Page last updated at 14:37 GMT, Wednesday, 20 August 2008 15:37 UK

Superdoctors - one small step

By Diana Hill
Director and series producer of Superdoctors

Steve Mannion and Robert Winston
Steve Mannion divides his time between the UK and working abroad
You could call him the Indiana Jones of surgery. Steve Mannion, an orthopaedic surgeon, has devoted his life to working in far-flung and under-resourced corners of the world.

"Part of my reason for going into medicine was to work overseas. I was a bit of an adventurer. As a student, I did an elective on the Afghan-Pakistan border."

His sense of adventure led him into working as a trauma and war surgeon for the Red Cross and medical aid agency Medecins Sans Frontiers.

Nowadays, Mr Mannion spends two weeks of every month at his job in Blackpool; and the other two weeks working for charities in countries like Papua New Guinea and Sierra Leone.

He features in the last film in a three-part series called SuperDoctors which looks at the progress being made in medicine.


The first two programmes focus on high-tech medicine in the form of surgical robots and costly stem cell therapy.

In contrast, presenter Robert Winston follows the surgeon to Malawi, one of the poorest countries on earth where the life expectancy is around 40 years.

Mr Mannion's human ingenuity in treating people in places that have no technology or money has seen him cross over a medical frontier.

"It may not immediately be apparent that working in war zones or developing countries is somewhere you can push back medical frontiers or be very innovative, but I feel it's even more important in these situations," he said.

Steve Mannion and patient
The surgeon believes you can push the boundaries of medicine in poor countries

He maintains his mantra that "necessity is the mother of invention."

Around Malawi, the surgeon has several clinics for children and adults with clubfeet.

Like Britain, somewhere between one to two children per 1,000 are born with this deformity.

Until recently the treatment in Britain has been extensive surgery, and when the treated child grows up they are often still in pain and scarred from the procedure.

In Malawi, however, Mr Mannion was one of only two surgeons for seven million people in the northern area of the country.


To keep up with demand, he had to come up with a new and non-surgical solution which he could train staff in the country to perform as well.

The surgeon found a little known and scarcely used physiotherapy treatment, called the Ponseti treatment, which proved to be successful.

It involves gentle manipulation of the bones and stretching of the skin through casting, followed by the child wearing a particular type of boots.

Quickly Mr Mannion spread the practice through clinics all over the country and soon evidence based on hundreds of cases showed that the treatment was excellent.

Not only that - it was better than the British treatment of surgery. He had stumbled across something big.

The programme follows the Ponseti treatment - both in Africa and Britain - and tells the story of Steve's struggle to overcome deep-set traditions and practices to eventually cross a new medical frontier.

Yet, for the cost of one advanced surgical robot - around 12 million - a quarter of a million children can be treated and given the ability to walk again.

Unlike expensive high-tech surgery, Mr Mannion found a simple solution within the reach of more than a small percentage of the world's population.

The first of three Superdoctors programmes in the series is scheduled to run on Thursday 21 August on BBC One at 2100BST.

Has China's housing bubble burst?
How the world's oldest clove tree defied an empire
Why Royal Ballet principal Sergei Polunin quit


Americas Africa Europe Middle East South Asia Asia Pacific