Seattle doctors work to make a difference in Africa

For the fifth time, the unconscious boy was undergoing surgery for cleft-palate revision.

Beneath the circle of light in the Seattle Children's hospital surgical suite, craniofacial surgeon Dr. Joseph Gruss cut a flap of skin that would bridge the gap in the boy's palate. The surgery would make it possible for the boy to drink without fluid entering his nasal cavity.

For Dr. H.O. Olasoji of Nigeria, who observed Gruss' unique method of repair, it was one more bit of knowledge he'd take back to Africa to teach others; one more step in making a life-or-death difference for children born with cleft palates; one more strike against infanticide or death from malnutrition and disease.

In September, Olasoji came to Seattle to observe surgery and other aspects of care at Children's as part of the project called Seattle-Kumasi Advocacy for Team Cleft-care in Africa (SKATCA). But last May, Gruss and his colleagues went to Kumasi, Ghana, as part of a unique program that Children's doctors hope will set an example for medical teams working in the Third World. The team focuses on cleft-palate surgery — one of the easiest problems to solve surgically but one that can mean the difference between ostracism or inclusion, or even life or death.

SKATCA was founded by the Children's craniofacial doctors, the Missouri-based Smile Foundation and doctors from Ghana. Seattle physicians operate with the available equipment in African countries.

In Ghana last year, using what was available meant doing surgery without an overhead light or even a clamp to hold open the patient's mouth.

By working in the same conditions as African surgeons do, the Seattle surgeons were able to show them ways to improve care with what they have, or how to do so with a few low-cost modifications.

"You don't just import something from America to Africa. It won't work," Olasoji said.

SKATCA was started by Seattle craniofacial surgeons Richard Hopper and Michael Cunningham.

After two trips to Africa, they've found that some of the needs are very basic, such as managing patient flow. Olasoji, for example, has no appointments; every day he picks out candidates for surgery from a waiting room of 300 to 400 patients.

The backlog of patients is so long that "a child who is malnourished because of a cleft palate has a greater chance of infection and death before even getting to surgery," he said.

After almost a week at Children's, Olasoji was full of new ideas.

"There are so many instruments available, but only 50 percent are used," he said. "If I can take just eight new ones back — things we can't afford. It will help the poor people of Africa."

Nancy Bartley: 206-464-8522 or nbartley@seattletimes.com