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German-African team treats cleft children in Rwanda

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After a one-year forced break due to the Coronavirus pandemic, our German volunteers Dr. Oliver Blume and Gunther Au-Balbach were finally able to treat cleft children in Rwanda again. Their mission took place from March 19th to 26th. They were joined by our surgeon Dr. Laurent Siborurema from Rwanda and anesthetist Dr. Emmanuel Munyarugero from Uganda, who have been working with Dr. Oliver Blume and Gunther Au-Balbach for many years now as indispensable members of the team. The host hospital for this joint German-African team is the Rwamagana Hospital in Rwamagana, just under two hours’ drive from Kigali, the capital of Rwanda.

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26 children are awaiting help

When our team arrives at the hospital, they are eagerly awaited by the 26 patients and their families. During patient screening, a little girl sticks out among the crowd: Claudine has a rare horizontal cleft.

The cleft extends from the right corner of the mouth across the cheek almost to the ear. The operation for this type of cleft is complicated. Oliver and Gunther are therefore happy to have an extremely experienced anesthesiologist at their side in Dr. Emmanuel Munyarugero. They have known him for almost 20 years and know that they can rely on him and his skills.

But it is not only Claudine’s operation that is more complex and therefore more time-consuming than a normal cleft operation. In almost half of the children, complex corrective operations have to be carried out. Such interventions are necessary if the first operation was not carried out professionally. It is not uncommon for this to be the result of relief missions by inexperienced teams – “Safari surgery” in which the children are essentially used for training purposes. Bulging scars, raised lips and large fistulas in the palate are the unsightly and often debilitating consequences.

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A written plea for help

Ernest’s story is particularly touching. The boy presents himself to the doctors at patient admissions with a piece of paper in his hand. “My name is Manirakiza, Ernest. How are you now. I am fine. I have education, I have painful mouth,” was the message the boy was sent to our doctors with.

At first glance, his problem is not obvious. It is only when the boy tries to open his mouth that his painful story is revealed. As a result of a chemical burn – presumably caused by acid – Ernest can hardly open his mouth. He has difficulty speaking, eating and drinking, and he suffers from chronic pain. It’s easy to imagine how painful it must be for him to yawn!

Even though Ernest doesn’t have a cleft, everyone on the team knows right away that this kid needs their help. Oliver and Gunther manage to restore an almost normal mouth opening. They also reconstruct the lips. Ernest can hardly believe his luck. During the entire operation he is always close to the team. Saying goodbye to Ernest is difficult. But it is reassuring for everyone to know that a new, better phase of life is now beginning for the boy.

As a sign of recognition and gratitude, an official photo session takes place in front of the Rwamagana Hospital with clinic management and community representatives at the end of the successful mission: A very special moment and the result of many years of trusting cooperation.

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Map of East Africa on a school wall: Over the 20 years we have been working in East Africa, we have treated cleft children in Uganda, Tanzania, Burundi and Rwanda.
German-African Friendship: Dr. Oliver Blume, Dr. Emmanuel Munyarugero, Gunther Au-Balbach (left to right)
Dr. Laurent Siborurema, head surgeon of our cleft project in Rwanda.
Group photo with the entire team
Claudine has a rare horizontal cleft.
In order to be able to restore the symmetry of the mouth and align the right half of the mouth with the left as best as possible, Dr. Emma intubates Claudine intranasally.
Great relieft: Shortly after the operation, Claudine is doing well.
A note full of hope: Ernest hopes that our team can relieve him of his chronic pain.
Shortly after the operation, Ernest’s lips are still swollen. In a few days he will be able to eat and drink normally and without pain for the first time.
Key local dignitaries show their appreciation by joining our team for a farewell photo: military and police chief, the mayor, the clinic director and the district health minister. We are grateful for their support!
From our projects
The story of Maui, cleft child from Colombia
Our new project to help children with cleft lip and palate in Colombia begins with a very unusual case. Maui was born with a cleft lip and palate. His parents belong to an indigenous people and do not know how to get him the help he needs. By a happy coincidence, Julia, a Swiss woman living in Colombia, is a neighbor of the family and offers to help. In search of treatment options, she comes across Deutsche Cleft Kinderhilfe.
Video: Impressions from Bolivia
The parents of our cleft children are always full of gratitude. When their child is born with cleft, they often do not know what to make of the malformation, much less that it can be treated. And even if they do - most of our little patients come from the poorest of backgrounds. Their parents could never afford the operation. It is an unimaginable happiness for them to learn that their children can receive qualified treatment, and free of charge even. This wonderful, touching film from our Bolivian aid project captures these special moments of happiness.
Video: Impressions from Pakistan
This film, made for our Pakistani partner organization, the Al-Mustafa Welfare Societey, by the father of one of our patients, shows scenes from our work in Karachi. From here, our senior surgeon Prof. Ashraf Ganatra treats cleft children from poorest families. He operates the children from Karachi at the Al Mustafa Medical Center. In order to reach the many needy families living outside the city, he also regularly heads out to local provincial hospitals to treat cleft patients there.