The impact of a single surgical intervention for patients with a cleft lip living in rural Ethiopia.

Abstract

Humanitarian organisations commonly provide reconstructive treatment for patients with cleft lip within developing countries, but follow-up is often non-existent, particularly for those living in rural areas. This study aimed to assess whether a single surgical intervention was sufficient to produce an observable change to the life of a patient with cleft lip living in rural Hararghe in eastern Ethiopia. 356 patients with isolated cleft lips, who received a single surgical treatment at least 6 months previously, were evaluated in 21 rural health centres. Patients and their families expressed unhappiness before treatment, mainly because the society reacted negatively towards the deformities, isolating the patients from community activities. Postoperatively, the percentage of school-aged children participating in education increased from 46% to 79%, some older patients were able to marry, but employment was unaffected. The prevalence of wound dehiscence in the lip repair was 3% and occurred more frequently in patients with a bilateral cleft lip compared to a unilateral cleft lip (p < 0.001, RR 49.25, 95% CI 6.7-1037.35). We demonstrated that follow-up can be achieved by charitable organisations treating rural patients and that the majority of patients report a positive impact following surgical intervention. We recommend that bilateral cleft lips have a more intense rural aftercare.