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Smiles for Africa

Online since 4.10.2017 • Filed under Feature • From Issue Fifteen - October to December 2017 page(s) 22-23
Smiles for Africa

What is a cleft lip or cleft palate? How do they develop, what causes them, and can they be prevented? Emma Dawson gets some myth-busting information about clefts from Sean Robs on at Operation Smile.

According to Sean Robson at Operation Smile, one in 700 children in South Africa is born with a cleft lip and/or palate; and worldwide, a child is born every three minutes with a cleft lip and/or palate. It is an extremely common birth defect that affects children regardless of their socio-economic background or race. And sadly, babies born with clefts have twice the odds of dying before celebrating their first birthdays.

What is a cleft?

A cleft is a gap in the mouth or palate that didn’t close during the early stages of pregnancy. ‘Sometimes a cleft condition can be easy to see because it’s an opening in the lip whereas, other times, it’s harder to tell if someone has a cleft because it’s an opening in the roof of their mouth (called the palate),’ Sean explains. The surgery to repair a cleft lip can take as little as 45 minutes while a cleft palate may take longer.

 What causes clefts?

‘There are many risk factors that can increase the likelihood of birth defects. While some causes are still unknown, genetics and family history, pre-existing medical conditions, poor nutrition, and exposure to harmful environmental substances can affect the healthy development of a baby. As a result, these factors could also be the cause of a baby born with a cleft lip or cleft palate,’ Sean points out.

‘Researchers continue to figure out all the genes involved in the formation of a cleft condition and the interaction of these genes with the environment, hoping to avoid clefts from happening someday. For example, the protective effect of taking folic acid supplements during pregnancy in other conditions such as spina bifida has been documented, but attempts to prove the same protective effect for cleft conditions has remained inconsistent until recently,’ Sean adds.

What are the dangers associated with clefts?

Babies born with a cleft lip and/or palate often have difficulties feeding, which in some parts of the world can lead to malnutrition or even starvation. Ear infections can occur, and recurring ear infections can lead to hearing loss. Dental development can be affected. Speech and language development can also be impaired. Children may also suffer from bullying and social isolation.

Help at hand

‘With surgery, a child suffering from a cleft lip or cleft palate can have a brand-new, beautiful smile. In an ideal situation, a pediatrician and a plastic surgeon work with a child’s parents soon after the child’s birth to choose the best timing for surgery. Most surgeons agree that a cleft lip should be repaired by the time a baby is three months’ old, and that a cleft palate should be repaired between the ages of 12 and 18 months,’ Sean explains.

And for those who can’t afford it, there is also help available. Operation Smile South Africa provides free surgeries to repair cleft lip and/or palate and other facial deformities. Operating in South Africa since 2006, Operation Smile is dedicated to finding families affected by cleft lip and/or palate and providing them with surgery so they can live happy, healthy lives.

Siyabonga’s story

When Siyabonga was handed to his mother, Athalia, shortly after his birth, she admits to being scared by his appearance. Siyabonga was born with a cleft lip and Athalia had never seen anything like it before.

Fortunately, the doctors and nurses were able to explain that the condition was correctable and that there would be an Operation Smile mission taking place at the same hospital later in the year. Athalia contacted Operation Smile South Africa (OSSA) and was advised to attend the mission held in Mbombela in September 2015. In the interim, she returned home with her baby boy and faced a community confused and afraid. ‘My community

asked why he looked this way, they didn’t understand. They were scared and wanted to know how he would end up in life,’ Athalia remembers.

Apart from the challenge presented by the community’s ignorance of cleft lip and palate, Athalia’s greatest barrier to care was the challenge of transport and its cost. Based around 90 minutes from the nearest town, Athalia and Siyabonga live off the beaten track and finding transport was problematic. OSSA assisted them to get to the mission; and Athalia admits her relief when she arrived and saw more children with the same condition as Siyabonga. ‘I was surprised, I thought it was only Siyabonga, but it isn’t,’ she says.

Siyabonga was selected for surgery and although his mother was undeniably nervous she remained confident that all would go well. When she was reunited with Siyabonga she couldn’t believe her eyes. ‘I was so happy.’

Six months later, during a post-operative trip, Athalia was still beaming with joy at the change in Siyabonga. He was charging around the garden adjacent to their home and, while Athalia says that he is a shy child by nature, since attending nursery school he has definitely come out of his shell.

When Athalia considers the confusion that her neighbours expressed after seeing the results of the surgery, ‘they thought his cleft had been fixed with flesh from his leg,’ she confirms that educating communities about cleft lip and/or palate is important. For now, though, all she wants is for Siyabonga to be happy. ‘The weight has been lifted,’ she says, smiling.


Operation Smile expanded its reach to South Africa in 2006 and since its inception has conducted nearly 50 missions across Africa. OSSA currently serves as the regional hub for Central and southern Africa. Our work includes multiple missions to South Africa, Mozambique, Namibia, Swaziland, Madagascar, Ghana, Malawi and the DRC. While we continue to expand our footprint, we look back on some 6 000 lives changed and look forward to changing untold more in the future. In 10 years, with a team that exceeds 50 medical volunteers, OSSA has helped over 418 South Africans and has supported and assisted in over 38 552 surgeries across the continent.
For more information, visit or their Facebook page

Issue Fifteen - October to December 2017

Issue Fifteen - October to December 2017

This article was featured on page 22-23 of Babys and Beyond Issue Fifteen - October to December 2017 .

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