Pro-bono surgery comes full circle for West Michigan team

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Dr. Brianna David, Jonathan Khan and Dr. Michael David are all smiles after the procedure to treat Johnathan’s clubfoot. Courtesy Anne Kendra

Through an ongoing partnership between a local physician practice and a nonprofit, a Ghana toddler recently received pro-bono treatment to correct his severely clubbed feet.

Healing the Children Michigan-Ohio collaborated with Foot & Ankle Specialists of West Michigan to begin treating Jonathan Khan last summer, 17 years after his mother, Priya Permaul, received similar life-changing clubfoot treatment in Grand Rapids.

Healing the Children Michigan-Ohio is a nonprofit that helps underserved children throughout the world secure urgent medical assistance they otherwise are unable to obtain. 

Escorted by an American Airlines ambassador, Khan travelled from Ghana to Grand Rapids and was met by his volunteer host parents, Hudsonville residents Carol and Bryan Nyeholt. The same couple hosted Permaul in 2002. 

Six days after Khan’s arrival, doctors Michael and Brianna David began the arduous task of straightening his little feet. Their colleague, Dr. Timothy Hulst, treated Permaul in 2002.

Michael David spent time training directly with Dr. Ignacio Ponseti, a pediatric orthopedist at the University of Iowa, to master the technique used for the toddler. The method of manipulating and remolding the club foot uses a series of plaster casts. After the feet are straightened, a minor surgery is performed to clip the Achilles tendon. Then for three months, the child wears a brace that consists of shoes attached to a bar. After that, a brace is worn at night for four to five years.

This is different than the traditional invasive surgery method to treat clubfoot, which creates scars and forces the foot into a normal position, resulting in stiffness and pain as an adult patient, David said. Compared to traditional corrective surgery, the Ponseti method yields a success rate of greater than 80%, allowing children to function normally, run and play sports.

According to David, clubfoot affects one in 1,000 babies and is the most common congenital condition of the foot and ankle. In about 40% of cases, both feet are affected.

“Treating children with clubfeet is an extremely rewarding experience,” David said. “If I can make an impact on a child's life, improve their daily function and return them to normal physical activity, it will have a major impact on their life.”

Over the years, David has seen most cases resolve the condition without any major surgical intervention. Every year, he treats anywhere from five to 10 patients with clubfoot, some who live in West Michigan and others who come to the U.S. from around the world to seek treatment.

After Khan’s surgery, Carol Nyeholt took Jonathan to the Foot & Ankle Specialists of West Michigan every seven to 10 days for three months. At each visit, the old cast was replaced by a new one. In October, David released Khan’s Achilles tendons and fitted him with a new cast. Three weeks later, he received a pair of shoes connected at the heels by a metal bar.

Since his mother is familiar with the protocol, Khan returned home to Ghana in December 2019, three months early.

“Jonathan is a sweet, fun-loving, super happy kid. He was a joy to have in our home, and we are blessed to have been able to care for him,” said Nyeholt, who has kept in touch with the toddler’s mother over the years. “We didn’t intend to begin a healing legacy when we offered medical care and love to Jonathan’s mom so many years ago, but we’re so very glad we did. Many thanks to all who had a hand in the healing then and now.”

David said he has treated about one patient per year for the past five years through Healing the Children, though the organization has worked with the practice, as well as many others locally, for much longer.

The local Healing the Children chapter’s Stateside Program, which arranges treatment for kids from abroad, has helped 1,200 kids from 63 countries since it was founded in 1984, according to chapter director Helen Salan.

The nonprofit’s medical, surgical and dental teams have served more than 14,000 kids on 136 team trips abroad.

The nonprofit’s Faces for the Future program focuses on support and treatment for needy children in the U.S., mostly locally, who have facial birth defects.

In 2018 alone, Salan said the nonprofit delivered over $3 million worth of care.

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