now on BRACING to prevent relapse.

Did you ever imagine the normal foot as the outcome?

Some call it magic... others say it is a miracle!

And this "MIRACLE" with angels on earth is what we want to share with the Clubfoot kids we have in the Philippines!

This miracle came upon the Philippine Clubfoot situation through Miracle Feet (2), a US based NGO founded by parents of children born with clubfoot in the US and whose mission is to increase access for proper treatment in low-income and middle -income countires through partnership with local health providers.

Miracle Feet had been in the Philippines since 2014 but became more active outside NCR and major cities, early this 2018, with the new Program Manager for Miracle Feet Asia, Ms. Cristina Mosende.

Miracle Feet and PNGOC for the Philippine National Clubfoot Program

The new local provider for the Philippines in the last quarter of 2018 is the Philippine NGO Council for Population Health and Welfare (PNGOC) who has fast-tracked the partnership with more regional health providers, now reaching 19 Ponseti clinics all throughout the Philippines as of June 2019 and with more to come. This is attributable to the Executive Director of PNGOC, Ms. Eden Divinagracia and team.

PNGOC Executive Director Dr. Eden Divinagracia and Dr. Rey Salinel during the renewal of the MOU with ZCMC Clubfoot Clinic last January 5, 2019.

Free Clubfoot treatment supplies and Miracle Feet Braces are now made available to all these clinics, thus FREE treatment is now accessible in many centers in the Philippines.

Here are the Ponseti Clinics in the Philippines partnering with Miracle Feet and the Philippine NGO Council (PNGOC).


Here is a Before and After photo at the ZCMC Clubfoot Clinic of  four of the Clubfoot kids, ages 12 days to 15 years old, with ongoing treatment using the Ponseti Method 

The changes are REAL!!!

We now have several Clubfoot kids and young adults ages 4 to 22 years with the so-called neglected Clubfoot with ongoing Ponseti treatment and they are responding well, although, they still have to complete their treatment for the final success rate to be determined. 

The Ponseti Method utilizes weekly gentle manipulation with casting for an average of 6 to 8 weeks followed with possible Tenotomy then Foot Abduction Bracing for 23 hours per day for the first three months and followed by bracing during naps and sleep time up to 5 years old, or an average of an additional 10 to 30 months to prevent relapse. (4) 

Clubfoot kids on Cast 

Clubfoot kids on Foot Abduction Braces from Miracle Feet

We now realize that "THERE IS HOPE FOR CLUBFOOT" whatever the age and we just have to refer the children to the Clubfoot Treatment providers to find out the options and the chances for improvement.

ZCMC Clubfoot Clinic Team: Head, Dr. George Rojo; Treatment providers: Dr. Carl Delatado, Dr. Joshua Comaingking, Dr. JayR Alviar, Dr. John Antolin Go; Site Coordinator, Ms. Natalys Sousa; Volunteers, Ms. Bea Flauta and Dr. Filipinas Rojo 

We, in the Zamboanga City Medical Center (ZCMC) Clubfoot Clinic together with, and as part of the Philippine National Clubfoot Program passionately want to SPREAD THE ADVOCACY that:

CLUBFOOT IS TREATABLE!

FREE TREATMENT IS AVAILABLE in the PHILIPPINES. 

The ZCMC Clubfoot Clinic and the Clubfoot in Zamboanga PH Program would like to invite you to share with us in this advocacy through:

**building awareness

**improving clubfoot identification and referral processes

**providing free treatment services as well as

**training for providers in strategic places in the Zamboanga Peninsula and neighboring islands to make treatment more accessible. 

Find out how can you help in whatever little way!

Thank you to Miracle Feet and PNGOC!
Thank you, families and friends of the Clubfoot kids for the love, commitment and support for the children to complete treatment!

Let us always remember...

Clubfoot is treatable!

Clubfoot Treatment is FREE at the 

ZCMC Clubfoot Clinic 

every Saturday, 8-11 am 

at ZCMC Ward 2.

