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The previous study in Wudoaba villages suggested that cleft lip and cleft palate (CL/CP) may be endemic in the Wudoaba cluster of villages in the Ketu South District of the Volta Region in South East Ghana. The study was to detect the prevalence of CL/CP in the Wudoaba communities and to investigate the factors associated with the causes of this malformation in the area. Two different interview-based questionnaires were designed to collect data over a period of 3 days from March 27 to 29, 2006. A purposive and accidental random sampling technique was used in the administering of the various questionnaires to the respondents. Data collected were recorded and analyzed with SPSS version 17.0. A total 99 respondents, with a mean age of 55.0 years, were interviewed. Out of it, 57.6% (n = 57) were related to their spouses: 54 first cousins and three other family relations. The prevalence of CL/CP is at least 6.3 per 1,000 people (i.e., 25/4,000). Majority (56.0%, n = 14) of the cleft cases were unilateral. Interviews revealed that genetic homogeneity and vitamin deficiencies in this community may be a causal factor for the high prevalence of CL/CP. This community provides clues suggesting that the magnitude of CL/CP may be larger than other studies and identifies the Wudoaba population as one that could be further studied to explore the underlying factors causing this congenital malformation.

This paper describes the efforts of one plastic surgery team composed of Ghanaians from one of the major metropolitan areas in Ghana to meet the plastic surgery needs of rural Ghanaian communities. The aim was to analyze retrospectively the cases managed by the team, the difficulties which arose over a 14-year period, and the provision of recommendations for such future work. This study reviewed the medical records of patients treated during 86 outreach visits to nine centers from October 1995 to September 2009. The team, drawn from three hospitals, comprised a plastic surgeon and surgical support staff. They mostly treated Buruli ulcers, postburns scar contractures, chronic ulcers, facial clefts, tumors, and breast diseases. In all, 2,284 patients were managed during the period under review, giving an average of 163 patients per year and 254 per center. Buruli ulcers accounted for the largest group of cases treated during the outreaches (41%). Other common diagnoses were postburn scar contractures and cleft lip and palate deformities. This paper provides an example of the possibilities for surgical outreach work that exist and how challenges that come up during surgical outreach visits can be handled effectively. It also highlights the need for outreach medical work in developing countries like Ghana, especially since there is a reduction in foreign outreach medical missions. The authors encourage all stakeholders involved in health care delivery to initiate and support local medical outreach teams to provide care to rural communities.