‘Smile Train Impact in West Africa Phenomenal, Revolutionary’
Smile Train is an international children’s charity with a sustainable approach to a single, solvable problem: cleft lip and palate. According to the organisation, millions of children in developing countries, including Nigeria, with untreated clefts live
How will you assess the activities of the Smile Train in Nigeria and West Africa? I will begin by saying that Smile Train System architecture is anchored on four pillars: medical, technology, donors and programmes, which revolve around financial help to poor patients, who cannot afford the cost of surgery and training of medical professionals to upgrade their skills. What makes us unique is the fact that all of the surgeries we fund are performed by local doctors in local hospitals through free training, equipment and financial grants; we are helping communities to become self-sufficient. Small Train has been in Nigeria for 10 years. Since I joined in 2011, we have been able to grow the programme in scale and numbers by over 400 per cent by simply using the ‘teach a man to fish’ model which has enhanced the sustainability of the programme for longer term. We empower the local medical professionals to provide free, safe, and high quality comprehensive cleft care to as many patients in their own local communities all year round. We have created over 25,000 smiles (and still counting) in the region. And I can tell you that the impact has gone beyond creating simple smiles. It is phenomenal and revolutionary.
What were some of the initial problems you encountered and how were you able to tackle them?
The West and Central Africa region is a diverse multicultural territory with an estimated 390 million population, yearly cleft birth of 12,000 in 22 highly segmented countries of three different major international languages – English, French and Portuguese. Travelling is prohibitively expensive due to the poor transportation system. We’ve had to deal with insecurity, terrorism and unstable political climate with the attendant adverse effects on the people and governance. In Nigeria, we keep experiencing incessant strike actions by medical professionals. And as in several areas of healthcare, the human resources and facilities available for the provision of comprehensive multidisciplinary care of patients with cleft lip and palate deformity on the continent are very limited. Initially, it was insufficient cleft surgeons and cleft care practitioners in the Francophone, Central Africa and some English-speaking West African countries like Liberia, Sierra Leone and The Gambia. So, my first task was to identify surgeons in these countries who are interested in cleft care and organise training for them so as to reinforce the scientific foundations of cleft surgery and provide them hands-on training in surgical techniques. There has been significant progress in this area.
Then, the challenge of infrastructure and equipment; most hospitals have poorly equipped operating theatre. Our number one priority in cleft care is ensuring the safety of the patient. Smile Train has provided partners with equipment such as anaesthesia machines, pulse oximeters and cleft sets/ instruments. This in no small measure has helped in improving the quality and safety of surgeries and care of our cleft patients. Worthy of mention is the Smile Train Global Oximetry project which has been of tremen- dous value. These pulse oximeters are what I simply call ‘Life Savers’. Not only are they crucial in monitoring the oxygen saturation of the patient who is under the administration of anaesthesia intra-operatively or post-op operatively, they are portals, durable and come with long-lasting battery life – which allows it to work without direct electricity. This is a plus considering the challenge of epileptic power supply in the region. We also have issues of malnutrition and underweight babies. Many of the children come from challenging environments including IDP camps and require nutritional rehab before surgery can be performed.
Cleft deformity comes with a lot of psychosocial problems. Many children with cleft lips or palates suffer discrimination and their family is traumatised. Those who manage to reach adulthood are often banished to a life of isolation. We still have a huge backlog of adult cleft patients in the region. So, lack of awareness is another challenge. The need to educate our people that cleft has no spiritual connotation cannot be over-emphasised. As was the case with twins before the great Mary Slessor, our people regard children born with cleft lip or palate as evil occasioned by witchcraft or punishment from God. This is why the support of the media is very important to help us propagate the message of hope and the availability of this service to our people. No cleft child should be left to suffer any extra day. Smile Train is here to help.
How would you compare the case of cleft lip deformity in children among West Africa, Latin America and Asia?
