The Nation Newspaper

Tag: lip

  • ‘We’re out to eliminate cleft lip’

    ‘We’re out to eliminate cleft lip’

    Cleft lip and palate leaves children with difficulty in eating, breathing, speaking, even hearing, apart from disposing them to infections as well. Nkeiruka Obi, Programme Director, Smile Train, which has funded and equipped corrective surgeries in Southeast and other parts of the country and West Africa, in this interview, throws more light on the organisation’s campaign to spare children the agony of the condition. Excerpts:

    ‘Our No.1 priority is to ensure the safety of the patient, and it is the guiding force behind every Smile Train programme and initiative, and our
    doctors and associated medical professionals abide by our strict standards’

    What is your assessment of Smile Train’s activities in Nigeria and West Africa?

    Smile Train System architecture anchors on four pillars: medical, technology, donors and programmes which revolve around financial help to poor patients who cannot afford the surgery and training of medical professionals to upgrade skills. What makes us unique is the fact that all of the surgeries we fund are performed by local doctors in local hospitals through free training, equipment and financial grants, we are helping communities become self-sufficient.

    Smile Train has been in Nigeria for 10 years.  Since I joined in 2011, we have been able to grow the programme in scale and numbers by over 400% by simply using the “teach a man to fish” model which has enhanced the sustainability of the programme for longer term. We empower the local medical professionals to provide free safe and high quality comprehensive cleft care to as many patients in their own local communities all year round.

    We have created over 25,000+ smiles (and still counting) in the region. And I can tell you that the impact has gone beyond creating simple smiles. It is phenomenal and revolutionary.

    On initial challenges and how they were resolved

    The West and Central Africa region is a diverse multicultural territory with an estimated 390m+ population, yearly cleft birth of 12,000 in 22 highly segmented countries of three different major international languages – English, French and Portuguese. Travelling is prohibitively expensive due to the poor transportation system. We’ve had to deal with insecurity, terrorism and unstable political climate with the attendant adverse effects on the people and governance.  In Nigeria, we keep experiencing incessant strike actions by medical professionals. And as in several areas of health care, the human resources and facilities available for the provision of comprehensive multidisciplinary care of patients with cleft lip and palate deformity on the continent are very limited.

    Initially, it was insufficient cleft surgeons and cleft care practitioners in the Francophone, Central African and some English speaking West African countries like Liberia, Sierra Leone and The Gambia. So my first task was to identify  surgeons in these countries who are interested in cleft care and organize trainings for them so as to re-inforce the scientific foundations of cleft surgery and provide them hands-on training in surgical techniques. There has been significant progress in this area.

    Then, there was the challenge of infrastructure and equipment. Most hospitals have very poorly equipped operating theatres. And our number one priority in cleft care is ensuring the safety of the patient. Smile Train have had to provide partners with equipment such as anaesthesia machines, pulse oximeters and cleft sets/instruments.  This in no small measure has helped in improving the quality and safety of surgeries and care of our cleft patients.

    We also have issue of malnutrition and underweight babies. Many of the children come from challenging environments including IDP camps and require nutritional rehab before surgery can be performed.

    As you well know, cleft deformity comes with a lot of psychosocial problems. Many cleft children suffer discrimination and their family is traumatised. Those who manage to reach adulthood are often banished to a life of isolation. We still have a huge backlog of adult cleft patients in the region. So lack of awareness is another challenge.

    Can this deformity be detected before birth in order to tackle it immediately after?

    Yes, it is possible to detect cleft deformity in a child before birth through the use of ultrasound scan. A cleft is a harmful condition though not life threatening in which the roof of the mouth and/or top lip does not close properly. It occurs due to errors in the growth process when the different parts of the face are formed in the womb. Normal lip development occurs between 4-6 weeks of gestation while the palate develops between 6-12 weeks. The upper lip develops from the fusion of two different process. Failure of fusion results in cleft.

    Why does Cleft occur?

