Cambodia’s rate of untreated cleft lip and palate: world’s worst.

Cambodia’s beauty hides some ugly truths.

Cambodia is a beautiful country which allows some of its not-so-beautiful cleft lip and palate babies to go untreated. I traveled there less than a year ago to pay homage to the country’s beauty and unbelievable historic ruins. But one could not escape the harsh political climate which may be a holdover from the help neighboring Viet Nam provided in overthrowing the genocidal regime of Pol Pot several decades ago. As a result, many Cambodians must go to Viet Nam and other countries to get basic medical care. This means babies and children with cleft lip and palate don’t get the corrective surgery they need unless they can afford to travel. Eating and speaking properly elude many of these untreated cleft kids.

But first, a few photos and comments about Cambodia’s beauty.

Cleft lip affected author and wife at Cambodian king's palace.

Cleft lip affected author … and wife at the King’s palace in Phnom Penh.

Angkor Wat is one of the largest, most impressive ancient temples in Asia . . . and the world, for that matter. Whether it’s Angkor Wat’s reflection in water or another view of the seemingly endless rooms and courtyards in this sprawling complex, the visuals of the temple are magnificent.

Wonder of World: Angkor Wat in Cambodia.
Wonder of World: Angkor Wat in Cambodia.

The ultimate Indiana Jones fantasy, Ta Prohm, is cloaked in dappled shadow. Its crumbling towers and walls are locked in the slow muscular embrace of vast root systems from trees. Undoubtedly the most atmospheric ruin of the Angkor temples, Ta Prohm should be high on the hit list of every visitor. It was for my wife and me. 

Cleft lip country? Author and wife at Ta Prohm temple at Ankor in Cambodia.

Cleft lip country? Author and wife at Ta Prohm temple at Angkor in Cambodia.

Unlike most of the temples of Angkor, Ta Prohm has been largely left to the clutches of the living jungle. A dynamic interaction exists between nature and and the temple.

Cleft lip country? Author and wife at Ta Prohm temple at Ankor in Cambodia.

Author and wife at Ta Prohm temple in Angkor.

Another beautiful ruin in Cambodia is  Angkor Thom which means “the great city” in Khmer. This 12th-century royal Buddhist city is especially famed for its grand Bayon Temple, but it has numerous other sights, including huge faces carved into temple structures. 

Angkor Thom, has giant faces, none with cleft lip or palate!

Angkor Thom has giant faces, but none with cleft lip or palate!


Rate of untreated cleft lip and palate is world’s highest.

The details of this shocking truth are provided by Erin Handley in her July 22, 2016 article in the Phnom Penh Post:

“Cambodia has the highest rate of untreated cleft lip and palate in infants, out of more than 100 low- and middle-income countries, a new global study has found.

The Kingdom’s rate of unrepaired cleft lip and palate stood at 28.5 per 100,000 people, compared to just 2.5 in Romania. The report, published in World Journal of Surgery on July 14, used data from Operation Smile surgical programs in 12 countries, together with information from the World Health Organization (WHO) and World Bank.

From there, it developed a model to estimate the numbers of cleft lip and palate cases that went untreated before the ideal ages of 1 and 2, respectively, in 113 nations. “Our model provides marked insight into the global surgical backlog due to cleft lip and palate,” the report states.

While the most populated countries had the largest number of untreated cases – such as India, with more than 200,000 – Cambodia’s 4,312 cases had the highest prevalence relative to its smaller population.

“[Cleft lip and palate] disproportionately affects those in low-resource settings secondary to poor nutrition and a lack of prenatal care,” the report continues. “A number of significant barriers to surgical care exist in low- and middle-income countries . . . including prohibitive costs, lack of availability, and social stigma.”

The study comes a year after Operation Smile – an organisation specialising in the surgery – wrapped up its operations in Cambodia.

But a spokesperson at Phnom Penh’s Children’s Surgical Centre, which performs the surgery free of charge, said the backlog and demand had fallen, due to an “influx of medical mission teams and more local surgeons being competent with cleft surgery [which] has made access to these surgeries more available”.

The centre conducted 140 of the life-changing surgeries for children last year, compared to a peak of 348 in 2011.

Dr Chou Vivath, WHO’s national professional officer on disability and rehabilitation, said his organisation was working with the government to include “rehabilitation intervention” on health-centre guidelines.

The aim, he said in an email, was “to improve the early identification and proper referral of people with some health conditions, including cleft palate, to proper support services”.

No one from the Ministry of Health could be reached for comment yesterday.”

Odd cleft lip  palate skulls in the Killing Fields of Pol Pot.

Various cleft lip and palate skulls in the Killing Fields of Pol Pot.

To learn about CLEFT HEART: Chasing Normal, click the Amazon or Barnes & Noble buttons in the margins. Or click the image of the book cover. My coming-of-age memoir has intertwining love stories, mystery, tragedy, and triumph.


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