What happens in the developing world?
In many parts of the developing world cleft patients remain untreated and therefore suffer a miserable existence – they may not go to school, they may be unable to obtain employment and they may not marry. In some parts of Uganda, babies born with clefts are called Ajok or Ojok, which means "cursed by God".
For parents in the developing world the cleft of the lip is frequently their priority, whereas it is the cleft of the palate that causes the major problems – affecting speech, hearing and even eating. Some patients have the opportunity for repair of their cleft lip but their palate is never repaired. Few are seen again and therefore further problems will never be rectified. Operating theatres are ill-equipped and often dirty. Wards are overcrowded. Operations are often postponed or cancelled as more urgent cases take priority.
There are always crowds of hopeful parents with babies that should be operated on and some adults as well. It is very difficult for surgeons to decide which patients to prioritise.
There is usually no follow up for patients in the developing world.