Management of cleft lip and palate in the developing world

  • M. Mars,
  • D. Sell &
  • A. Habel
(eds) UK: Wiley price £34.99; pp 221 ISBN 9780470019689 | ISBN: 978-0-4700-1968-9

This book presents practical and ethical issues surrounding the management of cleft lip and palate in the developing world, and the role of voluntary organisations in its provision. The book is a compilation of articles from contributors with a range of experiences in cleft lip and palate management in developing countries. The three editors are members of the North Thames Regional Cleft Unit based at Great Ormond Street Hospital, London.

The introduction explores the interesting issues of disproportionate demographics, the standing of cleft and palate amongst other life threatening conditions in developing countries, and the provision of peri-operative care such as speech and language therapy and orthodontics, and its sustainability. It also addresses the moral issues surrounding so called 'surgical safaris', where treatment is provided with alternative agendas, and where the beneficiaries are the visiting rather than the visited. This section is particularly well written, and sets the tone for the following sections.

The book is then divided into five major sections. These sections cover surgical, psychosocial, and auxiliary management such as audiology and speech and language therapy. There are also several chapters describing the range of cleft lip and palate organisations who deliver care in developing countries. Their respective history, governance, and obstacles encounters are detailed. A particularly noteworthy point is that the long-term vision of these organisations include a paradigm shift towards educating locals to ensure self-sustainability. This is a recurring theme of the book.

For those who are specifically interested in cleft lip and palate, the book features a section on current facial growth research, written by one of the editors. This section presents intriguing research on the impact of cleft lip and palate repair on facial growth, and is particularly thought-provoking for dentists with special interests in paediatric dentistry, orthodontics and maxillofacial surgery.

Due to this book being a compilation of articles, there is the occasional sense that it is lacking in continuity. Nonetheless, this book is a passionate account of ongoing efforts to provide comprehensive and sustainable care to cleft lip and palate patients in the developing world. Though there is little direct reference to dentistry, the practical and moral issues presented are certainly applicable across the spectrum of voluntary health-aid, and therefore, this book is wholeheartedly recommended.