Giving cleft patients in Nigeria more access to treatment

Birth deformities known as cleft lip and palate happen when a baby’s mouth or lip do not develop normally during pregnancy. “Orofacial Clefts” is the typical term used to describe these birth abnormalities.

A pregnant mother’s exposure to various environmental circumstances, such as what she consumes or drinks, or the medications she takes, might result in cleft formation in addition to her genetic makeup.

Additional variables could be conditions like diabetes, obesity, heavy alcohol or cigarette use, and inadequate nutrition in the mother.

According to the World Health Organisation (WHO), one in every 700 newborns worldwide is born with the illness.

The WHO also stated that African Americans account for one in every 1,200 estimated cases of cleft palate. In Africa, 19,000 cleft babies are born annually, with 12,000 of those babies born in West Africa and 6,000 in Nigeria.

In an interview with the News Agency of Nigeria (NAN), Dr. Akintunde Akintayo, a consultant surgeon with the Plastic and Reconstruction Unit, Department of Surgery, Jos University Teaching (JUTH), stated that clefts frequently result from specific body parts and structures failing to properly fuse together during foetal development. Akintayo claims that a cleft lip is an opening on the lip that occurs at birth, but a palate is an opening in the throat.

“Body tissue and unique cells from each side of the head grow towards the centre of the face throughout pregnancy, joining together to form the face.

An opening in the upper lip is the result of the lip’s tissue not joining completely before birth, which causes cleft lip formation.

The hole in the lip that leads through it and into the nose can be as little as a slit or as large as a hole.

But he promised me the cleft could be healed.

The surgeon cautioned mothers to be cautious about their lifestyle choices during pregnancy, explaining that anyone born with a cleft is likely to have other defects.

“Cleft is inherited and can be passed on from parents to their offspring. That said, there is a treatment for it.

“Since cleft is hereditary and difficult to repair genetically, it is not feasible to create a society completely devoid of the condition, however incidences can be decreased.

“Children with cleft are more likely to have the condition if both parents have it.

Mothers in particular need to look after themselves and refrain from using medications carelessly when they are expecting.

Additionally, we advise cleft-affected couples not to get married since doing so will naturally lower the number of cleft sufferers in our community.

To what extent are people aware of this condition? However, how can cleft victims’ access to treatment be improved? Who is in charge of making sure that access is granted? What part does the government play in stopping the threat? In an effort to comprehend the situation and put a stop to it, these and other inquiries are the ones that immediately spring to mind.

Given the foregoing and concerned about the circumstances, Smile Train, a non-profit organisation based in New York City that was established in 1999, has been offering corrective surgery to kids who have clefts.

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At the moment, it offers free corrective cleft surgery in 87 nations, trains local physicians, and finances the treatments at the hospital with the exclusive goal of promoting 100% free cleft repair surgery and all-encompassing cleft care for children worldwide.

For example, since 2002, Smile Train has provided more than 25,000 free cleft procedures in Nigeria.

Beyond the procedures, its sustainable strategy enables nearby healthcare providers to offer further cleft care in their communities, including speech therapy, orthodontics, and dietary assistance.

Akintayo praised Smile Train for offering free care to individuals with cleft palates, stating that since 2007, the group has funded over 300 complimentary procedures at JUTH.

He claims that victims now have more access to care thanks to Smile Train and other similar companies’ introduction of free treatment.

However, more needs to be done to raise awareness, especially in rural areas.

“Smile Train is doing great in this area, but many victims are still unaware that there is free treatment available.”

Cleft surgery in JUTH costs anywhere from N75,000 to N100,000. These numbers might not seem like much, but for a low-income household, they are significant.

“People in rural communities need to be sufficiently sensitised in this regard, but residents of urban cities like Jos might not know how and where to access free cleft treatment.”

In addition to providing additional information on the disease, Prof. Emmanuel Ameh of the Department of Paediatric Surgery at the National Hospital in Abuja urged the federal and state governments to allocate more funds for the purpose of enhancing the surgical care and treatment of cleft victims.

Ameh claims that the number of people dying because people with medical disorders like cleft palates cannot have surgery keeps rising and that decision-makers, who ought to take this seriously, typically think that surgery is too costly.

He pointed out that treating infectious diseases was frequently given priority by the government above addressing other medical issues.

Politicians have a tendency to overlook the surgical speciality of medicine because they perceive it to be highly costly.

