Cleft Surgery’s Role in Nutrition

Three-month-old Alham (left) shortly before her Smile Train surgery and five-month-old Alham two months after. Alham's story highlights the need for cleft surgery in order to obtain proper nutrition.

Three-month-old Alham (left) shortly before her Smile Train surgery and five-month-old Alham two months after. Alham’s story highlights the need for cleft surgery in order to obtain proper nutrition.

Tanga, TanzaniaIn honor of National Nutrition Month, Smile Train shares a story from Tanzania highlighting the role that timely cleft surgery plays in preventing malnutrition.

When Ahlam was born in rural Tanzania with a cleft lip and palate, her mother Salha, like so many mothers of Smile Train patients, did not know about the common birth defect. Salha’s first two children had been born without incident and perfectly healthy.

Salha and her five-month-old daughter Ahlam pose three months after Ahlam's cleft surgery. Ahlam's health and appearance have vastly improved thanks to her cleft surgery that has allowed her to eat properly.

Salha and her five-month-old daughter Ahlam pose three months after Ahlam’s cleft surgery. Ahlam’s health and appearance have vastly improved thanks to her cleft surgery that has allowed her to eat properly.

Luckily, shortly after Ahlam’s birth, the family was told about Smile Train and that the organization provided free care for thousands of children like Ahlam. The newborn girl would have to wait until she was three months old for surgery though.

During that time life for Salha was difficult. She had no problem feeding her other children, but Ahlam was different because of her cleft. Milk came out of Ahlam’s mouth and nose because she could not suck like a normal infant. With a large gap in her lip and at the roof of her mouth, feeding Ahlam was almost impossible.

Although surgery was a short time away, Salha worried her daughter would not make it. She was not steadily gaining weight and was becoming sick. Despite this, Ahlam’s surgery day came and weighed just enough to go through with surgery.Now at five months old, only two months after her cleft lip surgery, Ahlam’s appearance and health bear no resemblance to the baby girl who entered the hospital for cleft surgery. Not only does she have a new smile, but she has the chubby cheeks of other children her age. The difference is remarkable.

In four months Ahlam will undergo another surgery to correct her cleft palate, which should help her nutrition further as food can still escape through the roof of her mouth. Salha is also looking forward to her daughter’s next surgery and feels this will improve her health even more.

Salha is very grateful for the Smile Train surgery and is happy that her child will have a normal and healthy life.

___

To help mothers like Salha, Smile Train developed the following resource video demonstrating the best feeding methods for a child with cleft.

Patience Rewarded With New Smiles

Dr. Ashraf with a group of Smile Train patients from Djibouti after their free cleft surgeries.

Dr. Ashraf with a group of Smile Train patients from Djibouti after their free cleft surgeries.

Djibouti, Djibouti— When Smile Train East Africa Manager, Dr. Esther Njoroge visited Djibouti in February, she was not sure what to find. The tiny country’s lone Smile Train partner Al Rahma Hospital had been dormant for almost two years. Determined to revive the hospital’s Smile Train program, Dr. Njoroge decided she needed to visit the partner. This would be her first visit and what she found more than pleasantly surprised her.

When Dr. Njoroge arrived at Al Rahma Hospital located in Djibouti’s capital, also named Djibouti, she was met by a very warm and welcoming staff, as well as an impeccable hospital serving the poor community of the country. Located on the Horn of Africa neighboring Somalia to the southeast and Ethiopia to the southwest, Djibouti is one of the smallest countries in the world. Of its population of 900,000, 40 percent live on less than two dollars per day.

During the time that Dr. Njoroge had thought the hospital had suspended their Smile Train program, the staff had actually mobilized 45 cleft patients to receive free Smile Train surgeries. For a country with little more than 20 estimated cleft births each year, this was an impressive total.  “What do we do with these patients?” the staff asked. Their previous surgeon had left, but the staff at the hospital knew they needed to help these patients.

Dr. Njoroge quickly got in touch with an Egyptian surgeon living and working in Kenya, Dr. Ashraf Emarah. He agreed to not only visit to provide cleft surgery, but also provide cleft surgery training to another surgeon at the hospital eager to learn. On March 15th, less than a month after Dr. Njoroge called him, Dr. Ashraf made his way to Djibouti. During his two-week stay each one of the 45 cleft patients who had been waiting received free surgery, plus another, for a total of 46 new smiles!

Courage to Face the World: Elphas Sifuna

Nairobi, Kenya — When Dr. Sylvia Noah met Elphas Sifuna, she met a boy who hid behind an over-sized hat and a large, brown trench coat with a popped collar to cover his mouth. As Dr. Noah spoke to his guardian, Elphas quietly stared at the floor trying not to be noticed. He refused to take off his hat.

Smile Train patient Elphas Sifuna before and after free cleft lip surgery. Courage

“He was a loner and did not have any friends. He had not started school because of his cleft lip.”

As the screening progressed, Elphas whispered a question: he wanted to know if his cleft lip would be repaired and if he would be allowed to start school. Dr. Noah soon learned that Elphas “was a loner and did not have any friends. He had not started school because of his cleft lip. He was a shy boy who would not look you in the eye or talk comfortably unless he had his hat on.”

Luckily, a social worker found him and 11 other children with cleft and arranged for them to be screened for cleft surgery at Smile Train partner hospital Gertrude’s Children’s Hospital. The morning after his screening, Elphas received free cleft lip surgery and awoke from anesthesia a new child.

When he looked at himself in the mirror he was so pleased he could not help smiling. He came to the clinic before travelling home, without his hat or coat on and told me he was going to school. He had a sparkle in his eye, a bounce in his step and courage to face the world.”
—Dr. Sylvia Noah

Thanks to a network of compassionate people, most of whom he will never know, Elphas has been given a new chance at a normal life. By all accounts, he is determined to make the most of this gift.