 References

1 Adnan Ansar, et al. Systematic review and meta-analysis of global birth prevalence of clubfoot: a study protocol, BMJ Open, 2018: 8(3); e019246
2 Miracle Feet website https://www.miraclefeet.org/

3 http://www.ponseti.info/ponseti-method.html

4 Christof Radler, The Ponseti method for the treatment of congenital club foot: review of the current literature and treatment recommendations
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3764299/

IMAGES OF ZAMBOANGA CITY CIRCA 2011 PART 1

Today, I started so early and I decided I wanted to get IMAGES of ZAMBOANGA CITY. 
from Wikipedia: The City of Zamboanga (Zamboangueño Chavacano/Spanish: Ciudad de Zamboanga): is a highly urbanized, independent and a chartered city located in Mindanao, Philippines. It is currently ranked as the 6th most populous city (947,020 estimated population as of 2010) and the 3rd largest by land area in the Philippines (1,483.3849/km² (572.738/sq mi)).^[4][5] It is located at the southernmost tip of the Zamboanga Peninsula and is bounded in the north by the provinces of Zamboanga Sibugay and Zamboanga del Norte, in the west by the Sulu Sea, in the east by Sibuguey Bay, and in the south by the Basilan Strait. It is approximately 460 nautical miles (850 km) south of City of Manila, 365 nautical miles (676 km) northeast of Kota Kinabalu, Malaysia, 345 nautical miles (639 km) northeast of Manado, Indonesia, bounded to the west bySulu Sea, on the east by the Moro Gulf, and on the south by the Basilan Strait and Celebes Sea. Its distance from Cebu City is about 372.57 nautical miles (690.00 km), and is 340.17 nautical miles (629.99 km) from Davao City.^[6]

I just drove around for an hour and got shots of a school, church, hospital and some noted tourist spots in Zamboanga City...


Some of the data I inserted were taken from Wikipedia, from different Zamboanga City websites and related topics.


Here is Zamboanga City!

First stop: ATENEO DE ZAMBOANGA UNIVERSITY (ADZU) HIGH SCHOOL CAMPUS, TUMAGA

ADZU HS Campus in Tumaga is quite far (by Zamboanga standards) from the main "pueblo", but actually only 4 to 5 kms. away. 
But, the big building dedicated to the High School students alone, in a large open area is enough compensation for this... a very ideal campus!
Future plans also include transfer of the Grade School Department to this campus in another new building.   

Ateneo De Zamboanga University High School Campus...
Can you see a glimpse of Mount Pulong Bato in the background?

Second Stop: Still within the ADZU HS Campus, we see a view of MOUNT PULONG BATO and adjacent MURUK.

Mount Pulong Bato or Pulungbato is a landmark in itself and is part of Zamboanga City's landscape. 

From the airport, from Basilan Strait and from many parts of the City, Mount Pulung Bato is very visible.

And indeed, the mountain has a dome contour and indeed made of stone, and is part of the Zamboanga City watershed area.

The rounded mountain made of stone is Mount Pulong Bato,
considered as the biggest mountain within the city.

http://www.zambotimes.com/archives/5124-Watershed-transcends-boundaries.html

The Pasonanca watershed, the source of drinking water of Zamboanga City covers a land area of 12,107 hectares and a 5,307 hectares buffer zone which are all subject to actual survey.

http://www.mb.com.ph/node/323784/approval-water

ZAMBOANGA CITY, Philippines – The Lower House has approved, during its second reading, House Bill (HB) 422, “An Act establishing the Pasonanca Watershed Forest Reserve located in this city as protected area under the category of Natural Park and its peripheral areas as buffer zones."

Beside Mount Pulong Bato is the mountains of Barangay Muruk

http://www.zamboanga.com/z/index.php?title=Pasonanca_Zamboanga_City_Philippines

During the Christian holiday of Holy Week, thousands of people visit the holy cross near the top of Mt. Pulong Bato. On the way to the top about 50 to 75 meters apart are the 14 stations of the cross where the Christian faithful can pray or rest.