    No one knows exactly the cause, but most experts agree that there is an interplay between many genetic (internal) as well as environmental or nutritional (external) factors. Parents who have family history of cleft have a high risk of giving birth to cleft children. It could be environmental: poor nutrition, wrong use of drugs, folic acid deficiency, infection, habits – smoking and high alcohol in-take, exposure to ionizing radiations and even parental age. The only solution today is a simple life transforming surgery that cost as little as $250 and takes as a little as 45minutes.

    What has been the success rate of the surgeries?

    Like any other surgery, there are risks involved. At Smile Train, we have had very good success rate and near zero mortality rates.    to ensure patients receive the highest level of care possible. If a child has a cleft, he/she can live with that defect for the rest of his/her life. The only thing is that the child may not enjoy life to the fullest like a normal person.

    It is important to note that since 1999, Smile Train has performed 1,000,000+ (still counting) free, safe and high quality surgeries in more than 85 countries.

    Where to do you see cleft care in the near future?

    In addition to our dedication to safety and quality by offering a multitude of cleft education and training programmes and resources, Smile Train is also committed to ensuring that the care we are providing is comprehensive. Many may not realise this, but children born with clefts need more than just one surgery, and our local medical professionals evaluate whether or not additional nutritional, speech, dental, orthodontic, and therapeutic care is needed. Where these services are available, we do everything we can to provide our patients with access to them.

    Our vision of a cleft-free nation is to have a robust medical infrastructure and personnel easily and readily accessible to as many cleft patients especially young children who if early treated, can begin a great future without having to deal with all the stigma associated with cleft and go on to live and contribute productively as members of their communities (and also to adults to give them a second chance to at life to smile.

    Together, we can make sure every child in our region born with cleft is given an opportunity to live productive life.

  • Job creation beyond lip service

    Speaking at the 11th Benson Idahosa University convocation in July, former president Olusegun Obasanjo advised that the nation has to reverse the trend of unemployment by “empowering the youth with skills and taking them off the yoke of the unemployed.”

    Interestingly, it was exactly a week after President Muhammadu Buhari was quoted as saying: “We will no longer allow our markets to be flooded with things we can produce ourselves. We must believe in our system. Whenever you need my intervention at anytime, please come to me.” President Buhari was speaking to the Permanent Secretary, Abdulkadir Musa, and senior officials of the Federal Ministry of Industry, Trade and Investment. Also, Buhari said with its focus on job creation, his government was ready to do whatever it considers necessary to boost domestic manufacturing and industrialisation.  Buhari said: “So, we will shun all anti-development policies, and make the climate more suitable for entrepreneurs. We will create the environment for them to thrive. Generating employment was one of our key campaign promises and we will keep that promise”.

    While there seems to be a consensus on the need to teach Entrepreneurship in the formal schools as one of the strategies to create employment, little is done to practically and effectively achieve this. While there seems to be more emphasis and energy on the ‘hardware’ of infrastructure needs by entrepreneurial endeavour, the actual ‘software’ that will make more Nigerians willingly (my emphasis on ‘actual willingness’) embrace entrepreneurship with their heart and soul seems to remain unaddressed –  or is, at best, not yielding noticeable result.

    Consequently, I suggest the following steps must be urgently implemented: Firstly, public office holders must identify with fledgling business owners/entrepreneurs in their constituencies and tacitly endorse made-in-Nigeria service/product through visits to the entrepreneurs’ business premises. This will serve as a form of motivation to these entrepreneurs grabbling with a lot of discouraging factors and help stimulate patronage for such businesses as people will love to patronise such businesses on the strength of such endorsements. In turn, business owners will work hard not to lower quality of service in order to live up to such endorsements. I commend and recommend to other political leaders, the personal example set by the current governor of Lagos State, Akinwunmi Ambode, who has personally attended the launch of a few startups like a new school recently set up in Lekki and a hotel on the mainland. He should keep it up and extend such visits to other sectors like the printer in Shomolu, the fish farmer in Epe, the Cane village in Mende etc.

