Adika, a happy baby, is unable to see what we can. Despite her inability, she smiles as British medical professionals examine her cleft lip and palate, which she was born with. If this condition remains untreated, it could cause major issues, affecting not just Adika’s appearance but also her speech, eating, teeth, and even hearing. Globally, around 200,000 babies are born with cleft lips or palates each year. Fortunately, Adika will be one of the fortunate ones. Thanks to the support provided by UK charity CLEFT – Bridging the Gap to local physicians in Bangladesh, she will receive top-notch surgical treatment and care.
Did you know that one in every 700 babies is born with a cleft? This means that on average, there will be at least one child with a cleft in every school. While most clefts are less severe than Adika’s, those born in countries with good health services like the UK can have their clefts fully repaired before their first birthday, and their scars may not even be noticeable to their schoolmates. However, in Bangladesh, where 6,000 to 7,000 babies are born with clefts every year, the situation is very different. Shockingly, one in three babies do not receive any surgery, and those who do often have “bad repairs” from inexperienced surgeons, making it difficult for them to get through life without extra help. Fortunately, a plastic surgery unit in Dhaka is now working with a team of UK medics to change this.
Two years ago, the Sheikh Hasina National Institute of Burn and Plastic Surgery introduced a 500-bed facility that houses a comprehensive cleft center in partnership with CLEFT. Parents from the farthest corners of Bangladesh travel up to 12 hours for an appointment. It is a shocking experience for parents of babies born with clefts, but unfortunately, mothers in Bangladesh are often held responsible for this condition. For instance, when Abdur Rahman was born with a severe cleft affecting his left eye, neighbors deemed it a curse on the family. Sadly, almost every family in Bangladesh shares this experience since there is a widespread superstition that pregnant mothers can harm their unborn babies by doing certain things during an eclipse.
According to a belief, if a baby is born with a cleft, it is because the mother chopped food during an eclipse while cooking. Lysha Yasmin, who is a mother of a child named Abdur, remembers the birth and how she had a difficult time accepting her baby due to the community’s negative beliefs. They believed that it was a curse and blamed her for cutting something during the eclipse. Abdur has undergone two operations and his cleft has been closed, though his eye has not developed properly. In the future, he may be able to get an artificial eye. Lysha is now overjoyed and cannot express how happy she is.
Sumaiya, a 20-year-old mother, has made a 12-hour boat journey with her one-year-old son, Saim, to attend an appointment. She recalls how hard it was for her when Saim was born and how her husband did not support her. He blamed her for their child’s cleft and accused her of performing household chores during an eclipse. In response to this issue, CLEFT, a British charity, was established in 2007 as an alternative to larger charities that focus on finding quick fixes to the problem. The organization aims to provide sustainable solutions by either training local surgeons or bringing in Western doctors to perform the necessary operations.
The cleft center in Dhaka, which provides free treatment to patients, was established by Brian Sommerlad, an Australian plastic surgeon who dedicated his career to fixing clefts both in the NHS and abroad. Over the last 23 years, Sommerlad and his team have been working with other cleft specialists to export the best practices of the NHS to places around the world that need it the most. Despite the current obstacles, the NHS remains committed to providing the best available treatment to everyone for free. The goal of the cleft center in Dhaka is to equip and train local surgeons and specialists so that they can provide long-term care to patients who need more than just one operation. These patients require several surgeries, as well as speech therapy, audiology, and dental care. Simply paying someone to repair a cleft or bringing in a specialist from another location is not enough to address the needs of these patients.
Organizing the necessary facilities and training for the Bangladeshi people is more important than arranging it from London. Brian’s Cork, whom I happen to know because he is my father, has spent the last 15 years travelling the world after retiring from the NHS. My editors have given me the opportunity to see why he does it. It takes around 15 to 20 years to train a surgeon skilled enough to handle cleft cases, and even more for the most complex ones. Brian has visited Dhaka 26 times in the past two decades and has become an “adopted son” to Bangladeshi plastic surgeon Rabiul Karim Khan, also known as Papon. Together with other specialists, they are bringing hope to those born with clefts. The center repaired 264 clefts last year, with Papon personally operating on 104 of them.
According to Brian, they deal with a large backlog of complex cases involving craniofacial clefts that extend beyond the lip and palate in Bangladesh. These cases require multiple surgeries and long-term care. In his trips to Bangladesh, Brian has personally seen 125 of these cases, which are more common in this country than in the UK where surgeons may only encounter two or three in their entire career. To support research into these cases, their team of eight from London and Cambridge, including plastic surgeons, speech and language therapists, an orthodontist, a hearing expert, and a specialist cleft nurse, have all taken unpaid leave to travel to Dhaka with CLEFT.
While they cannot help everyone, the medical staff at a Bangladeshi unit are providing free medical care to families who would have otherwise only had access to expensive private treatment. Despite their efforts, some families refuse treatment, such as the parents of a severely malnourished baby who will likely die. However, most families are grateful for the opportunity to receive high-quality care. The organization CLEFT, supported by Bangladeshi-born British artist Rana Begum, has raised funds through donations and auctions to support the unit. Begum was inspired to help after speaking with a friend who had a cleft and seeing the importance of aftercare. She praised the high standards and full care provided by the unit, emphasizing the importance of such care for patients.