Third Stop: PASONANCA ROAD

This is close to the Zamboanga City Water District Treatment Plant and the Pasonanca Park Tree House. I love the shade the old tree gives and the character that the place has.

This is Pasonanca Road on the side of the PNPA (down below),
with large and old trees giving shade!

Fourth Stop: PASONANCA PARK TREE HOUSE

Ever since we were kids, I remember this image in our Social Studies book and when I visited Zamboanga City for the first time, I really looked for the place. 
Here is the Tree House... it looks small but it is well-maintained. 

The former Mayor, Maria Clara Lobregat made a larger multi-level tree house attached to a huge acacia tree in La Vista Del Mar.  

ZAMBOANGA TREE HOUSE
Elizabeth Stafford
Pasonanca Park Tree-House
September 30, 1963

This is originally constructed as the "Youth Citizenship Training Center" in the 60s.

http://www.zamboanga.com/z/index.php?title=Zamboanga_City,_Philippines

Pasonanca Tree House: The pasonanca tree house is visited by thousands of visitor per year. For a minimum fee you can rent this tree house. Then you can boast to your friends that you spent the night in a tree house. It has all the amenities of a small motel room.

Originally constructed to be the "Youth Citizenship Training Center" in April of 1960 with the generous assistance of the city council.

Pasonanca to this date continues to represent the beautiful side of Zamboanga City.

Fifth Stop: BOY SCOUT GROUNDS 

The Boy Scout Grounds is the campsite for Boy Scouts and has the trademark teepees and an outdoor ampitheater. This is also located in the Pasonanca Park complex.

the lined green teepees are the hallmark of the Boy Scout Grounds

farther ahead is the ampitheater...

http://www.zamboanga.com/z/index.php?title=Pasonanca_Zamboanga_City_Philippines

The Boy Scout Grounds is a campsite for the Boy Scouts. It has an outdoor amphitheater. There are several teepees in the campground for camping. This campground is often visited by many scounting groups in the area. The Antonio M. Limbaga memorial training center is located here in Pasonanca.

Sixth Stop: ASTORIA REGENCY CONVENTION CENTER

Astoria Regency Convention Center is an imposing building located also in Pasonanca, quite close to the Pasonanca Park Tree House.

Astoria Regency is a popular venue for big conventions (maybe because it has the biggest hall at this time!), weddings, debuts, proms, company parties, concerts and the like, as well as smaller parties and seminars.

There is a small hotel within the complex, which is convenient for the guests who use the convention hall and other function rooms. 

It also has a swimming pool, where many families and friends come over just to swim.  

Since this is a quick stopover, I didn't go in to take a picture of the pool.

From the vantage point of Astoria Regency is this view of the ZAMBOANGA CONVENTION CENTER, which has passed it heyday! 

http://www.zamboanga.com/z/index.php?title=Pasonanca_Zamboanga_City_Philippines

The Zamboanga Convention Center is located fronting the Boy Scout Grounds, it was used for entertainment events and symposia. It has been the temporary regional office of the Department of Interior and Local Government at the basement of the convention center.

only the top of the Zamboanga Convention Center...
but it has lost its luster and its original purpose!

Seventh Stop: CIUDAD MEDICAL ZAMBOANGA

From Pasonanca and Sta. Maria, I drove to Nuñez Extension and passed by Ciudad Medical Zamboanga.

Nuñez Extension is a relatively new road, but is now gradually filled with several businesses.

CMZ started its operations in October 18, 2003 and is now a 160-bed tertiary hospital and one of the largest hospitals in Zamboanga City.

From Wikipedia under Zamboanga City: Ciudad Medical Zamboanga - Is one of the most equipped and advanced medical center in the city. Ciudad Medical is a five-storey medical complex located at Nunez Extension.

Eighth Stop: ATENEO DE ZAMBOANGA UNIVERSITY MAIN CAMPUS

The ADZU Main Campus facade is located at La Purisima Street and its backfield opens to Nuñez Street, which connects Nuñez Extension. 

