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Have you tried to clean the doc in word? I too would recommend toxaris tools, but if you have an old word, you could do many things by hand. I assume the author used direct formating since otherwise the word output shouldn't be that messy.
If we are talking about a simple novel, you could just assign correct styles. Use words search and replace to mark headers and the few special cases then select all and give it the normal style. Now style the marked paragraphs. The word output should now be pretty good, remaining things are then easily corrected with sigil/calibre and search and replace.
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