Inside HRDC: Celebrating Success and Optimizing for the Future
Earlier this year, author Tom Hayes joined the AHF team on a trip to Nepal to meet with our partners and visit projects. During his visit, Tom immersed himself in the history of our programs and began writing about the deep-rooted relationship between AHF and our partners. In this four-part series, he shares his reflections on how these initiatives have grown into the successes they are today.
By 2018, HRDC was among the most active clubfoot treatment centers in the world, more than doubling its volume of Ponseti cases since 2004.
By then, some in that earliest group were already in their twenties. How well were they doing?
The hospital’s records showed that most still lived in their same villages or communities. This made it possible for Prakash Yadav, HRDC’s specialist in public health, to follow up with patients and their families. Were those patients still walking well? Were the soles of their feet still level to the ground, with the ankle at right angle to the shin bone?
What Prakash learned was remarkable: in 95 percent of cases, the corrected foot position held for at least ten years after those former toddlers and pre-schoolers were treated. The patients’ self-confidence had risen, they had little or no pain when walking and their strength increased. They were grateful.
The HRDC team soon published an academic paper in the prestigious Journal of Bone and Joint Injury underscoring for the first time what was possible with the massaging-casting method—even for teen-agers— in low-income countries.
Orthopedic physicians around the world lauded the findings. Here was an uncomplicated, lower-cost medical intervention, one with potential to transform hundreds of thousands of kids’ lives.
“This study significantly elevated our reputation on the international stage,” Bibek Banskota told me. “It positioned HRDC as a center of clinical and academic excellence in pediatric orthopedic care.”
Invitations poured in for the authors—Ashok and Bibek Banskota, David Spiegel, Prakash and three other hospital colleagues—to speak at international conferences. (David, a professor at the University of Pennsylvania medical school, has presented more than 400 invited lectures around the world, including in Nepal, Pakistan, Iraq, China, and Mongolia.)
The hospital now is treating nearly 600 clubfoot cases a year. One of them, the four-year-old child in the top photo, showed us her beautiful smile and snow-white cast on our visit this spring.
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AHF continues to be one of HRDC’s largest, most enduring benefactors. After heavy rains last year, for example, we funded construction of a new retaining wall along the hilltop campus.
We stepped up again this spring, replacing USAID funds canceled by the United States government that had been pledged for this new digital x-ray machine.
A follow-up study of the hospital’s Ponseti clubfoot patients contacted for that 2018 paper is getting underway. How are they faring into their twenties and thirties?
David Spiegel is underwriting the project through his endowed chair in Philadelphia— just one measure of how fond he is of HRDC and of AHF for first connecting him with Dr. Banskota in San Francisco nearly 30 years ago.
“HRDC is such a magical place. I’ve come now 28 times. If I didn’t have my life back in Philadelphia, I’d spend the rest of my time on the planet here.”
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Photo credits: Chime Tashi Lama, Tom Hayes