Bringing A Smile To Their Faces

Professor Hermann F Sailer is reaching out to thousands of people who require cleft lip surgery.

Sapna Dogra - New Delhi

Professor Hermann F Sailer duting his recent visit to India

Prof Sailer says, “A cleft face is amongst the worst fates a child may suffer.” About six years ago, when Hermann F Sailer, an internationally acclaimed maxillofacial, craniofacial and plastic surgeon, was visiting India, he was appalled and devastated to see the condition of poor children born with cleft lip defect. Children born with a facial cleft are more common in underdeveloped and developing countries like India due to bad nutrition, unhygienic living conditions and abject poverty.

At that instant, he promised himself that he would help these children, and bring a smile to their faces. Since then, Sailer has been relentlessly working to fulfil his mission of reaching out to thousands of patients born with cleft lip in India, but deprived of corrective surgery. He founded Cleft Children India (CCI) and set up centres at Mangalore, Hyderabad, Chennai and Mumbai. Adopting a multidisciplinary team approach, the centres cover cleft lip and palate repair, speech therapy, orthodontia and craniofacial procedures. Apart from performing free operations, CCI also helps in rehabilitating as many children as possible.

Numbers Behind The Cleft

Even as about 35,000 children are born with cleft lip or palate defect in India every year, only an estimated 15 per cent of them receive surgery and close to 15 million patients are untreated for this defect in the country. The problem is compounded by the fact that though this can be corrected even in infancy with simple plastic surgery, over 50 per cent of the parents are unaware of the treatment and 75 per cent of the children do not receive it.

The pattern of the disease in Europe and India is more or less the same with one cleft lip per 600 normal births. However, the fact that 30 per cent of India’s population lives below the poverty line and existing malnutrition increase the magnitude of the malady.

On a winter afternoon on his recent visit to Delhi, Sailer shared his vision and plans for India. The Indian public health services are overloaded with a population of 1.2 billion people and the government cannot cope with the problem of cleft lip, he bemoans. “Of course, the government has perfectly mastered and handled several health problems but this problem is something which has not yet been addressed in an organised manner,” he adds.

Though the definite cause of cleft is unknown, insufficient folic acid in pregnant women leads to children born with malformation, says Sailer. Also, more boys have the cleft lip than girls. Interestingly, there are 14 different types of clefts besides that of the lip and the palate.

Why In India?

In 1972, Sailer founded the Craniofacial Centre at the University Hospital Zurich and began to receive malformed patients from all over the world. Later, extensive work by his foundation revealed that a cleft child is born somewhere in the world every three minutes, and the highest number of cases occur in India. India needs at least 60 cleft centres to address the problem, he professes. “However, even if we have 20 centres it would be great. In Europe, there are about 12 centres and in the US, the number is less than this. The low number of centres in these places is because one needs at least 60 new patients for a training centre to keep going and train new surgeons.”

One way of prevention is through careful administering of folic acid to women, suggests Sailer and adds that one can do it in special districts but it would be cheaper to perform operations at cleft centres. “If we could reduce the number of 35,000 to half, it would be some achievement,” he says and adds that there is need to raise awareness about treatment available.

Dual Training Needed

Though a maxillofacial /plastic surgeon is a specialist in his own right, he cannot perform proper cleft surgery. It is one of the most demanding operations in surgeries and more difficult than heart transplant, Sailer claims. One needs special training in a special centre to become adept. Having a dual qualification in medicine and dentistry is a prerequisite, he avers. Sailer himself studied medicine, dentistry and maxillofacial surgery.

Sailer has been training Indian doctors at his centres, and is happy with their skills and learning capabilities. A philanthropist at heart, he keeps busy fund raising for his centres and training doctors who want to take up this specialty. Soon he will set up centres in UP, Bihar and Rajasthan. However, doctors desirous of working in his centres need to sign a contract for a certain number of years so that his painstaking efforts and knowledge don’t go waste.

Now, Sailer wants to expand the centres, and plans to set up cleft lip/palate correction centres in and around Delhi. The founding president of Cleft Children International, his cheerful disposition and unassuming demeanour make him popular with doctors and patients alike. A diehard optimist, Sailer’s aim is to create a chain of charitable hospitals for treating this malformation of the face and the moment this is achieved, he will expand to other purposes as well. There is so much to do in the malformation of the face that it would be many years before the problem is solved, he observes. This altruist has shown us the path.

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