A rural cleft project in Uganda

Over an 8-month period a cleft project was organised across Uganda. The aim of the project was to travel to as many districts as possible in the available time and repair all the cleft patients who could be mobilised. Local surgeons were trained and the results of the project were assessed. This was a prospective study which assessed immediate patient outcome, feedback from participating hospitals and cost. The team visited 20 hospitals, many in remote rural areas. All equipment necessary for surgery was transported to the hospitals. 336 cleft lip repairs and 41 cleft palate repairs were performed on 343 patients. There was no anaesthetic morbidity or mortality and no immediate perioperative morbidity. Two cleft lip repairs developed partial wound dehiscence and there was one palatal fistula. Five local surgeons underwent cleft training. All centres participating in this project requested further visits. The total cost for each cleft repair was 27 pounds sterling. Visiting remote centres with a mobile team is an efficient, safe and cost-effective method to treat the large numbers of unrepaired clefts in developing countries.