Kenyan hospital where cleft patients get to smile again

Bella Risu Medical Centre (BMC) is Africa’s first and only cleft lip and palate only health facility, offering treatment to patients, and care to their caregivers.

Tucked in one of Nairobi’s busiest and biggest business hubs is Bela Risu Medical Centre, a cleft lip and palate-only health facility. It is a slow day as there are no scheduled surgeries or medical procedures at the medical centre. But a few people walk in and out; enquiring about different things. A few minutes to 5pm, a young man walks into the compound and heads straight to Dr Martin Kamau, BMC Co-Founder and lead maxillofacial surgeon at the facility. His quick glances around the artistic work in the compound depicts a hopeful soul; perhaps convinced that his kin would smile again and gain the required nutritional milestones.

Dr Martin Kamau, BMC Co-Founder and lead maxillofacial surgeon at the facility

Seemingly happy to have found Dr Martin free and available to talk to him directly, the young man wastes no time. He starts to explain the feeding challenges that his nephew is facing following a recent corrective cleft surgery. “We are not sure what foods to eat, neither are we aware of how long it will take for the boy to recover,” he explains to Dr Martin. “You will get all the help you need here,” Dr Martin assures him as engages him in the discussion on post-surgery nutrition and speech therapy.

This young man paints the picture of many caregivers of cleft patients who grapple with multiple challenges post-surgery. “Cleft lip is more than just a cleft lip. There are other issues to deal with. They range from nutritional challenges as children with this condition struggle with breastfeeding which is essential in their early years,” explains Dr Martin.

A section of BMC medical facility in Nairobi

Due to the existing health systems, cleft lip and palate treatment remains a challenge as it is not prioritized in many countries’ health policies. As such, the medical outreaches are spontaneous and only serve those who can access the periodic medical camps. With 47 counties in Kenya, it requires more targeted and
continuous medical camps to reach everyone who needs this service. This, however, leaves a gap on subsequent medical enquiries and follow-ups.

Comprehensive care facility for cleft lip and palate patients, families It is this gap that inspired Dr Martin and his co-founder to seek a permanent solution; a facility that would offer comprehensive care not only for patients but also to their families who often face stigma and stress. “In 2017 we saw this space
and decided to do something to ensure continuity of care and fully connect to the patients.”

After some years of outreach in remote parts of Kenya, Somalia, South Sudan, Angola and Bangladesh, BMC experienced challenges in effective follow-up and possible dropout by patients who needed consistent medical attention post surgery. This comprehensive care centre consists of two theatres and 25 beds to handle speech therapy, dental alignment, nutritional advice, and facial deformities. Dr Martin refers to it as the brick and mortar of the cleft and palate treatment and care where the team treats the visible (cleft and palate) and the invisible (the associated stigma of the condition). Here, patients can walk in from Monday to Saturday 8-5pm for inpatient services.

Teaching communities to ‘fish’ While medical outreaches play a critical role in taking the services of cleft lip and palate repair to the remotest parts of the African continent, the ability by local communities and health professionals to own the solutions to this challenge remains paramount. To achieve this, BMC’s Education and Training equips local healthcare providers with comprehensive hands-on surgical training. In May this
year, the team trained six maxillofacial residents at the Central Hospital of Lubango, Angola.

Dr Martin recounts the instances that have left him glued to the mission of putting a smile on the face of cleft patients: “My most memorable case was in 2014 in Butembo, North Eastern Congo. We conducted surgeries under the Central Church of East Africa. Although we travelled with the anesthetist, we never had any equipment and relied on theirs. We conducted about 20 surgeries in about two days.”

He narrates about the community’s act of appreciation that inspired the BMC team to keep up the work hey do to date: “We stepped of the operation room to find mothers dancing outside in appreciation. It occurred to me and my anesthetist that we were a huge inspiration and source of hope to these families.”

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