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A rural cleft project in Uganda.

A M Hodges1, S C Hodges

  • 1Kagando Hospital, Kasese, Uganda. A.Hodges@ukgateway.net

British Journal of Plastic Surgery
|February 5, 2000
PubMed
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A mobile surgical team provided cleft repair surgery across Uganda, training local surgeons and achieving excellent patient outcomes. This approach proved safe, cost-effective, and highly requested by participating hospitals for future visits.

Area of Science:

  • Global Health
  • Surgical Outreach
  • Craniofacial Surgery

Background:

  • Cleft lip and palate are common congenital conditions, particularly in developing countries.
  • Access to specialized surgical care remains a significant challenge in remote and underserved regions of Uganda.
  • A substantial number of unrepaired cleft cases exist due to limited resources and infrastructure.

Purpose of the Study:

  • To assess the feasibility and outcomes of a mobile surgical team providing cleft repair in Uganda.
  • To train local surgeons in cleft repair techniques during the outreach.
  • To evaluate the cost-effectiveness and patient safety of this surgical model.

Main Methods:

  • A prospective study was conducted over an 8-month period, involving a mobile surgical team visiting 20 hospitals across Uganda.

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  • The team performed cleft lip and palate repairs, transporting all necessary surgical equipment.
  • Immediate patient outcomes, hospital feedback, and costs were systematically assessed. Local surgeons received training.

    • Main Results:

    • A total of 336 cleft lip repairs and 41 cleft palate repairs were performed on 343 patients.
    • No anesthetic morbidity or mortality was recorded; perioperative morbidity was minimal (two partial wound dehiscence, one palatal fistula).
    • Five local surgeons received cleft repair training, and all participating centers requested follow-up visits. The cost per repair was £27.

    Conclusions:

    • Mobile surgical outreach is an efficient, safe, and cost-effective strategy for addressing the backlog of cleft cases in resource-limited settings.
    • Training local surgeons enhances sustainable capacity for cleft care in developing countries.
    • The model demonstrated high patient satisfaction and a strong demand for continued services.