    Secondly, most Nigerian formal educational institutions are presently teaching entrepreneurship without a comprehensive business opportunity handbook that adequately compiles the thousands of local and international business opportunities like it is done in most nations that have successfully got more of their citizens to start and run their own businesses. The scope of entrepreneurial education for most Nigerian undergraduates  is restricted to the knowledge of the few popular business ideas commonly executed in Nigeria and most of them are not even aware that there is a Nigerian-published comprehensive business opportunity handbook that contains thousands of business ideas, summary of how to execute each idea, contacts of credible local and international funding sources, sample business plans and business plan templates, marketing tips and so much more valuable practical business information. Consequently, most undergraduates are not sufficiently exposed to the limitless benefit of a business opportunity handbook. To reverse this trend, schools should take a cue from what’s being done in Covenant University, Ota, which has integrated entrepreneurship education into its academic programme and gone an extra length to provide its students access to the mobile app of a popular business opportunity handbook. The uniqueness is that this mobile application is regularly updated with new business ideas, funding sources, business contacts etc. at no extra cost even after leaving the university.  Such a laudable programme and initiative should be extended to all schools all over the federation.

    Thirdly, the media has a critical role in giving enough exposure to Nigerian entrepreneurs to serve as motivation for aspiring entrepreneurs. Most Nigerian media houses, especially those in the online, print and electronic categories are guilty of a discouraging practice of having the same advert cost regime for large corporate organisations and small/ medium scale business owners and startups. Perhaps, by no fault of the media organisations, the cost of acquiring media leverage by Nigerian startups for their goods and services is presently to the disadvantage of such category of Nigerian entrepreneurs’ potential marketing gains and brand penetration. The ultimate loser is the society in terms of job creation and the media itself, which in the long run may lose patronage from struggling entrepreneurs who eventually turn out successful.

    To address this concern, media organisations should provide special advertising price packages for the Nigerian small or medium business owners either through individual or trade group mutual partnership arrangement or outright discount incentives.  Influential organisations like National Broadcasting Commission (NBC), Nigerian Guild of Editors(NGE), Broadcasting Organisation of Nigeria (BON),Nigeria Union of Journalists(NUJ) and Newspapers Proprietors Association of Nigeria(NPAN) can facilitate such partnerships. Furthermore, the media should do more to extol the merits of self-employment and the small firm as a vehicle for self-fulfillment, economic rejuvenation and employment generation.

    Finally, the small and medium enterprise economy relates to the large corporations and public sector sub-economies in a variety of ways. The real economic implications of the present Forex squeeze and tactical banning of 40 imported items by the Federal Government are yet to be fully understood even by most stakeholders and the government. The general theoretical assumption that these policies will automatically benefit the Nigerian entrepreneur as it is expected that more indigenous made-in-Nigeria products will be patronised will prove to be unrealistic unless the new government chooses to act differently.   The immediate beneficiaries of this policy are the smugglers and corrupt customs/immigration officers because the demand for such imported products will result in their scarcity and fuel increase in such commodities’ prices which will in turn serve as incentives to the smugglers. Within a week of this policy, the unofficial price of forex in the parallel market has spiralled out of control, further increasing the pressure on the depreciating naira. Also, within a week, the price of frozen chicken (one of the 40 items removed from the import list) has surged from N750 per kilogram to N1100 per kilogram, an equivalent of approximately 50 per cent increase.

    Yet these are the same imported poultry products, not those supplied by the Nigerian poultry farmer-entrepreneur. Except the government moves in immediately, this policy will not translate into economic benefits for the Nigerian entrepreneur. Government should immediately meet with the large corporations, wholesale importers, mega superstores and trade associations to track the sourcing of these ‘banned’ items by the big players, address their genuine fears and give incentives to large corporations that will genuinely abide by this policy by patronising local producers and suppliers of these items. The media should also help to report progress made in this regard. No doubt, the Economic and Financial Crimes Commission (EFCC) will need to investigate and possibly prosecute corporate players that may want to support smuggling or sabotage this policy.

