Shiva's cheeky smile doesn't hint at the immense hardship he's already faced in life - but it's impossible to miss the tenacity of this 8-year-old boy as he races past with leather knee orthoses strapped to his bowed legs.
Born with a condition known as multiple epiphyseal dysplasia resulting in bowlegs, Shiva lives in a cramped one-room house with his parents and sister in a remote Nepalese village.
Although his condition was evident from birth, Shiva never received medical attention, partly due to the remoteness of their home but also because his father Tanka believed a family history of orthopaedic conditions meant that nothing could be done. Tanka has 'windswept' condition, his mother Goma has cerebral palsy and Shiva's sister Himali also has mild bowlegs.
Shiva learned to walk by the age of 3 but his awkward swaying gait caused pain in his knees and ankles. Because of this, his parents have to carry Shiva 30-minutes to school - a slow and difficult exercise, given their own physical struggles.
When Shiva's parents eventually did seek out medical advice, they quickly realised it was impossible to save the money needed for surgery. Tanka struggles to make ends meet as it is, earning only $2 a day as a goat farmer.
"The doctor advised that a surgery was needed for both children and their legs would become straight after a couple of years," Tanka said. "But we didn’t have money for a treatment like that."
With tears in her eyes, Goma said she was heartbroken that her son was teased and bullied for the way he looks.
“Shiva often returns home crying. Children mimic his way of walking, and never allow him to play with them," she said.
However, one day Tanka was listening to the radio and heard that a CBM-supported outreach camp was going to be in the area.
“I thought this was the opportunity I was always waiting for. I was full of hope that my children would get treatment,” Tanka said.
When CBM workers first visited Shiva's village, they found a sad little boy sitting on the step watching the other children play ball games. He walked with a distinct waddle and people stared as he passed by.
"I like to play football. But they don't allow me to play with them," Shiva said, dropping his head. "I wish I had straight legs … I wish I could run and play with my friends."
After a 10-minute assessment, the health worker determined that, while Shiva's legs were a severe case, he was confident that surgery would work. Himali's legs would also be treated. And in further good news for Tanka and Goma - CBM would pay all the expenses!
Soon after, doctors operated on Himali's legs and fitted 8 plates in Shiva's legs, designed to stop the bones growing on one side while the other side grew naturally. Doctors reported that the surgery went well but warned it was a slow process and it could be up to a year before Shiva saw any external improvement.
But within 3-months the doctor was pleased to note that the changes were already visible. Himali's legs had straightened nicely and Shiva was looking promising too.
At a home visit 11 months after surgery, the dramatic change to Shiva's life was clear. He was walking without pain and, thankfully for his parents, no longer needed to be carried to school. That day at lunchtime, Shiva laughed as he ran around the playground, chasing a football with his friends. On the walk home from school, he was asked whether he was worn out or had pain in his legs.
"No I'm not tired," Shiva said, flashing a big smile. "I like to play football."