Why do we focus on Cleft Lip and Palate Surgeries? Well, besides the obvious answer of “it changes a child’s life forever,” cleft operations are a perfect fit for a short term mission trip. A cleft lip repair can take place in as little as 45 minutes. Modern medicine has given us safe anesthesia options, absorbable suture and tissue glue. With this combination, a child can be discharged to home the next day (or possibly the same day), with no need to return for suture removal. There are few post-op complications and little risk of bleeding or infection post op. The waterproof tissue glue, Dermabond*, allows the babies to breast or bottle feed immediately. Some children also have a cleft palate, and we schedule a return visit within a year to repair the palate.
Cleft palate repair can also be accomplished in a short time – as little as ninety minutes. There is more risk of bleeding and more need for IV fluids post op as the child’s mouth is sore and painful, so we schedule these operations early in the week. This affords more healing time before the team leaves. There are always physicians and surgeons in country, but many patients live hours away from medical care, so we prefer to watch them for 48 hours prior to discharge. Remarkably, the palate patients are typically drinking and taking soft food well by post op day 1 or 2. With absorbable sutures, there is no need for suture removal. Ideally, speech therapy is provided prior to discharge (teaching parents techniques to work on at home) and at follow up. Ongoing speech therapy would be even better, but this is rarely an option in the developing world. (If you are a speech therapist interested in helping please reach out!).
I am often asked why the incidence of clefts are higher in other countries than here at home. Truthfully, the incidence is lower in Africa than in the US. The problem is the lack of surgeons and sometimes the expense of surgery. Hence our mission of providing the surgery free of charge and teaching local surgeons.
*Dermabond costs $50 for one single use vial and we can always use a little help to defray those costs. Consider making a Donation.