Cleft deformity is a major problem in developing countries where there are millions of children suffering with unrepaired clefts. We know from reviewing the World Health Organisation data that every year more than 170,000 children are born with cleft lip or palate in the developing world. It’s a common birth defect. In fact, globally one in every 700 children is born with it. One in 1,200 children estimated cleft incidence is of Africa/Africa descent. 19,000 cleft children are born every year in Africa out of which 12,000 in West Africa and 6,000 in Nigeria alone. In my opinion, these figures could be underrepresented because they are based on registered hospital birth records. How about babies that were delivered at home or at the farm? Cleft babies are usually born to parents of low socio-economic status; many in the rural areas, with poor access to care. Sadly, the problem is enormous and not a priority of most governments. This is why the support of Smile Train is very commendable.
Is there a way the deformity can be detected before birth?
Yes, it is possible to detect cleft deformity in a child before birth through the use of ultrasound scan. A cleft is a harmful condition though not life-threatening in which the roof of the mouth and/or top lip does not close properly. It occurs due to errors in the growth process when the different parts of the face are formed in the womb. Normal lip development occurs between four and six weeks of gestation, while the palate develops between six and 12 weeks. The upper lip develops from the fusion of two different processes – failure of fusion results in cleft.
So, when the cleft is picked from the imaging, the family gets well informed and prepares ahead to what to expect and the available treatment services.
Why does cleft occur?
It is still a medical mystery. Research is ongoing to better understand the condition. No one knows exactly the cause, but most experts agree that there is an interplay between many genetic (internal) as well as environmental or nutritional (external) factors. Some cleft are isolated (sporadic) and others syndromic (associated with genetic mutations). Parents who have family history of cleft have a high risk of giving birth to cleft children. It could be environmental: poor nutrition, wrong use of drugs, folic acid deficiency, infection, habits – smoking and high alcohol in-take, exposure to ionizing radiations and even parental age. The only solution today is a simple life-transforming surgery that costs as little as $250 and takes as little as 45 minutes.
What has been the success rate of cleft surgery in Nigeria and West Africa?
Typical like any other surgery, there are risks involved. At Smile Train, we have had very good success rate and near-zero mortality rates. Our number one priority is to ensure the safety of the patient, and it is the guiding force behind every Smile Train programme and initiative, and our doctors and associated medical professionals abide by our strict standards to ensure patients receive the highest level of care possible. If a child has a cleft, he can live with that defect for the rest of his life. The only thing is that the child may not enjoy life to the fullest like a normal person. Thus, cleft, for us, is still an elective procedure not an emergency and the repair must be done under the safest condition. We subject our partner hospitals to a rigorous credentialing process to ensure that the safety and quality protocol are met. Then we sign a Treatment Partnership agreement that would factor in the anaesthesia and surgical guidelines, timelines, safety and quality assurance checklist among others. If the partner does not meet and adhere to these requirements, they obviously cannot be on board the Smile Train. Our partners have attested to the fact that meeting Smile Train standards has immensely helped them to improve on their overall healthcare service delivery systems even for non-cleft related cases and many have successfully got accreditation from through various bodies.
Why do you choose to train your doctor-partners?
Again, we provide training to everyone involved in cleft care – nurses, surgeons and anaesthetists, dentists and orthodontists, speech therapists, social workers, communitybased workers. This is primarily to build local capacity, improve skills and expertise in providing comprehensive cleft care and for long-term sustainability. We also want to position our surgeons in the global arena and network of world-class cleft surgeons. We sponsor and give scholarship for international conferences. It is important to note that since 1999, Smile Train has performed over one million (still counting) free, safe and high quality surgeries in more than 85 countries. A recent study of Global Economic Impact of Smile Train Cleft surgery published in the World Journal of Surgery shows that for every $250 committed for one cleft repair surgery, as much as $50,000 is put back into the local economy (as the recovered patient goes on to meaningfully contribute to their society and lead a full, productive life). The economic output of a single cleft surgery is as high as 200 times the input.
In some West African countries, there are cases of unreported infanticide of cleft kids. How is Smile Train strengthening the advocacy?
