WE NEED TO CREATE A CRANIOFACIAL UNIT IN LAUTECH teaching HOSPITAL FOR THE PEOPLE, being the theme of an address by Dr Seidu Bello, Executive Director, Cleft & Facial Deformity Foundation at the opening ceremony of ‘team 25’ free cleft and facial deformity surgery programme holding on Tuesday 17th May, 2022 at LAUTECH Teaching Hospital, Oyo State.

Protocols

                 Facial Deformities is a group of diseases that present not just with body pain, but immense

                  Psychological disturbance brought by social stigmatization. Affected people are socially 

                  Dislocated, have their potentials decimated, hence special attention is needed.

From our experience, facial deformities could be divided into 4:

1. Facial clefts (Cleft lip and Palate): Openings on the lip and palate. Patients are born with the condition (Congenital defects). In most cases, causes are unknown but occasionally genetics and some environmental factors could be responsible.

2. Facial Tumor: Refers to various facial swellings that can occur. They are acquired and the causes are unknown in most cases. This occurs at all ages.

3. Locked Jaw {TMJ (Temporo mandibular joint) Ankylosis}: Refers to inability to open the mouth. Usually occurs as a result of ear infection in infancy that spread from the ear to the joint. It could also be due to trauma to the joint in infancy.

4. Noma: This is a condition that presents with extreme facial distortion that can range from minor to some grotesque facial deformities. However unlike cleft lip and palate, children are not born with Nomah , instead it occurs as a result of childhood mouth disease that is occasioned by under-nutrition. The disease has been eliminated from the Western world by the end of 19th century, but is still persistent in Africa due to poverty and under-nutrition.

All these entities have one thing in common: Stigmatization, decimation of children potential, societal dislocation and ‘children out of school syndrome’.

 CLEFT & FACIAL DEFORMITY FOUNDATION (CFDF) was conceived about 11 years ago to serve as a platform to proffer a Nigerian solution to Nigerian problem of facial deformity scourge by creating awareness and assisting the less privileged with free surgery. It has in its fold a conglomerate of Nigerian volunteer professionals that are capable of carrying out surgeries on children and adults that are afflicted with facial deformities.

The aim and objectives of the foundation are:

1. To sensitize the Nigerian populace about the scourge of CLP as well as other facial Ydeformities in the society.

2. To assist the predominantly poor victims (or their parents) in the repair of the facial deformities; only foreigners have shown interest so far in this respect.

3.To  promote research in the field of CLP; establishing good data base, assist in training and joining similar organizations all over the world in improving quality of care.

4. To establish a facial deformity hospital in Nigeria, to offer free care for the less privileged.

Our journey in the past 11 years has been challenging and fulfilling. We have traversed various hospitals in  FCT, Niger, Kogi, Taraba, Edo, Katsina, Oyo, Nassarawa and Delta States. We have succeeded in creating awareness about the scourge of facial deformities in various communities. We have operated on close to 4000 patients out of about 7000 patients in attendance. One significant experience is the drastic reduction of adult cleft in Nigeria. In the first 4 programs, adult cleft was predominant with an average of 14.2 years. However at the last edition in the FCT, apart from one isolated 30 year old, the oldest cleft lip patient was 3 years, bringing us at par with the rest of the world where cleft surgery is essentially for the children.

The present 25th edition has witnessed a massive turnout of patients with different kind of facial deformities. As at today, 44 patients have registered. We have operated on 13 while surgery continues for one week with a target of 50 patients. It is obvious that we cannot attend to everybody which is a wakeup call to the reality that the facial deformities are not rare.

From the statistics, 20 (45%) of the patients are from Ogbomoso while  32 (72%) are from Oyo state. THIS IS AN INDICATION THAT WE NEED A CRANIOFACIAL HOSPITAL IN LAUTECH HOSPITAL. This will make maxillofacial service more accessible and cost less. While I urge the management of LAUTECH to consider engaging a surgeon, I appeal to well spirited individuals to assist the foundation with a sum of 5 million naira to purchase basic instruments to start the unit. I also urge oyo state and LAUTECH management to expedite action on the establishment of School;lkp of Dentistry at the university to provide manpower in dentistry and maxillofacial surgery.

For the realization of this team 25 festival, we are greatly indebted to the following:

  • TYDanjuma Foundation who is the major sponsor of this programme. Our sponsors  are here as the General TY Danjuma is highly delighted to extend his benevolence to the people of South West.
  • The LAUTECH and Oyo State administration for the approval of the hospital for use, and maximum cooperation we have enjoyed so far.
  • Smiletrain international that support cleft programme all over the world.
  • We also got some support  from Nigerian Communication Commission (NCC)
  • My fellow ever resilient and never tired team members and volunteers.
  •  Wonderful and supportive staff of  LAUTECH Ogbomoso.
  • My family members who have all virtually become CFDF Foundation members.

In conclusion, it is absolutely unacceptable that Nigerians still go about with glaring psychological disturbance of facial deformities in our society while the rest of us look elsewhere.  Facial deformity is not an exclusive disease of the poor but the care of it requires funds and technical know-how. If professionals like us can come together to carry out free surgeries, it is important that healthy individuals support us with funds so as to continue this good work as the era of depending on foreigners for funding is gradually coming to an end. WE MUST RISE UP AND DO SOMETHING. On our own part, we have resolved to continue this project. We challenge all professionals in other specialties to rise up to the occasion.

Thank you.

Appendix

Cleft lip and palate (CLP) are the commonest congenital deformities of the craniofacial region. It is a condition that affects every population of the world. It affects 1 in every 700 children all over the world. Facial cleft occurs as a result of disturbances of growth between 5 to 12 weeks intrauterine life of a foetus. The disturbances could be due to genetic or environmental factors. Environmental factors include radiation, malnutrition, hypervitaminosis, drugs, infection etc.

Cleft Palate refers to the opening at the roof of the mouth. It remains a challenge because even though not obvious, the patients can never speak well. It is advisable to repair before 2 years to allow for development of normal speech.

We have recorded a number of NOMA cases. This is a condition that presents with facial deformity. However unlike cleft lip and palate, children are not born with NOMA, instead it occurs as a result of childhood mouth disease that is occasioned by under-nutrition. The disease has been eliminated from the Western world by the end of 19th century, but is still persistent in Africa due to poverty and under-nutrition.

Facial tumours and TMJ ankylosis (Locked jaw) are a major source of social dislocation in the society. While facial tumours are abnormal tissue growth outside the control of individuals, TMJ ankylosis usually occurs as a result of early childhood ear infection and trauma and also leads to inability to open mouth.

An emerging challenge from our experience is the reasonable percentage of the patients (40%) that are affected by facial tumours and some patients that cannot open their mouth (TMJ ankylosis).  Many of these cases are handled while some of them cannot be handled in this present set up. Even though we have the technical know-how to handle the cases, the material and equipment demand makes it impossible. However, arrangement could be made for their treatment within Nigeria if the funds are available.

Thank you.

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