“Infectious diseases are prioritised by governments at all levels over other medical conditions; the COVID-19 pandemic outbreak is a prime example of this.”

Nine out of ten people in low-income nations like Nigeria do not now have access to basic surgical care.

Therefore, greater funding from the government is required for anaesthetic and surgical care.

In addition, he recommended that the government increase access to surgical care for 75% of the populace and 50% of children under the age of 15.

The surgeon also urged the government to guarantee that limitations on the treatment of surgical disorders be eliminated from the National Health Insurance Scheme (NHIS).

Ameh also demanded that the government appoint additional professionals to receive surgical training, especially in the area of life support.

Before receiving therapy, Rhoda Ajiji, who was eligible for free treatment through Smile Train, described her experience.

According to Ajiji, a resident of the Maijuju village in the Jos East Local Government Area of the Plateau, certain members of her community went to great lengths to keep her from receiving medical attention.

“I learned about Smile Train’s free treatment programme at JUTH in 2009.” I heard about it from someone at the village market.

However, after hearing about it, several in my community—including family members—refused to let me receive the treatment.

“I had to hike for two days to get to JUTH for treatment because they warned people driving cars or motorcycles not to pick me up,” the patient said.

Recognising that clefts were a genetic ailment, Rev. Ayuba Asheshe, Secretary General of Evangelical Church Winning All (ECWA), concurred with Akintayo, rejecting the notion held by some that the condition could constitute a spiritual attack on the victims.

Asheshe claims that the Church encourages everyone, regardless of religion, to seek medical attention when necessary and does not discriminate against anyone based on their health.

Today, the majority of churches have built hospitals that serve the medical needs of the broader public, regardless of affiliation with any particular religion or culture, in addition to their own members.

“Thus, the Church does not discriminate based on a person’s health condition, but we encourage our members to seek medical care in addition to prayer when facing any health issue,”

Asheshe pledged to raise awareness of the free treatment options available to those who have cleft lip and palate.

The district head of Riyom, Da Samuel Jok, pledged to aid Smile Train and other pertinent organisations in their efforts to provide assistance to all cleft victims living in remote areas.

Therefore, it is anticipated that incidences of cleft in Nigeria, especially in rural communities, would significantly decline with coordinated efforts by key players in the health sector, as individuals who presently have the condition would have access to Smile Train’s free treatment.

1. Understanding Cleft Lip and Palate: Cleft lip and palate are congenital conditions where a baby’s lip and/or palate do not properly fuse during prenatal development. Various factors, including genetics and maternal lifestyle choices, can contribute to the condition.
2. Prevalence in Nigeria: Nigeria sees a significant number of cleft cases, with 6,000 cleft babies born each year. The condition is more common in West Africa, including Nigeria.
3. Causes and Risk Factors: Maternal lifestyle choices and genetics can contribute to cleft formation. It’s important to raise awareness about the risk factors and encourage mothers to take precautions during pregnancy.
4. The Role of Smile Train: Smile Train, a non-profit organization, has been instrumental in providing free corrective cleft surgery and care in Nigeria. They have made a substantial impact, offering surgeries and supporting local healthcare providers.
5. Need for Awareness: While Smile Train and similar organizations are doing valuable work, there is still a lack of awareness, particularly in rural areas. Many cleft patients and their families are unaware of the available free treatment.
6. Government Involvement: The government plays a crucial role in improving access to care for cleft patients. Increased funding for surgical care, particularly for those who cannot afford it, is essential. This can be achieved through the allocation of resources in the healthcare budget.
7. National Health Insurance Scheme (NHIS): The government should work on eliminating limitations on the treatment of surgical disorders from the NHIS, ensuring that cleft patients can access the care they need through this insurance scheme.
8. Training Healthcare Professionals: To address the shortage of surgical care in the country, the government should invest in training more professionals, particularly in life support and surgical specialties.
9. Community Awareness and Involvement: Communities should be educated about the condition and the available treatments. Local leaders, including religious figures, can play a significant role in spreading awareness and encouraging patients to seek treatment.
10. Coordinated Efforts: A coordinated effort by government, non-profit organizations, healthcare providers, and community leaders can significantly reduce the incidence of cleft lip and palate in Nigeria. This effort should include both surgical procedures and comprehensive care, including speech therapy, orthodontics, and dietary assistance.