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From Fred Ezeh, Abuja
Craniofacial is a medical term that relates to the bones of the skull and face. Craniofacial abnormalities are birth defects of the face or head. Some, like cleft lip and palate, are among the most common of all birth defects.
These growths and tumours often disfigure the face of the patients, thus breaking the self-confidence, and in some cases send such persons to obscurity to avoid open stigmatization and discrimination by the public.
But just like other diseases and ailments that could be easily spoken of, particularly the cause and other things about the disease, doctors are yet to clearly and boldly state the cause of the disease.
Some health professionals stated that craniofacial malformations are the result of an infant’s skull or facial bones fusing together too soon or in an abnormal way. And when the bones fuse together too early, the brain can become damaged as it grows, hence cannot expand properly, and the infant may develop neurological problems.
On the contrary, Executive Director, Cleft and Facial Deformation Foundation (CFDF), Dr. Seidu Bello, said medical sciences are yet to come to terms with the real causes of craniofacial that often present different forms of facial deformation.
He, however, raised the alarm that more people are getting stocked in their facial deformed state due to absence or shortage of qualified surgeons to support the surgery: “These facial deformities are 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 potential decimated, hence special attention is needed.” Unfortunately, the cost of these “special attentions” is high for the patients, most of whom are less privileged with low financial background.
Types of facial deformation
Facial deformities could be divided into four. Facial cleft, which is a cleft lip and palate. This is an opening on the lip and palate. Patients are born with the condition known as congenital defects, and in most cases, the causes are unknown. But occasionally genetics and some environmental factors could also be responsible.
The second type is facial tumour. These are the various facial swellings that occur in any human. They are acquired and the causes are also unknown in most cases. It can occur at all ages.
There is also the locked jaw otherwise known as Temporo Mandibular Joint (TMJ). This is the type that makes it difficult for the patients to open their mouths. It usually occurs as a result of ear infection in infancy that spreads from the ear to the joint. It could also be due to trauma to the joint in infancy.
Noma is another type. It’s one of the recognized Neglected Tropical Diseases (NTDs). This is a condition that presents with extreme facial distortion that can range from minor to some facial deformities. However unlike cleft lip and palate, children are not born with Noma. It occurs as a result of childhood mouth disease that is occasioned by under-nutrition. The disease was eliminated from the Western world in the 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’s potential, societal dislocation and “children out of school syndrome.”
Why cases are on the rise
Bello confirmed that more people are coming down with the disease due to, perhaps, increasing ignorance and poor financial strength for necessary corrective surgery.
He also linked the development to shortage of manpower, dentists: “There is a need for a deliberate effort to increase the workforce by producing more dentists and maxillofacial surgeons across Nigeria especially in the face of massive exodus of doctors. There are just about 10 schools of dentistry in Nigeria producing less than 250 dentists yearly.
“A School of Dentistry should be established at University of Abuja (UNIABUJA), to make it easy utilising already existing medical training infrastructure and will reinforce postgraduate training of specialist maxillofacial surgeons at the teaching hospital.
“Effective management of facial diseases requires continuous production of maxillofacial surgeons, a specialty of dentistry in short supply nationwide, with a little less than 200 specialists in Nigeria.”
Interventions
Due to the high cost of the surgery, only few of the patients often afford the financial support for the surgery, which is the only way to correct the disorder. But in most cases, the cost of the surgery is always out of the reach of the patients, hence the consistent suggestions for philanthropic interventions for the surgeries.
Support has come from different individuals and philanthropic organizations to support the surgery and other healing processes.
Last week, TY Danjuma Foundation sponsored free craniofacial surgery for people with these facial deformations. Team of doctors and volunteers from CFDF led by Bello who is also a consultant maxillofacial surgeon, carried out the operation.
The exercise took place at the University of Abuja Teaching Hospital (UATH), Gwagwalada. It enabled over 50 patients to enjoy free corrective surgeries. Bello said: “Some of them live and bear the pain and stigma of the disease for several years because of funds to support the surgery.
“Our target for this round of intervention is 50 cases. Over 40 have registered and we have done 13 so far, and the operation still continues. No doubt, the situation of facial deformation is alarming in Nigeria. Besides, we have a poor cancer registry and that has worsened the situation.
“Whenever we have a round of intervention, we hardly finish the cases. This is because many people have the problem but they don’t have the money to support the surgery. So, they choose to take advantage of the free medical outreach to get the surgery.”
Chief Executive Officer, TY Danjuma Foundation, Gima Forje, said: “Part of our responsibilities is to support free medical outreaches in Nigeria so that people in poor communities can have access to quality health care. And to do that, we work with qualified and tested partners, and that’s why we support CFDF to bring these services to people who are in need.
“Without such outreaches, we won’t be able to reach out to these sets of people that are down with facial deformation. Another reason is that these surgeries are quite expensive and complex, so many patients are unable to afford the cost.”
UATH Chief Medical Director, Prof. Bissallah Ekele, said: “Happiness is being restored to these people who were not expecting it. And the most important part of it is that it’s free. As a health care facility, we offered our support by providing the space and other logistics needed for the success of the surgery.”
Bello said CFDF also offered some interventions: “We have traversed 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 over 5,000 patients out of about 7,000 patients in attendance. One significant experience is the drastic reduction of adult cleft in Nigeria. In our first four programmes, adult cleft was predominant. But most of our cleft patients now are babies, bringing us at par with the rest of the world where cleft surgery is essentially for the children.
“Facial deformity is not an exclusive disease of the poor. But the care requires funds and technical know-how. If professionals can come together to carry out free surgeries, then it is important that wealthy individuals support with funds to continue the good work. The era of depending on foreigners for funding is gradually coming to an end.
“We must rise and do something about the disease. On our own part, we have resolved to continue this project. We challenge all professionals in other specialties to rise to the occasion.”
He made reference to the desire to establish a specialist hospital: “When completed, it will provide free surgery for the poor, quality treatment for the rich and will be a centre for training and research. We hereby solicit the support of the public for the completion of the project.”
