Feet First Worldwide - The Lytham medics changing lives in the Third World

PUBLISHED: 12:29 09 November 2011 | UPDATED: 20:15 20 February 2013

Feet First Worldwide - The Lytham medics changing lives in the Third World

Feet First Worldwide - The Lytham medics changing lives in the Third World

A group of passionate medics from Lancashire have been changing lives in the Third World. Photographer Paul Canning accompanied them

Id never been to Africa before and it turned out to be a humbling experience, a real eye-opener. I was travelling with a group of medics from the Blackpool and Fylde areas orthopaedic consultant Steve Mannion, consultant anaesthetist Simon Mills, senior orthopaedic theatre sister Bernadette Huyton and radiographer Daniella Baldwin.


Steve founded the Feet First Worldwide charity in 2004 with the aim of treating and preventing disabilities in children worldwide. He and his team work in developing countries such as Malawi, Laos, Ethiopia and Papua New Guinea treating children and adults. Steve works part-time for the NHS in a job-share post at Blackpool Victoria Hospital in addition to working at Spire Fylde Coast Hospital.


This means he can visit poor countries such as Malawi three or four times a year. Here, he not only operates on disabled children, but also undertakes vital orthopaedic procedures and training for local medics.

One of the most common musculo-skeletal conditions they treat is club foot. Around 500 children are born with this condition in Malawi every year and there are approximately 5,000 children awaiting life-changing treatment. The capital, Lilongwe, has just one orthopaedic surgeon in a country with a population of 14 million.

Children born with club foot should be treated in the first year of life, says Steve. If not, then the deformity becomes fixed and needs a complex operation to correct it. Untreated, the child cannot walk, cannot wear normal shoes and cannot go to school.

Up to the age of one, treatment is by whats known as the Ponseti method, which involves manipulation followed by casting at regular intervals. Crucially, it can be undertaken by nurses, medical assistants and physiotherapists rather than surgeons. However, older children must have intricate and complex operations by surgeons such as Steve.

In June I travelled to Malawi in central south eastern Africa with Steve and his team. We started in the hospitals of Lilongwe and I was shocked by the number of children with limb deformities and others with horrendous burns caused by unprotected road-side fires.

But as my photographs show, some children still had time to give me a smile although there were a few tears as they awaited operations. These frightened children were given a comforting hand of reassurance.

Many Malawians are very poor and will walk for hours or even days to get to hospital to see Steve and his team. Once there, they wait patiently, hour after hour, until they are seen and treated. Typically, the whole family travels with them and they all pitch up in the hospital grounds where everything from cooking, washing, cleaning and sleeping is undertaken.

They arrive at hospital frequently exhausted with some just crashing out on the grass outside the hospital entrance until it is their turn to be seen. It all seemed so primitive, but wonderful to be surrounded by your whole family prior to surgery, during recovery and for recuperation. Its very different to the lonely elderly patients found on NHS wards in the UK today, with no family around them.


The team found the lack of post-operative pain relief shocking and quite upsetting. Limited analgesia was available, and what there was wasnt necessarily administered as we would do in this country which was very frustrating to observe.


We travelled for several hours to the north of the country to Rumphi Hospital. Due to their limited funds, the resident medical teams has to improvise with the equipment available. For example, traction means using an old iron weight or even a brick hanging from a string a far cry from the sophisticated equipment used here.

A kettle was used as part of the surgical equipment sterilisation process - surgical tools were actually put inside the kettle and left in the boiling water. The sinks were filthy, they just dont have the time or the facilities to maintain the levels of hygiene that are essential in our country.

Elsewhere, I spotted an ambulance created from an old motorbike with a dirty tray attached to a side-car. It was heart-warming to see how innovative these people could be and their continual determination to overcome adversity.

A young teenager was wheeled out on a trolley into the recovery area following surgery to repair his broken left ankle. Recovery proved to be a communal corridor, not a designated, fully-equipped, supervised enclosed area. Life-changing and life-saving operations were being conducted before my eyes I felt very humbled.

An elderly lady sat dignified and motionless on the operating table, she neither winced nor uttered a sound as an epidural was administered. Her grotesque leg injury was caused by a dog bite, which had to be cleaned before a painstaking skin graft. The composure these wonderful people show is astounding, they just calmly deal with each situation as it arises.

Malawi has a low life expectancy of around 50 and a high infant mortality rate. I lost count of the number of coffin shops in every town and village we passed through. HIV and AIDS are very prevalent and there is a high risk of diseases such as malaria, rabies, typhoid fever and hepatitis A to name but a few. Malawi is among the least developed and most densely populated countries in the world. Its economy is based on agriculture - farming with cattle and goats and producing tobacco, cotton, sugar cane, tea and potatoes.


Despite the adversity, Malawians are not melancholy people. On the contrary, they are friendly, inquisitive and welcoming, making the most of what they have. In the hospitals, clinics and wards I always got a handshake and a smile. I now know why they call Malawi the warm heart of Africa. To experience Malawi is very special and leaves you with a strong desire to return. We could surely learn a thing or two from them about family love and support and their capacity to overcome adversity.

Focus on Paul

Paul Canning has been a professional photographer and instructor for over 26 years. His work includes commercial, industrial, weddings, portraiture, forensic, medical, landscape and worldwide travel. He spent 15 years working for the Metropolitan Police forensics team working on high profile investigations such as the Rachel Nickel and Jill Dando murders. He is also the author of Historic Lakeland.

Paul now runs his own business, PhotoNotion, (www.photonotion.co.uk), and is based in Preesall on the Fylde. He can be contacted on 07753 289 852 / 01253 811032 or via email on photonotion@btinternet.com.



You can help

Steve Mannion featured in the BBC documentary Super Doctors with Lord Winston. He is supported by Feet First Worldwides trustees as well as local people. Please support this inspiring charity funds are desperately needed. All the work is done by volunteers and 100% of funds raised are used directly for the purpose of the charity. Money raised will ensure that more children are able to grow up leading normal lives, more adults will have life changing surgery and the essential work of Feet First can continue. It can be contacted through www.feetfirstworldwide.com and by emailing info@feetfirstworldwide.org





The print version of this article appeared in the November 2011 issue of Lancashire Life

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