PESHAWAR, Sept 6: Cousin marriages are a prime cause of increase in cleft lip and palate cases among children, says an expert.

“Seventy per cent of the cleft lip and palate cases occur due to marriages between cousins,” said Dr Tahmeedullah Khan, a plastic surgeon at the Hayatabad Medical Complex (HMC). Other causes can be hereditary, environment related, malnutrition and self-medication by pregnant women.

Cleft lip and palate are a major problem in developing countries where millions of children suffering from disability cannot eat or speak properly. They also find it difficult to attend a school or hold a job, resultantly experiencing isolation, pain and heartache.

Dr Tahmeedullah, also coordinator of TheSmileTrain, a US-based charity organisation in Peshawar, said the organisation received $10,000 in grant annually. “We repair 20 cleft lips and palates free of cost.”

He said that since March 2000, TheSmileTrain had treated 250,954 cleft lip and palate patients in 71 countries. “The good news is that every single child with a cleft can be helped with surgery that costs as little as $250 and takes only 45 minutes.”

The organisation repairs 10-12 clefts in operation theatres twice a week. The ideal age for cleft repairs is between first and 30th day of birth.

The patients are required to be followed up to the age of 21 years.

“During the past three years, we have repaired more than 800 clefts. Every repair is completed within three to four phases of surgeries,” Dr Tahmeedullah said.

Children with clefts are unable to suck milks due to which they are fed through specially-designed feeding bottles.

“Lack of awareness and poverty has caused the problem to rise,” he said, adding that patients were reluctant to visit doctors.

Dr Tahmeedullah said the patients also needed services of speech therapists which were not easily available.

He said that a UK-trained speech therapist had offered two-day speech assessment services to the patients free of cost.

He said the NWFP had one plastic surgery unit and the waiting list for clefts was piling up. Local plastic surgeons in Lahore, Karachi, Rawalpindi and Islamabad also provided free services under the TheSmileTrain programme.

TheSmileTrain coordinator said the Pakistan Association of Plastic Surgeons in its last annul meeting in Peshawar had sought training facilities for plastic surgeons to cater to the patients’ demand.

Dr Tahmeedullah said that people should be encouraged to marry outside their families to contain the incidents of cleft lip and cleft palate.

“Fathers as well as mothers can pass on genes that cause cleft lip. One in 33 children is born with some sort of defect in South Asia. One in 700 is born with a cleft-related birth defect in Pakistan. Most of the cleft-affected babies are boys, but it is not uncommon for girls,” he added.