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A reason to smile

  • Published at 12:13 pm March 17th, 2016
A reason to smile

After surgery for his wide cleft lip deformity, Masudur Rahman was in utter shock. He whispered in disbelief: “I do not recognise myself.”    Masudur Rahman's surgery is one among the 40 surgeries done by the Smile Bangladesh team in CSS Hospital in Tilok, Khulna. This was the 16th charitable surgery mission of Smile Bangladesh, a New Jersey based nonprofit organisation which is committed to provide free cleft surgeries to disadvantaged children and adults living in remote areas of Bangladesh.    The team visits Bangladesh from USA twice a year, the latest being a five day surgery mission in Khulna from March 6-10. The team members comprised of surgeons, anesthetists, residents and nurses. So far, over 1100 people, mostly children have received surgeries that have changed their lives. During each visit the team works with a host organisation who provides operation theatres, collects cleft victims for surgery, conducts prescreening and also ensures post-surgery recuperation care.    It is estimated that there are up to 300,000 children and adults in Bangladesh with unrepaired cleft deformities. Approximately another 30,000 children are born with cleft deformities every year adding to the staggering number. There aren’t enough Bangladeshi surgeons to tackle this massive number of cleft cases, particularly poor patients living in remote areas.    The greatest hurdle for cleft patients in Bangladesh is access to care. Largest number of patients with cleft deformities are from the rural areas of the nation. Many don’t even know that clefts can be repaired; those who do are often unable to access or afford care.    Cleft lip and palate are congenital facial deformities that can be easily repaired. Especifically, cleft lip deformities occur when the muscle and skin of the upper lip do not fuse together properly. Cleft palate deformities occur when the bones and muscle that make up the roof of the mouth do not fuse appropriately. Both deformities create a functional problem, affecting one's ability to eat and develop proper speech. Furthermore, cleft lip deformities have an associated social stigma, due to its facial disfigurement. In traditional cultures such as the one in Bangladesh, children with clefts are often ostracised by their community, resulting in social isolation. Mothers of these children are often blamed as there is a myth that the cleft lips occur if pregnant women cut vegetables and fish during an eclipse.    Babies born with cleft deformities typically require care through their early 20s – adjunctive procedures, such as speech therapy, orthodontics, orthognathic surgery, dental implants, and rhinoplasty are all performed on cleft patients as they develop.    Unfortunately, in Bangladesh, a comprehensive care system for cleft patients does not exist. It is a future goal of Smile Bangladesh to develop a multidisciplinary cleft centre within the country to perform these secondary procedures.    Smile Bangladesh's board of directors include Dr Shahid R. Aziz, president; Dr Samuel T Rhee, vice-president; Dr Jose M Marchena, secretary; Sue Walsh, CRNA, treasurer; Dr Anita Puran, executive director and Christina Rozario, director of Operations.