     

    • Vaughan is the host of Biz Lifelines on Lagos-based Inspiration FM and Radio Continental.
  • Lip Care

    Lip Care

    HERE are a few tips that will ensure your lips remain soft, supple and luscious this rainy season. As we all know, lips, unlike our skin, do not have oil and sweat glands, so they are more susceptible to dryness and chapping than our skin.

    First, the golden rule: do not lick your lips consistently. This can lead to dry and cracked lips which will definitely result in chapped lips because the moisture on the lips would have been licked off and the lips would then be exposed.

    Exfoliate weekly-This will peel off the weathered outer covering or layer.

    Coat your lips with a nourishing balm and softly stroke them with a baby brush.

    You can also make a mixture of honey and sugar pastes and lightly massage it over your lips to remove dead cells.

  • Cleft lip and other defects

    lefts of lip can occur on one side of the face – (unilateral) or both sides (bilateral). The size of clefts varies. It may be minute -just about a notch, or could be complete, right through the bony jaw. It could be complete or incomplete.

    The problem of speech results from cleft, the lips, cheeks, tongues, teeth that are involved in making sound – pickering, whistling ‘o’ or ‘ah’ etc sounds cannot effectively do so.

    Clefts can occur in isolation of either the lip or the palate. Or other structures like the ovula. This is when the palate (Roof of mouth) is having an anterior part (primary palate) and a posterior part (secondary palate). Or anatomically, the hard (bony) palate and the posterior (soft) palate with muscles. The clefts of any of the regions show a wide variation.

    To understand the causes of cleft one has to have an idea that the developing embryo structures do so in tandem. The tissues involved migrate and fuse from one end to the other, usually the end mid face, nose, jaws both lower and upper (mandible and maxilla).

    In the developmental process, should there be a failure to fuse, of any of the processes, a space (cleft) results. Most of the facial structures begin development in the embryo at the age of six weeks post conception.

    A lot of factors/causes have been associated with oral and facial clefts. In most cases of clefts, the aetiology (causes) remains unknown – no single factor stands out to be the cause. Clefts can be isolated – the affected individual has no related health problems. Clefts can also be a part of other birth disorders and syndromes.

    A syndrome is a group of physical developmental and sometimes behavioral trait that occur together. This implies that the presence of a cleft may be a part of more serious health problems so every incidence of clefts must rule out associated health problems.

    There are over three hundred syndromes where clefts are a feature. However most of them are extremely rare. They are often named after the scientists who makes the discovery (associations). Most cleft lips and palates are often isolated occurrences. Some of the syndromes are genetic. It is important that the medical geneticists are contacted early in the management process of clefts.

    For clefts that are non syndromic, it was thought hereditary played a large role however evidence has not shown this to be significantly correct, depending on the figures quoted. The implication of any genetic correction does not rise more than 20 per cent.

    Environmental factors as shown in experimental animals during the developmental process have been implicated in the causation of clefts.

    There are other factors such as nutritional deficiencies, radiation, several drugs, hypoxia – lack of sufficient oxygen excess of vitamins or deficiencies in certain clefting requirements in the oral/facial apparatus.

    Should there be a genetic predisposition in clefts in individuals, the parents may need to be counseled on the relative risks of clefting in their offspring’s.

    Generally speaking orofacial clefting is produced by mechanisms that have not been fully understood but certain to be a combination of genetic and environmental factors.

    Individual with cleft develop enumerated problems below:-

    • Dental problems: – This is often from missing, teeth, extra (supernumerary) teeth. The cleft usually develops in the lip between the front teeth (incisor). The first and second one. The teeth may become rotated, displaced or absent entirely. They may be extra teeth or even fail to erupt.

    • Malocclusion that is the jaw relationship and teeth relationship. The teeth may be crowded or due to different sizes. One jaw or both jaws grow at different rates hence they become disproportionate.

    • Defermation of the nasal bone

    • Swallowing and feeding.