As typical of Africans, we have deeply entrenched cultural beliefs and superstitions. Recall the killing of twins or multiple births before the missionary, Mary Slessor, helped to de-mystify it. We can say it is almost similar with cleft. It varies from region to region. In Yoruba culture, a pregnant woman is advised not to go out at night so that evil spirit does not possess the unborn baby, or she should attach a safety pin to her dress. Some would say child is born with cleft because the mother sighted the moon or solar power at a wrong time. Some attribute it to ancestral curse to his or her family and the pressure on parents often leads to divorce or the banishment of the family from the village. Most often, these children are branded as witches, and often forced to live as outcast. They are labelled evil spirit, seen as product of infidelity or past wayward activities on the part of their mothers. Some believe it is a punishment from God, while others especially in northern Nigeria take it as a gift from God for alms begging on the streets to generate income to sustain the family. The list is endless but it doesn’t rule out that fact that if the cleft is unrepaired, these children will lead lives filled with shame and isolation, pain, and heartache. Those affected may not live past their first birthday, will have difficulty eating, speaking and breathing.
Therefore, at Smile Train, we have strengthened our advocacy by initiating the Cleft Awareness Week. The aim is to have partners institutionalise a week in their calendar annually dedicated to creating awareness about the programme in any targeted community. When I visited many communities with many cultural sensitive issues and social hierarchy, I discovered that some still stigmatise cleft families, reject and even kill cleft babies. Meanwhile, the solution is right at their door step. The cleft week affords the community to take total ownership of the programme – information is power. During the cleft week, there are public enlightenment activities aimed at educating the populace and correcting the wrong perception of cleft. Cleft is not a curse or a bad omen. Cleft patients are not witches or demons and should not be stigmatised. We have health talks on all available media platforms – radio, TV and of course, the social media. Handbills and posters of pre- and post-operation photos of patients are distributed. This is to show that cleft can be easily corrected and the person can live a meaningful life. This initiative has proven to be a catalyst for the programme’s growth in the region.
We also have another advocacy initiative called ‘First Lady Initiative’. We try to put the face of the mother to the problem. Usually, when a woman gives birth to a cleft child, she is all alone and abandoned. We have engaged community leaders and influencers to support the programme and advocate for the care of the cleft child. They are very important to the success of our program. And we have received tremendous support thus far. About 70 per cent of our governors’ wives in Nigeria are Smile Train ambassadors. Recently, we’ve also signed on the MBGN Universe Nigeria – Debbie Collis, as one of our goodwill ambassadors. She has been active on a door-to-door advocacy and her One Smile Campaign. The message remains: No child should be killed because of cleft. Please when you come across any person with cleft, kindly refer them to any Smile Train local partner hospital. In Nigeria, we have partners and surgeons in all the 36 states and the FCT, Abuja. In West Africa and Central Africa, we have our programme running actively in these countries: Benin, Burkina Faso, Cameroun, Cape Verde, Central Africa Republic (CAR), Chad, Cote d’Ivoire, Equatorial Guinea, Gabon, The Gambia, Ghana, Guinea, Liberia, Mali, Mauritania, Niger, Nigeria, Republic of Congo, Senegal, Sierra Leone, and Togo.
Where do you see cleft care in the near future?
In addition to our dedication to safety and quality by offering a multitude of cleft education and training programmes and resources, Smile Train is also committed to ensuring that the care we are providing is comprehensive. Many may not realise this, but children born with clefts need more than just one surgery, and our local medical professionals evaluate whether or not additional nutritional, speech, dental, orthodontic, and therapeutic care is needed. Where these services are available, we do everything we can to provide our patients with access to them. Our vision of a cleft-free nation is to have a robust medical infrastructure and personnel easily and readily accessible to as many cleft patients especially young children who if early treated, can begin a great future without having to deal with all the stigma associated with cleft and live to contribute productively as members of their communities (and also to adults to give them a second chance to at life to smile. Together, we can make sure every child in our region born with cleft is given an opportunity to live productive life.
