Free surgeries fight cleft lip 'curse'

When Josyline Nekesa from Kwanza, Kitale County gave birth, she was at pains to explain what was wrong with the newborn’s mouth to her husband. Their son was born with a cleft lip, and even though cleft lip and palate is one of the most common congenital malformations, affecting one in every 700 newborns in Kenya, they did not understand it. Neither could they afford Sh100,000 for corrective surgery.

However, a free surgical camp at the Kapenguria County Referral Hospital in West Pokot County, has given them and their nine-month-old son a reason to smile. The camp held last month saw more than 50 patients with cleft lip and cleft palate get corrective surgery. It was organised by the county government and conducted by a team of 11 doctors from the Kenyatta National Referral Hospital, under the sponsorship of Cleft Kinder Hilfe (from Germany) and the Kenya Society of Plastic, Reconstructive and Aesthetic surgeons.

Many residents rely on such camps because they can’t afford to pay for the surgery, which is considered cosmetic. Moreover, the surgeons who can perform the corrective surgeries are located in urban areas, meaning that families like Nekesa’s are too far from help. They live isolated and stigmatised, and their children are hidden from public view.

“We have to create awareness that this is a medical condition that can be corrected when children are still young. It is not a curse,” says Dr David Karori, the deputy medical superintendent at the Kapenguria County Referral Hospital, noting that many parents consider the surgery risky and opt to leave the children as they are.

Causes of the malformation are not well understood, but research has shown that taking folic acid during early pregnancy can reduce the risk.

“We advise mothers to take a lot of greens,” says Dr Karori, noting that poor diet and poor health are risk factors. The malformation can also be a result of drug abuse or smoking. It could also be genetic.

“We advise expectant mothers to only use medications if prescribed by qualified physicians,” the medic adds.

Corrective surgery for cleft lip is done on children who are 10 months old, weighing four to five kilogrammes, while for cleft palate, surgery is done when the child is a year old and healthy.

West Pokot Governor Prof John Lonyangapuo called on residents to register at health centres to help with collection of accurate data on the condition for planning purposes. He added that the county would sponsor training for specialists to perform the surgeries.

“Many children are hidden, condemned, abandoned or killed at birth, while others get bullied and called names,” he said, and asked residents not to abandon those affected by the disease. He also urged leaders to mobilise residents to take advantage of free surgeries.

“Children who have not undergone corrective surgery don’t go to school, and adults with the condition can’t work because of ridicule. This perpetuates the problem of poverty,” said Prof Lonyangapuo.