Global Variation in Cleft Palate Repairs: An Analysis of 352,191 Primary Cleft Repairs in Low- to Higher-Middle-Income Countries

Children with cleft lip and/or palate deformities are an inevitable component of every culture and community
throughout the world, and as the global population continues to increase, the global burden of cleft deformities
escalates. Early surgical intervention is essential to improve the quality of life for these patients, and in many cases, the operation is life-saving (Cubitt et al., 2012). Despite the variations in overall clefting incidence between geographical and racial groups, the underlying correlation between cleft lip and cleft palate incidence should remain universally constant (Sayetta et al., 1989)

Article on Cleft Palate rapairs

3D technology to ease limb replacement

Mitch Wilkie, Director, International Programmes at CBM-Canada demonstrating how the scanner works

Ugandans seeking to replace lost limbs with artificial ones (prosthetics) now have reason to smile.

The Comprehensive Rehabilitation Services in Uganda (CoRSU) is piloting a project to use 3D scanning and printing to rebuild sockets for limbs faster and cheaper than ever before, especially for children. It is partnering with the University of Toronto, led by Prof Matt Ratto and Christian Blind Mission (CBM), an international NGO.

At CoRSU’s orthopaedic department, Mitch Wilkie, the director of international programmes at CBM-Canada, demonstrates how the technology works. He runs a handheld scanner around an outstretched arm which sends quick flashes of light at it.

Within 45 seconds, the scanner had created a fine image of the hand’s shape on a computer next to him. It is this image that he works with, angling, creating grids and gauging size in order to create a socket that will later be printed using a 3D printer.

In prosthetics, the socket is the most crucial part because if it does not fit correctly, one may experience pain, sores and blisters, thus compromising movement.

“It takes a skilled technician about five days to construct a customized socket for the prosthetic to fit into. With 3D technology, this is dramatically reduced as it takes five minutes for the technician to work on the software and about three to six hours for printing,” Wilkie said.

This new technology, which is being officially launched in the country in October 2015, will benefit children in distant areas who cannot afford to come to hospital all the time. Wilkie said the process can be carried out on site among communities.

The World Health Organization (WHO) says there is a 40,000 shortfall of prosthetic technicians in the developing world and it will take 50 years to train 18,000 more. CBM is investing $20,000 (approximately Shs 51m) into the pilot.

ninsiima@observer.ug

Commissioning of the new Anaesthetic machines

CoRSU has officially unveiled two new anaesthetic machines that were recently acquired.
One of the machines was purchased using part of the money that was donated by Brussels airlines through the February 2014 Bike for Africa tour.

The second machine was donated by Drager, a Germany company that specialises in making breathing and protection equipment, gas detection and analysis systems, and non-invasive patient monitoring technologies.
According to Dr. Sarah Hodges, the CoRSU Medical Director, these machines will enable us to deliver high quality, safe anaesthesia to even the smallest baby. “These machines have a variety of functions that enable us to deliver high end care to all types of patients. We do complex surgery on some very small babies and children and these machines allow us to do this safely.” Explains Dr. Sarah explains.
The two state of the art machines will go a long way in helping us to improve service delivery to our patients.

During the commissioning, Brussels airlines country manager Sebastiaan Spijkers pledged to continue supporting CoRSU to restore hope to children with ability.
To donate: 0341042038 UGX, 0344009643 USD, and 0344005788 EUR
Or visit our website http://www.corsu.or.ug for more information

We want more Special Needs schools- CwDs

6/06/2014

By: Phionah Katushabe

In a recent survey conducted among the children undergoing rehabilitation at CoRSU aged between 6-17 years, most of them asked the government to put up more Special Needs schools that can offer them free education. A big number of them cited their disabilities as the reason for failure to go to school. They said fellow pupils tease, harass and mock them. Another factor they mentioned was lack of scholastic materials. Statistics show that of the 589 children interviewed in the different parts of Uganda, 74% said lack of scholastic materials was a major issue affecting their education.

