We all expected a simple happy story when we arrived in Larabanga to meet Faruk and his family. However, we witnessed the social and financial impact that cleft lip and palate has on families in developing nations all over the world. Faruk’s father rejected him and his mother shortly after his birth. The father, his family and many members of the Larabanga community labeled Faruk and his mother as cursed. Although the community gradually started to accept Faruk and his mother after the repair, they still were living off alms.
Category: Cleft Palate
Cleft palate is a condition in which the hard palate does not fuse together during embryonic development. This results in a hole in the hard palate, which may or may not be covered by soft tissue, that can lead to speech and feeding issues. Cleft palate can co-occur with cleft lip but cleft lip can also be present without a cleft in the actual palate.
Ghana January 2014: More to see and learn: Mole and Larabanga
Today we drove from Tamale to Mole on the bus while enjoying an “African massage” from the unpaved, bumpy roads. Along the way we stopped to see a traditional village. The village consisted of several families living in mud huts. Unlike cities such as Accra where it’s more common to have fewer children, men in this area would have multiple wives, and up to 20 children. We met the elders of the village, and were introduced to a chief from the surrounding village who’s daughter had a physical disability. The chief explained that the family treats the child just like all their other children, and Jenna spoke on behalf of the group to agree with this approach, and to share how we try to accept children with disabilities in the US.
Ghana January 2014: Fourth and Final Day at Korle Bu
Today was our final day at Korle Bu Teaching Hospital. We spent the morning providing outpatient speech and language therapy to patients who ranged in age and diagnosis, from adult stroke patients to young children with hearing loss, and everything in between! We are grateful to have had the opportunity to work with and learn from the Speech and Language Therapy team at Korle Bu, especially Dr. Albert Osei-Bagyina (the first Speech Language Therapist in Ghana), Josephine, Nana Akua, and Clement.
Ghana January 2014: Continuing to learn at Korle Bu Hospital
Today was an exciting day! We headed to Korle Bu Hospital bright and early and immediately started seeing patients. We saw many new and some old faces as some of our previous patients came back for a second or even third day of therapy. Throughout the day we continued to work with patients with autism, language delay, articulation disorder, hearing impairments, vocal fold paresis, and patients who have suffered from a stroke.
We were then whisked away to go see a cleft palate surgery in small groups! Dr. Ampomah, head of ENT at Korle Bu Hospital, warmly welcomed us into his operating room and we stood elbow to elbow with him as he operated! During the surgery, Dr. Ampomah made sure to explain the process and his every step. We eagerly looked on and excitedly recognized various structures and anatomy of the mouth. This was a once in a life time opportunity that we will always remember!
After our busy day at Korle Bu hospital we headed to a local Ghanaian market in Accra to do some shopping. We ended the day with a talk from the famous Albert, one of the amazing SLT’s we work with in Ghana, and his son Pius. Albert shared his story about becoming a speech language therapist, while Pius discussed both the challenges and rewards of being a doctor in Ghana. Afterwards, we reviewed cleft palate to prepare for our exciting day at the cleft palate conference tomorrow!
Thanks to Eleni Gkikas and Allison Lekich for the post.
International Resources: Feeding Babies with Cleft Palate with Breast/Cup: Parent Handout in English
FEEDING BABIES WITH CLEFT PALATE.pdf
This handout was based on the original by Dr. Cate Crowley, Miriam Baigorri, and Jayne Miranda for Dr. Crowley’s international work in East Africa. It is a parent friendly single page document with easy to understand language and accompanying illustrations to help parents understand the basics of feeding a baby with cleft palate using a cup or the breast.
Playlist of Cleft Palate (Paladar Hendido) Videos: Video Tutorials to Improve the Speech of Children with Cleft Palate/ Videos para Mejorar el Habla de Niños con Paladar Hendido
This is a collection of 7 videos in Spanish created by Cate Crowley and Miriam Baigorri while working with children in Guatemala who had repaired cleft palates. The sounds covered include S, K, P, and D. Cate and Miriam also discuss feeding problems caused by cleft palate. Click on the Next or Playlist button to advance to a new video. Read More
Ghana Summer 2013: A little of everything speech, language and hearing
Today we got to choose what we wanted to do for the morning at Korle Bu. Some of our group headed to the Children’s Ward where we played, read, colored, and just tried to have fun with the children who had bandages on different parts of their bodies due to burns and other complications. A 3-year old child named Janice was coloring a picture with her bandaged hand and identified each color of crayon she used. We noticed that she produced /s/ as /θ/ so we had an opportunity to work on her articulation. We practiced producing /s/ by telling her to “trap the snake in the cage,” meaning keep her tongue behind her teeth to produce the sound. The patient from yesterday’s cleft palate operation was also there. She seemed to be doing well; she had an IV but her parents were giving her water orally, which was a good sign that she was recovering well.
Ghana Summer 2013: The surgeon is the teacher
Today we continued our work at Korle Bu Teaching Hospital. We spent the morning working with a variety of patients, some of whom were returning to follow up with either the Speech Language Pathologist at Korle Bu or for continued evaluation from our students. We genuinely enjoyed learning from the wide range of patients and their families. We were able to assess and then provide recommendations for children with language delays, autism spectrum disorder, other intellectual disabilities, and even an adult voice patient.
Throughout the morning, we worked on a rotation. At any given time about three quarters of us were working directly with the patients, while the other quarter was in the midst of experiencing a very special opportunity. Dr. Ampomah, the renowned cleft palate surgeon at Korle Bu, granted us permission to observe one of his cleft palate surgeries. We went in groups directly in the operating room, in scrubs, booties, head covers, masks and all. This was a learning experience that we would never have been so privileged to receive in the US and Dr. Ampomah was a wonderful and engaging teacher.
As each new group of students went in, Dr. Ampomah oriented us to what stage of the surgery he was at and what we were seeing anatomically. It was extraordinary to be able to look inside the mouth of a patient undergoing cleft palate surgery, watch each suture being threaded, and listen to Dr. Ampomah explaining his surgical strategies. As we observed the surgery and later discussed it amongst ourselves, some aspects that stood out included the suturing of the bifid uvula, the levator veli palatini, soft palate, hard palate, and both layers of mucosa.
It was increasingly evident to our whole group just how applicable and useful this experience would be in our work with any future patients with cleft palate and how it could contribute to our development of clinical experience and judgment. Additionally, we all felt that this would greatly contribute to our understanding of our patients from a more global perspective and we really saw the value of cooperating on a multidisciplinary team.