Lagos Floods and the Lone Boat Man
Although we in Shomolu were not affected by the recent rains and flooding that took over most of the island, we still had our own small share of leaking roofs and overflowing drainages. What we saw and heard about the wreckage that happened on the island was no child’s play. We were inundated with pictures and clips of different flooding episodes. People’s living rooms totally taken over by flood, whole streets and neighbourhoods turned into lagoons and oceans with sea faring large cargo ships sailing through some neighbourhoods like VGC where a full US warship passed through on its way to the Korean peninsula. It was not funny my people o, the rich people on the island were suddenly turned into destitute watching their expensive furniture and cars floating away right before their very eyes. It was really sad. Some people woke up in other people’s bedrooms o, I tell you. Someone actually saw himself on his neighbour’s housemaid’s bed, the water had dragged him there without his knowledge. But in all these, my real anger was with that lone boat man rowing his boat on Ahmadu Bello way. This thing pain me no be small. At first I thought it was a clip of a beach resort in Mexico that I was looking at until I saw the Silverbird galleria and suddenly realised that it was our own Victoria Island turned into an estuary of the Atlantic Ocean. This foreigner rowed his boat so casually down the length and breadth of the road even past the junction I usually buy suya with no care in the world. This person was basically laughing at us, at our ineptitude and our eagerness to allow our inefficient and corrupt ways get the better of us with such avoidable calamities. That man must be identified and arrested. He must be tried and convicted for laughing at us. Who gave him the permission to row that boat on our street or should I say newly formed temporary canals. I don’t even know who to blame for this flooding wahala. From Donald trump who does not believe in climate change, to the people who are sand filling everywhere to sell land that is in high demand, to those who have turned their drainage into dustbins. All have sinned and that is why water is taking up everywhere and rendering our people homeless and hapless. I think it is time for us to go back to our gods. Sacrifices will have to be made to appease the water gods or by this time next year, it may be a deluge.
Aviation Safety: Ooni of Ife Style
The internet is a lovely place. Another video which has caught my attention is the one showing the great Ooni of Ife carrying out his own safety measures. You know how it is when the flight is about to take off and the sweet young nubile flight attendants will stand in front of you asking you to fasten your seat belt and tell you where to jump to if the plane was dropping into the sea. The Ooni and his team did not really have time for that one o, they got a priest in full regalia complete with bald head to carry out safety precautions the traditional style. The man with the gourds in both hands went up and down the aisle chanting incantations and checking all components of the plane traditionally to ensure a safe trip for the highly respected king. It was very hilarious and I wished I was on the flight, I would have also stripped to my boxer shorts, dabbed a little bit of palm oil on my forehead and moved from my economy seat into the business class with the hope that all the incantations and rituals would make me invisible as I sit and wallow in the luxury that is a business-class travel. Na wa.
Etisalat Nigeria – A Bitter Lesson
Let me tell you guys what I have learnt from the ongoing wahala with Etisalat. I have learnt that blood is thicker than water. All these our people who will just be running around to go get foreign partners to do things when they can do them reliably better with local investors always have themselves to blame. You see now, the Arabs who owned about 40% of the company are withdrawing and not only that, have given them just three weeks to stop using their brand name. What is a partnership if it is not to withstand storms like this? Why would they jump out at the very first sign of trouble and this has led me to the question that apart from their names, what exactly did they really bring to the table from the outset? We have been taken for fools, they come with their highfalutin names which mean nothing but our bankers, the demagogues that they are will be falling over themselves to form empty consortiums to lend them money. Can you imagine the sheer quantum of funds involved, poor people’s money o and if you owe them N2,000 the kind of recovery agents they will unleash on you ehn, you will regret. So these vultures mobilise funds from our grassroots people, sell their services to the same grassroots people and take revenues generated from the grassroots people and pay back the same loans and keep a good spread for themselves. Making money out of nothing. What do we get in return, they employ some of us and we are dancing, their partners also get a small part of the cake and they too are happy. Now the bubble has burst they have run away leaving their big-headed partners alone with an empty sack to face creditors and regulators. This is what we used to call in the University of Ibadan mumu 101. We are just a country of n………. let me don’t talk. We are watching as the whole thing unfolds and will continue to comment and hope that our business leaders and indeed political leaders will learn from this saga. I have dumped my Etisalat line, the thing don kuku stop to work.
