For these people, lack of treatment and equipment often results in a foot which rolls to one side or points downward, not allowing the ankle to remain straight or the heel to touch the ground. Over time the deformity can increase to the point where walking becomes very awkward, tiring and painful.
Many people eventually require canes and are limited to walking short distances.
A brace also prevents an increase of disability by keeping the leg from becoming progressively more deformed. Lack of treatment and equipment for them too often means simply having to crawl everywhere on their hands and knees. Freddy Armel Andre in hospital wheelchair, and crossing the street Most Most disabled persons who are presently forced to crawl on all fours could in fact stand and walk with full-leg braces and crutches. In these cases, there are almost always serious muscle contractures , meaning that surgery followed by multiple casts is almost always necessary. Since in Africa the streets are often unpaved, muddy, and full of people's rubbish, and as bathrooms are in many cases just primitive, dirty outhouses, people who have to crawl clearly have a hard time staying clean.