    Swallowing food is normal once material being fed reaches the posterior parts of the mouth – beginning of the pharynx. The difficulty encountered is in suckling as often not enough negative pressure is produced when the mothers nipple is placed in the bay’s mouth.

    The reason for this defect in cleft affected individual is the defective development of the muscles of the oral cavity.

    This is initially overcome with the development of specially designed repples that elongate forwards.

    The posterior part of the oral cavity. The orifice of the feeding teats are also larger to cope with the reduced negative pressure and increase the flow. Simpler methods include use of droppers like the eye dropper apparatus, plastic syringes.

    The drawback here is the child will tend to swallow a lot more air therefore feeding is not done in the recumbent position

    Ear problems tend to increase viz infections of the middle – ear. The association is the anatomy of the palate and functions of the palatal muscle especially the posterior part – sift palate. There may other associated ano,alities with cleft lip, palate or other clefts of the orofacial region. The probability of associated anomaly in children with higher than in those without cleft.

    Congenital defects such as club foot, neurological disturbances may occur in addition to clefs in the orofacial region. These muscles of the palate have connections with the middle ear apparatus, their absence in clefts result in the middle ear essentially becoming a closed space and no drainage mechanisms hence infection of the inner/middle ear.

    Speech problems (the consonant variety – p, b, t, d, k and g most commonly). The consonant sounds are essential for development of vocabulary much language activity is restricted, sometimes omitted.

    The structures of the tongue, lips lower jaws and soft palate all work in sync to produce speech. The soft palate acts as a value hence if not developed or with defect, there will be speech problems.

    Parents who have children with cleft can receive help through some assistance from dedicated NGO’s like the smile train most teaching and specialist hospitals. The affected individual is first screened treated begins early to deal with all defects as it may arise.

    See you next week…

     

  • I’m having tiny boil-like things on my vaginal lip

    Dear Mrs. Adeola, I am a girl of 13 and I have 3 questions to ask. I started my menses January/February this year. My blood smelt like urine for four days. Second, there are tiny boil-like things on my vaginal lip. Please is it an infection? Third, there are white fluids always discharged from my vaginal. Please if this is an infections what is the cure?

    Dear Teenager, you may or may not have an infection, but when cases like this come up, my first reaction is always that you seek medical attention. In the case of infection for instance, different cases sometimes have similar symptoms and only laboratory analysis can detect the real cause of such symptoms. Boils on vagina skin or lips can be caused by a number of factors, including: poor hygiene, poor diet, being overweight, or an immune disorder. Most commonly they are caused by ingrown hairs that develop as a result of shaving your vagina. They can also be caused by friction, created by wearing underthings that are too tight or that are made of synthetic materials that don’t allow the groin to get enough air. Finally, if you are a regular exerciser, moisture can get trapped between your workout clothes and your skin, allowing bacteria to grow into vaginal boils.

    How To Treat Them: Treating vaginal boils requires that you keep the area as dry and free from friction as possible. Switch to cotton panties if you don’t already wear them, and be sure to change them frequently -at least once a day and more if you are sweating or working out. If you use pads or liners during your monthly period, be sure you are changing them frequently throughout the day to prevent moisture and bacteria from building up. If you shave, add daily exfoliation to your routine. A dry brush swiped several times over the shaved area will keep dead skin cells sloughed off and prevent ingrown hairs.

    Getting Relief From The Symptoms: Let’s face it – there isn’t much you can do to avoid a little friction in this area, and your skin is probably hyper-sensitive if you are suffering an outbreak of vaginal boils. First, get a homeopathic spray that contains hepar sulphar.

    This all-natural ingredient helps to calm skin sensitivity, and reduces pain and swelling. Next, apply a warm compress to the area several times a day. This should help you bring the infection to a head. Remember, this is a highly contagious infection, and you need to be extremely careful when it starts to drain. Use antibacterial wipes to clean the drained fluid away, and then swap the area with hydrogen peroxide.