‘When they come here you can see they have no hope. But when they leave it makes me happy to see the smiles on their faces.”

This is how Dr Unathi Ngonono describes the joy of helping children to walk again. Ngonono is an orthopaedic surgeon and part of a team of doctors at Bedford Orthopaedic Hospital in Mthatha who has quietly been working to restore the gift of walking for 40 children in the Eastern Cape.

“Our patients were hopeless. In many cases, they had no hope that it would work. So it is lovely to see a smile on the children’s faces.” The children all suffer from Blount’s disease, a condition that causes outward bowing of the lower limbs at the knee. “It can occur at the early ages of life just after two years or sometimes later, around 10 years,” Ngonono explained. Ngonono, originally from Flagstaff in the Eastern Cape, trained in Cuba and at the University of the Free State. He has been leading the outreach to the Eastern Cape’s rural areas to find children they can help. He said that when he had finished his initial training as a doctor he returned home to Holy Cross Hospital to “give back to his community”.

Children with Blount’s disease at the hospital. Dr Unathi Ngonono says many children with the disease are bullied at school and stop going, but once he and his team have fixed their legs they return. (Photo: Hoseya Jubase)

But Ngonono isn’t done yet. Now he wants to make sure that all the children with Blount’s disease in the Eastern Cape at least get a chance to be helped. “We want those cases to at least be known,” he said, adding that children who are affected must be taken to their nearest hospital so that they can be sent to Bedford for treatment. Ngonono said they set aside time on a Friday for older children. “If they need an operation we will schedule it… so that their schooling isn’t interrupted,” he said. “For a diagnosis, you need to rule out rickets [caused by a vitamin D shortage], physiological bowing and other causes,” he explained. “This is done through the use of X-rays.” Ngonono added that they are also redoing surgeries that failed. “We are trying to restore the dignity, confidence and good quality of life for affected children.” He said they have had more than 40 successful cases and some are still in progress. “The duration of these procedures and hospital stay is determined by the severity of the condition.” Ngonono added that they are looking for more patients to help in the Eastern Cape’s urban areas.

Nurses with children affected by Blount’s disease at Bedford Orthopaedic Hospital in Mthatha, Eastern Cape, on 7 February 2024. (Photo: Hoseya Jubase)

“The earlier we find them the better for us. The difficulties we have are often with the older children. The young ones are easy to correct,” he said. Although the journey for patients and doctors is a long one that involves a number of surgeries, Ngonono said it is worth it. Some patients need a number of procedures, as the doctors first fix the bones to make the leg straight and then fix the joints, and then they need to direct growth.

What helped me through is that I do believe this is going to work. The pain will be worth it.

“We have a very high success rate. Two patients will be discharged today. “These kids are bullied at school and called names by their friends. It makes them lose their focus and concentration at school. Many will stop going to school, but once we have fixed their legs, they go back. The teachers everywhere are very excited about our programme and support us everywhere,” he said.

Children with Blount’s disease at Bedford Orthopaedic Hospital in Mthatha on 7 February 2024. (Photo: Hoseya Jubase)

One of Ngonono’s patients who will be going home this week is 13 years old and has had several failed operations to correct her legs. “This is the fourth time that I am in hospital for my legs. The first two times we had to go to Durban. This will be the last time. If this is a success my life will go back to normal. I will be able to travel and I will go back to school. I couldn’t walk before,” the young patient said. Read more in Daily Maverick: Stitching up the gaps: The vision of a paediatric surgeon determined to expand care to rural South Africa She spent her December holidays in hospital and had her surgery just after her last exam in 2023, but remains in hospital. “My school has organised a catch-up plan and a family member brings me my schoolwork. “What helped me through is that I do believe this is going to work. The pain will be worth it,” she said. DM This story first appeared in our weekly Daily Maverick 168 newspaper, which is available countrywide for R29.