title: The impact of a single surgical intervention for patients with a cleft lip living in rural Ethiopia.
abstract: BACKGROUND
  Humanitarian organisations commonly provide reconstructive treatment for patients with cleft lip within developing countries, but follow-up is often non-existent, particularly for those living in rural areas. This study aimed to assess whether a single surgical intervention was sufficient to produce an observable change to the life of a patient with cleft lip living in rural Hararghe in eastern Ethiopia.
  
  
  METHODS
  356 patients with isolated cleft lips, who received a single surgical treatment at least 6 months previously, were evaluated in 21 rural health centres.
  
  
  RESULTS
  Patients and their families expressed unhappiness before treatment, mainly because the society reacted negatively towards the deformities, isolating the patients from community activities. Postoperatively, the percentage of school-aged children participating in education increased from 46% to 79%, some older patients were able to marry, but employment was unaffected. The prevalence of wound dehiscence in the lip repair was 3% and occurred more frequently in patients with a bilateral cleft lip compared to a unilateral cleft lip (p < 0.001, RR 49.25, 95% CI 6.7-1037.35).
  
  
  CONCLUSIONS
  We demonstrated that follow-up can be achieved by charitable organisations treating rural patients and that the majority of patients report a positive impact following surgical intervention. We recommend that bilateral cleft lips have a more intense rural aftercare.
authors.affiliation: Frenchay Hospital, Bristol, UK. Electronic address: mattfell@doctors.org.uk.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Fell
authors.affiliation: Project Harar Ethiopia Charity, London, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Hoyle
authors.affiliation: Yekatit 12 Hospital, Addis Ababa, Ethiopia.
authors.forename: Mekonen E
authors.initials: ME
authors.lastname: Abebe
authors.affiliation: ALERT Centre, Addis Ababa, Ethiopia.
authors.forename: Yegeremu
authors.initials: Y
authors.lastname: Kebede
authors.affiliation: Yekatit 12 Hospital, Addis Ababa, Ethiopia.
authors.forename: Yohannes D
authors.initials: YD
authors.lastname: Medhin
authors.affiliation: Yekatit 12 Hospital, Addis Ababa, Ethiopia.
authors.forename: Fikre A
authors.initials: FA
authors.lastname: Hiwot
authors.affiliation: Yekatit 12 Hospital, Addis Ababa, Ethiopia.
authors.forename: Taye H
authors.initials: TH
authors.lastname: Cifeta
authors.affiliation: Yekatit 12 Hospital, Addis Ababa, Ethiopia.
authors.forename: Ibrahim M
authors.initials: IM
authors.lastname: Ali
authors.affiliation: Guy's and St Thomas' Hospital, London, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: McGurk
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D062109:Dermatologic Surgical Procedures / Q000379:methods*; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D010781:Photography; D011183:Postoperative Complications / Q000453:epidemiology; D019035:Rural Health Services; D012424:Rural Population; D016896:Treatment Outcome
keywords: Cleft lip; Developing countries; Ethiopia; Outcome; Post-operative follow-up; Rural outreach