Cleft lip and palate treatment in Bangladesh

This study is a description of experiences concerning a plastic surgical health program in Faridpur, Bangladesh. In Bangladesh, plastic surgical help is almost non-existent particularly for the treatment of facial clefts and burn wound contractures. Since 2000, a team of plastic surgeons and one anesthesiologist from The Netherlands set up a health care program in the rural region of Faridpur, west of Dhaka. Apart from lip and palate closure, training of local doctors is definitely part of the program. An analysis was made related to criteria for selection of patients, types of clefts treated, and incentives for the future. In Asia, there is a high prevalence of clefts: two to three per thousand live births. It is estimated that possibly 300,000 people are waiting for correction of their clefts. In 4 years, 255 patients were treated. Indications for operation are different from those in the western world; girls aged 18 years are more important than babies because of their wish to get married with a repaired face. Up to now, five surgeons have been trained to perform operations in patients with clefts. In Bangladesh, there is a high need for correction of clefts for social as well as for functional reasons. Future actions should be directed to training of surgeons, development of specialized centers, and social as well as political commitments to health care programs.