 

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Teacher Miriam in class with some of the patients 

As we join the world to celebrate the International Day of the African Child 2014 under the theme “A child friendly, quality, free and compulsory education for all children in Africa,” we ought to reflect on the issues that affect the children and how we can do more to create a better conducive environment for them to grow. The UNICEF, Gender ministry and Economic Research Centre report on child poverty and deprivation shows that over half of Uganda’s children live in extreme poverty. Nutrition, Water, health, sanitation, shelter, education and information are important aspects for any human being, mostly children. According to the report, a child is considered to be poor if they do not have at least two of these.

 

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Nadege (C) with some of the pupils who took part in the survey 

Among other rehabilitation services, we offer children classes during the time they spend at the hospital to keep them in line with their studies so that they do not lag behind. According to Miriam, their teacher, there are few Special Needs teachers in the country, yet teaching CwDs requires a lot of commitment and patience to bear with them in all conditions.

Education is a tool of empowerment for children in Africa, enabling them to achieve their maximum potential and enhancing their capacity to benefit from other entitlements that promote their well-being.

It is not easy, but if all of us in our capacities, either as government, NGOs, parents, teachers, health practitioners, community members or individuals can each contribute a block, we can in time easily roof this building.

 

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Standing with their heads held high

Jane

Looking at her profile from the right, she seemed ok, in fact perfect. A tall dark skinned beautiful face. It is only when she turned that one would notice the deformity. Jane lost most of the outer part of her left ear in an #LRA ambush more than 10 years ago.

 

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Jane before surgery

 

“I was on my way with several people headed to Kitgum town when a few hours into the journey we heard gun shots. I saw a bright light and heard a strong sound. That is when I passed out. I do not recall anything else about the fateful day. I woke up a day after in Gulu regional referral hospital, in excruciating pain. At first i did not recall the incidents of the previous day. But after some time i started to remember and that is when I realised that my ear had been hit off by a bullet. I was thankful to be alive because some of the people we were traveling with had died in the incident.”

To make matters worse, the war robbed Jane of her husband. With only her children to live for, the mother of two says it had become normal for her to exist with the deformity.

“I am a petty trader so there is no way I could have afforded to pay to have  surgery. I got used to being like this though I had to stand scorn from other people. But deep down in my heart I kept grudging about the fact that I had a deformed ear. Because of that I had to always cover my head, enclosing both ears so that people don’t see me. I so much desired to have both my ears normal so that I could also walk with my head high, wear earrings and other things.”

 

Ear shapeoperation

Santa

The 40 year old mother of two smiles when the doctor tells her she qualifies to be operated on. She does not understand English and relies on the interpreter to make a decision on whether to have the surgery to reconstruct her external ear or not. Both Santa’s ears were injured more than 22 years ago.

“It was one afternoon and I was at home when fighting broke out between the LRA rebels and government forces. I managed to escape, with my five year old child strapped on my back.”

But the bliss of the escape was short lived as moments later she bumped into an LRA ambush.

“They wanted to kill me, thinking I was a government spy. I heard them plotting and arguing until they agreed that the best punishment was to cut off my ears. I was apparently supposed to serve as an example to the rest of the community members who dared to collaborate with the government. During the short captivity I was beaten, tortured and the only thing that kept me going was my baby who I held onto firmly. When they were done with cutting off my ears, they said ‘Go and tell the others what we will do to them’. From then on people used to laugh at me and my ‘half ears’. I would feel bad but I had nothing to do about it. My husband also said I had become too ugly and went to look for other women…”

Santa and Jane are two of the many women who were mobilized and brought to CoRSU (www.corsu.or.ug)  for surgery by Watoto Reconstructive Surgery Project. Santa was diagnosed with low type 2 partial bilateral amputation while Jane had unilateral partial amputation. With the other women they were admitted for ear reconstruction that was performed by world re-known Plastic surgeon Dr Françoise Firmin and her team with our in-house doctors.

There was tension all around the hospital as a group of them waited for the doctors to remove the patches they had put on their ears after surgery. The tension turned into jubilation as people gathered to see how these ladies’ ears had been restored. According to Dr. Firmin, they all had successful operations. More than six months later, they are going to have minor surgery to elevate their ears to have good projection. #September will be a special month.

Santa (R), Jane (3rd R) and some of the other ladies at CoRSU, after surgery

As narrated to Phionah Katushabe