How Not to be a Role Model
In my life I have been influenced by some great people. People like Akin Kekere Ekun and much more recently Gabriel Ogbechie. These two people and a smattering of others have continued to show me that hard work and integrity remain the footstool of enduring success. In trying to build my career and my person, I strive to live by the ideals I have learnt from not only these two great men but others that I have passed through. However same cannot be said of some others who have shown a great sense of disloyalty and dishonesty not only to me but also to the society. My people, there is nothing better than being forthright, nothing better than being a man of your words and despite the challenges that are besetting us in life especially the harsh economic climate, one needs to continue to stand forth and be counted as a pillar in society. That is my plan and my pledge to my son who has been watching my every dealing and action with a keen eye. This advice I will like to give to others who we see as role models and father figures to always remember that their actions and indeed inactions impact and influence those of us who look up to them for leadership. Let me keep quiet at this point even as I restate my continued loyalty and love to all those who I consider my role models. Abeg, nobody should call and ask for explanations o, na just idle talk.
AJUDUA’S HOME FOR SALE?
When Fred Ajudua, an alleged serial fraudster, built his Victoria Garden City (VGC) home some years ago, not a few purposely took trips to the house styled after an Arabian palace. Everything about the architectural masterpiece then oozed taste and wealth.
But today, investigations revealed that the story has changed tremendously, as the house is now a shadow of itself. No more the glowing coats of paint. In fact, it has lost its beauty, as weed has now covered almost the entire exterior.
A source hinted that the palatial building might have been put up for sale. The reason, according to the source, is that the house was fast giving the residents in the neighbourhood sleepless nights. It is said to have become a haven of sorts for different species of snakes.
Ajudua is allegedly involved in one of the celebrated cases of Advanced Fee Fraud, otherwise known as 419 in the Nigerian parlance. He has been facing trial alongside one Alex Okorie for defrauding two Dutch businessmen of $1.69 million since 2003.
He is being prosecuted by the Economic and Financial Crimes Commission, EFCC, for allegedly deceiving the victims by claiming that the money was for sundry payments to various government officials.
Until his descent into infamy, the Delta State-born businessman was a top socialite and one of the biggest boys in town. He was also popular among some top musicians who constantly sang his praises and were handsomely rewarded.
ADEMOLA ADELEKE’S DANCE OF JOY
Anyone who has seen the trending video of Ademola Adeleke, the newly elected senator representing Osun West Senatorial district, dancing so heartily would have been little surprised if he or she has read the words of Mark Twain: ‘’Keep away from those who try to belittle your ambitions. Small people always do that, but the really great make you believe that you too can become great. “
It was an impulsive dance of joy; a dance of victory in a moment of glory. In the thinking of some, the historic dance is understandable for one major reason: his dream to replace his late brother, Senator Isiaka Adeleke, at the Upper Chamber had been actualised, in spite of the alleged threat by the state Governor, Ogbeni Rauf Aregbesola.
The Lagos-based socialite and businessman had the dream, held on to it with the firm belief that he would surely be victorious. Until his emergence as senator in the last Saturday bye-election in the state on the platform of the Peoples Democratic Party, PDP, many had sneered and even called him unprintable names.
With the victory, Ademola is now the third senator from the Adeleke family. His father, the late Chief Ayoola Adeleke who was Balogun of Ede was a senator under the Obafemi Awolowo- led Unity Party of Nigeria, UPN; his elder brother, the late Isiaka Adeleke otherwise known as Serubawon, was also a senator.
He left the All Progressives Congress, APC, after a fierce battle with Governor Aregbesola whose preferred candidate was the more politically experienced Mudashiru Hussein of the ruling All Progressives Congress, APC.
