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Patient with cleft lip: An Inside Story


A cleft lip is a physical split or separation of the two sides of the upper lip and appears as a narrow opening or gap in the skin of the upper lip. In most cases, the cause of cleft lip and cleft palate is unknown. These conditions cannot be prevented. Most scientists believe clefts are due to a combination of genetic and environmental factors.

What Problems Are Associated With Cleft Lip and/or Palate?

  • Eating problems.
  • Ear infections/hearing loss.
  • Speech problems.
  • Dental problems
  • social stigma

Who Treats Children With Cleft Lip and/or Palate?

Due to the number of oral health and medical problems associated with a cleft lip or cleft palate, a team of doctors and other specialists is usually involved in the care of these children. Members of a cleft lip and palate team typically include:

  • Plastic/ Maxillofacial surgeon to evaluate and perform necessary surgeries on the lip and/or palate
  • An otolaryngologist (an ear, nose, and throat doctor) to evaluate hearing problems and consider treatment options for hearing problems
  • An oral surgeon to reposition segments of the upper jaw when needed, to improve function and appearance and to repair the cleft of the gum
  • An orthodontist to straighten and reposition teeth
  • A dentist to perform routine dental care
  • A prosthodontist to make artificial teeth and dental appliances to improve the appearance and to meet functional requirements for eating and speaking
  • A speech pathologist to assess speech and feeding problems
  • A speech therapist to work with the child to improve speech
  • An audiologist (a specialist in communication disorders stemming from a hearing impairment); to assess and monitor hearing
  • A nurse coordinator to provide ongoing supervision of the child’s health
  • A social worker/psychologist to support the family and assess any adjustment problems
  • A geneticist

Ghana Inside Story:

In Ghana, people are dedicated and committed to transforming the lives of these patients with facial clefts and slowly the team of specialist are growing strongly. These team can be found in Komfo Anokye Teaching Hospital, kumasi every wednesday afternoon at the maxillofacial unit and in Korlebu teaching hospital Accra at the plastic surgery unit. And there alot of NGOs out there, ready to reach out and support.

On July 30, 2016 Professor Peter Donkor, President, Ghana Cleft Foundation, called for a national dialogue to develop a coherent approach to manage Cleft Lip and Palate (CLP) condition. The conference brought together Ghanaian experts and Non governmental Organisations to network, share ideas, advocate for quality care, develop public education strategies and collaborate for the benefit patients. He called for the creation of a national association to be called “Ghana Cleft Palate/Craniofacial Association(GHACPA)” to provide leadership and united voice on cleft issues.

On 10-14 October 2016 I was privileged to be part of a team that transformed 144 lives with free surgeries in Tamale Teaching Hospital on the Operation smile NGO platform and here is a story of one of our patients we all consider to have an awesome story. I assisted the surgeon during the transformation and the anesthesiologist on the team Clive Duke put up a summary of her story on his facebook post, I will share below:

“I need to tell you the story of this beautiful, happy little 2 year old girl that we operated on today (13th October) here in Tamale, Ghana. One of the most powerful stories I’ve heard or been involved with in any of my 10 Operation Smile missions to date.


Afia was born a twin and when her parents and community saw her, they wanted nothing to do with her and, in fact wanted to kill her because of her cleft but they were told that they would be reported to the police if they committed murder. So she was left in a room to starve to death whilst her parents fed her twin brother normally. That’s when Sabrina, our Op Smile regional director found her, aged 3 months old.

Afia when found emaciated aged 3 months
Afia at a previous mission when she did not receive surgery because of illness

This is the reality of the stigma and superstitions held by many communities in Africa and the Far East, thinking that god had abandoned them and that they had done something terribly wrong.

After hours of work by our Op Smile team in Ghana, they were persuaded to feed her up and let us operate. Unfortunately, she has been cancelled from 3 missions over the past year because of pneumonia and anaemia (due to malnourishment). She should, by rights have not had her operation this week because she is still severely anaemic but the parents said that if she did not get surgery on this occasion then they would not return again and Afia would not be fed. So, knowing what the alternative would be, she was scheduled for surgery and was given a blood transfusion earlier in the week making surgery possible. We have just finished operating.

Sabrina, our Op Smile Regional Manager who found Afia, happy and emotional after surgery


I have just taken Afia into recovery and into the arms of her mother who started smiling broadly. All who were watching had a huge smile and a tear in our eyes as we had the strong feeling that a life had just been saved.

Afia and her twin brother
Mum seeing Afia in recovery straight after surgery

I started today tired, having lost my mojo. I now feel proud of our Operation Smile team and, dare I say it, a little proud of my contribution in helping Afia. She still needs further surgery but the future is there for her now.” – Clive’s Post

There are numerous stories out there and so many people to reach out to. I am also proud to be part of these missions changing lives one smile at a time. So please lets stop the stigma and support those helping and let the patients with facial cleft know there is hope for them even in Ghana. Its Teethlicious Tuesday, Stay Gorgeous & Stay Professional.


Photo Credit: Clive Duke 


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