Nandi kids’ hidden smiles set free by cleft surgery

Hema Akinyi, 25, from Bumula, Busia county, has been living a life of misery since she delivered a child with cleft lip and cleft palate.

Baby Debra Akinyi was born six months ago in Bumula Hospital with a mouth and lip defect, a misfortune associated with either witchcraft or curses on a family.

When Hema went to Bumula maternity for delivery in July last year, after undergoing a normal routine at the facility, she gave birth to a baby girl.

“I only realised the baby's mouth was defective hours after delivery, when I tried to breastfeed. I was short for words when I scrutinised only to discover the opening,” Hema said.

The condition arises when either the lip or palate or both split in the upper roof of the mouth after the tissues fail to fuse together during development in the womb.

Baby Debra, now six and a half months old, was among 52 patients who underwent free corrective surgeries of cleft lips and palate at the Nandi Hills Subcounty Hospital in Nandi county between January 19 and 25.

The children, aged between three months and eight years, underwent surgeries to have a correction of their cleft lips and palate by Bela Risu facilitated by Smile Train, an international NGO in collaboration with Nandi Health department.

Bela Risu held a two-day camp, where 52 children with cleft defects had them corrected through elaborate surgeries.

The organisation carries out her programme with volunteers from various hospitals in Kenya and doctors from Nandi County.

Emmanuel Kibet, eight, a Grade 1 pupil at Teta Primary School in Keringet division, Molo, Nakuru county, had travelled together with his mother Anita Sawe, 29, for the free surgery.

“My son could not concentrate in class and had a problem with speech. And the worst of all is that other children made jokes out of his situation, and that is why he remains behind in class,” Sawe said.

“He should be in Grade 3 but because on many occasions he does not attend classes, he has been weak healthwise because he could not eat enough food.”

CULTURAL CONTEMPT

Helen Nakitar from Trans Nzoia was full of relief after her daughter Faith, three, successfully underwent the surgery, much to the delight of the family.

Nakitar, a mother of four, said she was making her last move to save her marriage after she was hounded out of her matrimonial home after giving birth to a child with a cleft lip.

“I was told to return to where I was born and be cleansed. That I was suspected to have engaged in some evil ritual, resulting in the lip defect of my child,” she said.

Faith walked out of an observation bed with her mouth completely covered.

Her mother could not hide her joy as she expects her in-laws, who had incited her husband to expel her, will now rescind the decision and allow her back to her house.

“They should thank God and the volunteers from Bela Risu and the county government of Nandi for hosting us for a week before the surgery,” Nakitar said.

She said the family will be happy to see their child Faith with a new smiling and attractive face.

Different communities have various cultural beliefs associated with the defect, which include curses and witchcraft or either parent engaging in infidelity.

Among the Kalenjin community, such children are treated with contempt. Girls with defects were married off without any dowry negotiations or even the parents demanding for anything as bride prize.

NUTRITION SUFFERS

Nandi Health executive Ruth Koech said for the last three years, she has managed to coordinate four times in a row for corrective surgery campaigns for cleft lip and cleft palate in the county.

Many children were being hidden by parents from the glare of the public because of the stigma associated with the mouth defect.

Koech said children with the cleft lip and palate suffer rejection from their families and peers because of it being treated as a misfortune.

“They suffer a lot from malnutrition because they cannot feed properly due to the opening in the upper lip that extends into the nose,” Koech said.

Those suffering from cleft lip and cleft palate have a common characteristic of being malnourished due to lack of suction pressure that enables one to swallow food.

“Food commonly comes through the child’s nose at the cleft palate because one is unable to squeeze either the bottle or mother’s nipple,” Koech said.

She has been reaching out to various organisations that do corrective surgeries to visit Nandi county and offer free surgeries to patients.

“Since I worked most of my life in the US, sometimes I failed to comprehend and come to terms with our citizens trying to hide from the public children with these kinds of deformities,” she said.

“In developed countries, such health conditions are identified before birth, when mothers attend routine postnatal clinic, through the use of ultrasound equipment.”

More than 400 children have had the needed corrective free surgeries in Kapsabet County Referral and Nandi Hills Subcounty hospitals since 2018.

“It has all been free surgeries. At times, surgeons have to first do a corrective surgery for the cleft palate and leave it to heal, then the next phase of the cleft lip is done at a different date, maybe after months or a year,” Koech said.

The visible deformity elicits stigma that hurts self-esteem, resulting in psychosocial issues.

Such children or persons with the cleft lip or palate on many occasions suffer from depression as peers keep away from them because of their situation.

HAPPY AGAIN

Dr Mahabubur Khan, a volunteer cleft surgeon for 36 years, is happy that he has put a smile on the faces of thousands of people who have benefited from free corrective surgery.

Khan praises the work of his team of volunteers, who dedicate their time to travel to various parts of the country to support the campaign to help correct cleft lip and palates.

“It’s not an easy task,” Khan says. I have with me anaesthetists, paediatricians, nurses specialised in various fields, like critical care, all who accept to leave their families while off duty to support this campaign.”

Khan has a piece of advice to parents in Kenya. “Stop hiding children with such deformities in the bush of homes. It isn’t a curse and it’s correctable for free. Come forward and we will help you.”

Correction of cleft lip and palate cost between Sh100,000 and Sh300,000 in private hospitals. The cost depends on the age of the child and the extent of the split and the parts.

Khan, a Bangladeshi by birth, says he has now dedicated his life in Kenya to voluntarily carrying out free corrective surgeries on children and adults.

The success of hosting cleft lip and cleft palate surgeries in various hospitals in Nandi county is due to the availability of modern theatres.

“We are fortunate that the county government has seen it fit to expand the number of theatres in our hospitals, which has enabled us to dedicate some for such operations for the whole nation,” Koech said.

“We now have four functional theatres in Kapsabet County Referral Hospital and three in Nandi Hills. These have enabled us to invite volunteers like Bela Risu Foundation to help needy Kenyans.”

Nandi Hills medical superintendent Dr Joseph Kangor urged Kenyans to make the most of the operations.

“My appeal to Kenyans, please identify those with the deformity so we can try and locate volunteers to correct and give them another smile in their lives,” he said.

Edited by T Jalio