His defection to the PDP turned the fractured political platform into a formidable force for the July 8 senatorial contest.
In the face of this, he pinned his hope on his family, who is a force to reckon with in politics in Ede, Osun State, his home town.
OPEYEMI BAMIDELE RETURNS TO THE CENTRE STAGE
Vibrant and brilliant Iyin Ekitiborn former Commissioner for Youth, Sports and Social development in Lagos state, Opeyemi Michael Bamidele could be said to have adopted a low profile for several months as little or nothing has been heard from his ends. He was last heard about after his failed attempt to become the governor of his state, Ekiti, during the last governorship election in the state.
It will be recalled, his ambition became a thing of interest to many even beyond the shores of Ekiti because he actually contested the election against the wish of his mentor and godfather, Asiwaju Bola Tinubu, that he decamped from APC to pursue his ambition on the platform of the Labour Party. However, he has since reconciled with Tinubu and returned to the APC fold. Meanwhile, the graduate of Obafemi Awolowo University and University of Benin, Bamidele may have concluded to return to center stage, if information reaching SPYGLASS is anything to go by. According to a source, the former member of House of Representatives will clock 54 on the 29th of this month and invites are said to have been sent to guests to join him in Ekiti State to mark the anniversary. The event, we learnt is expected to re-launch MOB, as Ope is fondly called to political limelight as it is said to have been designed to have political colouration, especially as it has been confirmed Ope still has his gaze on the governorship seat of Ekiti State even as the incumbent’s tenure is slated to come to an end next year.
For a fact, the Ekiti State-born politician received his political tutelage under the APC national leader, having served as a commissioner under him while he was governor of Lagos. Much later, Tinubu ensured his victory in the race to the House of Representatives in 2011 under the Action Congress of Nigeria (A.C.N). To say that Opeyemi also enjoyed a robust relationship with Tinubu until 2013 is to say the obvious.
But they fell apart before the Ekiti election that brought back the present governor, Ayo Fayose before they finally reconciled few months to the 2015 general election.
OLORI WURAOLA’S ACTIVISM
Again, Olori Wuraola Ogunwusi, wife of the Ooni of Ife, HRM Oba Adeyeye Ogunwusi, has lent her voice to the fight against domestic violence in our society. Penultimate week, the woman of substance led a campaign tagged “Walk Against Domestic Violence” in the streets of Lagos. A number of female personalities, including star actresses in Nollywood, joined her in the walk, as they carried banners with screaming inscriptions against the condemnable act. Olori Wuraola is not new to being in the forefront of the struggles for the cause of the womenfolk in the country, particularly in the South-west. In the past years, she has been reaching out to her target audi- ence through her non-governmental organisation, The House of Oduduwa Foundation. A few months ago, she donated relief materials to some IDPs in Ife, organised a ‘Give Back Concert’ in Lagos at the Convention Centre of the Eko Hotel, Lagos and also executed ‘The Orphan Aid Project’. It will be recalled that she was part of the United Nations delegates to a conference in New York, US a few months ago, where she was one of the six international panelists; she shared her views on ‘Safeguarding and protecting the endangered cultural heritage in time of conflict’. Her contributions as gathered, earned her a standing ovation from the audience.
KAY OVIA’S HEART OF GOLD
When you think of women who are blessed with beauty and brains, Kay Ovia, wife of billionaire banker, Jim Ovia, Chairman, Zenith Bank Plc., comes to mind.
By all standards, she could be said to be one of the few born under the proverbial lucky star. But unlike many in her shoes, she loves to identify with the hoi polloi. It is a fact that she loves kids and is doing everything humanly possible to give hopes and a bright future to disadvantaged ones through her talent hunt project.
Spyglass gathered that the amiable woman, who is very motherly, loving and welcoming , embarked on the project to help Nigerian children who are creative and talented, but don’t know how to explore their God-given talents. Since the inception of the project, many have benefited immensely. She organises a party annually for orphanages at her house.
In spite of her privileged position, her doors are always open to all.