Within the ADZU Main is the Grade School Department as well as all the College departments, including the ADZU School of Medicine and this year, the Law School opened.

from Wikipedia: The Ateneo de Zamboanga University is a Catholic and Jesuit university in Western Mindanao. It is also known by the acronym AdZU. Founded by the Society of Jesus in 1912, it is the second oldest Jesuit school in the Philippines. It initially catered to primary and secondary education for boys. It became a college in 1952, and a university in August 2001. The Ateneo de Zamboanga began in 1912 as Escuela Catolica, a parochial school run by Spanish Jesuits at the old site of the Immaculate Conception Church, right across the Sunken Garden. Fr. Manuel Sauras, S.J. was the first director.^[1]

It operates two campuses. The main campus in La Purisima Street houses the Colleges and the Grade School, while the newly constructed campus, outsideZamboanga City proper holds the High School.

Ninth Stop: METROPOLITAN CATHEDRAL OF THE IMMACULATE CONCEPTION

Just beside ADZU Main Campus is the Metropolitan Cathedral of the Immaculate Conception, another main Zamboanga City landmark.

I remember the old Cathedral... and I remember in 1998, the demolition of the old cathedral and eventually, the making of the new Cathedral which I sort of documented.

• 
  
• From Wikipedia: Modern Metropolitan Cathedral of the Immaculate Conception - Founded in 1810 as a parish located at the present day Universidad de Zamboanga campus, the Cathedral is the seat of the Roman Catholic Archdiocese of Zamboanga (created in 1910 as diocese and elevated in 1958 as an archdiocese). It is known as one of the most modern cathedrals in Asia, built in 1998-2001. The cathedral is located at La Purisima street. The cathedral's structure is a cruciform, resembling a cross and its facade is patterned after a candle (which is connected to the Blessed Virgin Mary).^[85]

A new landmark of Zamboanga City completed in December 1999. It is perhaps the country's most modern cathedral and the only one with an elevator. Summary: 2-storey Cathedral accessible by ramp & side stairs; Cruciform design accented elliptical/oval forms in the shape of candles - 3 at main entrance (foot of cruciform) and 1 each at 3 other ends of the cruciform Ground Floor: Area - 2,303.77 sq. m.; 400-500 capacity Day Chapel; 536 sq. m. Conference Room; 250 capacity Perpetual Adoration Chapel; 355 sq. m. Crypt; Public and Clergy Offices Second Floor: Area - 2,276.82 sq. m.; 1,600 to 2,000 capacity Main Cathedral; 250 each capacity Baptistry and Blessed Sacrament Chapel; 116 sq. m. Sacristy; highly proportional Sanctuary and Altar, elevated Bishop's Chair, ample area for Ordination ceremonies; approached by Front Ramps, side stairs, and winding stairs.

Did you know that the central round part of the stained glass was preserved from the old Immaculate Conception Church (ICC) and placed again to the central stained glass at the facade of the new Metropolitan Cathedral?

the stained glass of the Immaculate Conception
came from the old Immaculate Conception Cathedral

This is the new Bell Tower, which was just inaugurated this year.

Tenth Stop: ZAMBOANGA CITY MEDICAL CENTER

This is the main government hospital of Zamboanga City and is a DOH retained hospital.

It has an American type of architecture and is sprawling.

However, in the recent years, the Tzu Chi Foundation has helped the ZCMC a lot, with two buildings, the Rehabilitation Medicine Building and the Eye Center with the Tzu Chi design. Thanks a lot to the moving forces of the Tzu Chi Zamboanga Chapter.  

from Wikipedia: Zamboanga City Medical Center - Is the largest medical facility in Region IX in terms of bed capacity. The hospital was founded in 1918 as the Zamboanga General Hospital; better known simply as "General Hospital", is located in the corner of Veterans Avenue-Fort Pilar road.

Zamboanga City Medical Center

ZCMC Tzu Chi Great Love Rehabilitation Center and Annex

ZCMC Tzu Chi Great Love Eye Center

For me, Zamboanga City has lots of facets... the Filipino, Spanish, American, Muslim and modern influences rolled into one.
I have still another set of images of Zamboanga City...