Cleft & facial deformity foundation (CFDF) outreach model: 6 year experience of an indigenous Nigerian mission in the surgical correction of facial clefts

Abstract

Introduction: Orofacial cleft has a worldwide distribution but it is peculiar in the developing countries due to poor healthcare facility with resultant high incidence of unoperated adult cleft. Various model of surgical mission by foreign experts had existed to combat this menace. The indigenous rotatory model by Cleft & facial deformity foundation is hereby presented. Methods: Carrying out an outreach programme in a rural area begins with the identification of a hospital with optimum facility, followed by effective awareness campaign, then a pre- surgical meeting with the hospital management. Personnel, equipment and materials were mobilised to the site while surgery usually lasted one week. Results: Seventeen outreach programmes were carried out in 10 different hospitals from March 2011 to June 2017. There were 546 orofacial cleft patients, 280 (51.3%) males and 266 (48.7%) females. The age ranged between 1 week to 70years with a mean age ± (SD) of 9.3±11.5. Four hundred and forty eight (82.1%) of the cleft patients were operated. Three hundred and twenty two (59.0%) patients were treated under general anaesthesia while 126 (23.1%) were treated under local anaesthesia. Eight surgeons and 4 anaesthetics were trained during the study period with several local practitioners benefitting from exposure to standard practice. Standard techniques were employed for cheiloplasty and palatoplasty. Minor complications were recorded with one mortality. Conclusion: This model is an effective and efficient way of reaching out to the poor patients with orofacial cleft. Effective mobilization, large volume of safe and quality surgery, easy knowledge transfer and possibility of patient review are some of its advantages. With regular training and funding, it could be an effective way of minimising ignorance and eradicating adult cleft in Nigeria and other developing societies.