(MENAFN- Pajhwok Afghan News)
KABUL (Pajhwok): 'Cleft lip and cleft palate' are two congenital anomalies that, in addition to creating health problems for those affected, also have negative psychological and social impacts on their lives.
Experts believe that the treatment of these defects should adopt a comprehensive approach that simultaneously addresses health, psychological, and social aspects.
Every year, a significant number of children with congenital“cleft lip and cleft palate” are born in Afghanistan, and these anomalies occur during the early stages of fetal development.
Cleft lip often appears as a gap in the upper lip, while cleft palate affects the palate area and may be unilateral or bilateral.
In developed countries, reconstructive surgeries and specialized care are widely available, but in some remote areas of Afghanistan, patients face numerous difficulties.
Causes, health problems of cleft lip and cleft palate
Health experts say most individuals affected by these two congenital anomalies face problems with nutrition and speaking. Children with these defects typically have difficulty sucking milk, which can lead to malnutrition and growth disorders.
Dr. Suraya Izedpanah, a specialist trainer at a hospital in Kabul, explains that cleft lip and cleft palate are congenital defects, and the exact cause is still unclear.
However, factors contributing to these anomalies include hereditary issues, consanguineous marriages, multiple children, maternal malnutrition, exposure to X-rays, the use of medication during pregnancy, and maternal viral infections.
She added that public awareness programs should be implemented to educate people about these issues and efforts should be made to prevent“cleft lip and cleft palate” during pregnancy.
She also emphasized that in some cases, children with cleft lip and cleft palate may also suffer from other problems such as dental issues and crooked noses, which must be addressed in different stages of treatment.
Dr. Izedpanah pointed out that cleft lip and cleft palate can be hereditary, and multiple children in a family may be affected by these conditions.
Dr. Najia Ahmadzai, a plastic surgery specialist, said that individuals with“cleft lip and cleft palate” generally face issues related to appearance, psychological health, difficulty swallowing and sucking food, and respiratory problems.
The best time for cleft lip surgery is at 10 weeks, while surgery for cleft palate should be performed at 10 to 12 months.
She added that there are three types of cleft lip and three types of cleft palate, all of which have been observed in Afghanistan, and it is also possible for a patient to have both conditions simultaneously.
Dr. Ahmadzai said that based on the patients they see, cleft lip is more common in males and cleft palate is more common in females.
She noted:“Patients with cleft lip and cleft palate need pre-operative care. They undergo a general examination, their weight must be appropriate, their blood should meet certain standards, and they should not have any other physical problems. Post-operative care includes proper wound care and strengthening the patient.”
She added that surgical techniques have evolved globally, and in Afghanistan, they are now performed using modern methods.
In her message to parents across the country, she advised against consanguineous marriages, the use of tobacco, and emphasized the importance of proper nutrition.
Is speaking problems solved after cleft lip, cleft palate surgery?
Dr. Mohammad Asif Jabarkhil, a speech therapy specialist for cleft lip and cleft palate patients at one of Kabul's hospitals, said that patients may face speech difficulties after surgery.
After evaluations, it is determined at which level the problem exists, and patients are advised to practice speech exercises for 40 minutes to an hour daily for 2 to 3 weeks.
He explained that patients are given one to three months to practice, and after this period, they are re-evaluated to check their progress. If no improvement is seen, they may be referred to a second stage of treatment.
He added that the second stage would involve further consultations with surgeons, and a long-term speech therapy process would follow.
Psychological, social impacts
Psychologists say that in addition to physical health problems, cleft lip and cleft palate have profound psychological impacts on individuals. In some cases, those affected by these anomalies face ridicule and discrimination due to their appearance, which can lead to a decrease in self-esteem and social isolation.
Abdul Jalil Amarkhil, a psychologist, told Pajhwok Afghan News that in third-world countries, patients with cleft lip and cleft palate are often viewed with contempt, leading to psychological issues such as low self-esteem, anxiety, depression, and emotional problems.
He added:“When others avoid talking to these individuals, not eating with them, or making friends with them, they think they are deficient or disabled. This feeling causes them to withdraw from social interactions, which is an early sign of depression.”
He explained that when these individuals feel others do not value them, they also fail to value themselves. This lack of self-worth leads to a lack of courage and difficulty in decision-making.
Suraya Yousefi, another psychologist, noted that children with cleft lip and cleft palate often have difficulty participating in social activities because they are sometimes ridiculed or mocked.
She emphasized that these children face many challenges in their social relationships and often suffer from low self-esteem.
Mohammad Nader, the father of a child with cleft lip in Herat, said:“My son had a cleft lip, and even though it was treated, the effects are still visible on his face. Neighbors and children of his age make fun of him, so my son sometimes refuses to go outside to play.”
Treatment challenges
While cities have medical facilities for reconstructive surgeries, many rural and remote areas lack these resources. Families have to travel long distances and incur significant expenses to seek treatment for their children.
In recent years, some non-governmental and international organizations have been working to improve the situation of these children by offering free surgical services and awareness programs.
Dr. Sayed Fatah Hashimi, head of the plastic surgery department at Cure Hospital, said that the free cleft lip and cleft palate treatment program has been running for 17 years, with patients from all over Afghanistan visiting the hospital.
He added that patients who come to Cure Hospital through various health organizations are initially registered and then treated based on a classification system.
He noted that since the program started, 15,000 patients have been operated upon, and in 2024 alone, 1,050 patients were treated, most of whom were children.
He pointed out that initially, people thought this condition was a“divine curse” and feared that treatment might cause other problems. However, over time, this misconception was cleared, and more people are now seeking treatment.
Dr. Hashimi added that before the political changes in the country, most patients came from central provinces, but now, with improved security, people from all provinces are seeking treatment.
Isa Anwari, the father of 19-year-old Reza, who suffers from both cleft lip and cleft palate, came to Kabul from Herat. He said that he had taken his son to a doctor in childhood, but the doctor had said that his son needed to grow stronger before surgery.
He expressed happiness about the availability of free treatment.
Zahirullah Naseri, a resident of Shakar Dara district in Kabul province, said that he had brought two patients to the hospital for surgery, both of whom were suffering from these problems.
He was also pleased with the availability of free treatment, calling it a great initiative.
Meanwhile, Qudratullah, a 23-year-old patient who came from Badakhshan for cleft lip surgery, said his condition had improved significantly, and the problems he once had had been resolved.
Pajhwok tried to contact the Ministry of Public Health for comment on the number of cleft lip and cleft palate cases, awareness programs, and free treatment centers across the country. However, despite repeated attempts, the ministry spokesman did not respond by the time this report was published.
sa/ma
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