Nepali Times
Loving our little Ganesh

BEFORE AND AFTER: A seven-month old Palpali girl before her operation, and the same child, at one-and-a-half years, with no visible scarring.

Surely everyone loves Ganesh, the friendly-looking elephant-headed god of auspicious beginnings.

Well, apparently not. In many rural areas the arrival of a 'Ganesh' in the family is not a reason to celebrate, but something to fear, with the family facing ostracism in the village.

When Tirtha Magar was born to his family in Bhojpur, the first thing his father said to his mother was, "Go, dump this Ganesh in the fields."

Ganesh is the cruel nickname people often give to a baby born with a cleft lip, which they claim resembles an elephant's trunk.

It is not life-threatening but can affect the child's speech and cause dental and eating problems as well as attracting the sort of unwelcome attention facing anyone with an unattractive disfigurement.

Tirtha's father hated the child, ignoring him for long periods at a time, not really caring whether he lived or died, all because of a disfigurement. It was only after months of protest that he agreed to take Tirtha to the local hospital in Biratnagar.

Upon arrival, he saw that Tirtha wasn't the only Ganesh around. Many other children and even adults with cleft lips were present. A simple operation later, he was no longer a Ganesh, and there was no longer a reason for his father to hate him.

"There have been documented cases where fathers have left their families moments after they saw the deformed baby," said Kiran Nakarmi, a doctor at the Interplast Surgical Outreach Program (ISOP) which provides reconstructive surgery. "Mothers have been known to dump their babies in the fields." Health researchers estimate one Nepali child in every 700 has a cleft lip at birth, with at least 30,000 untreated cases across the country.

The problem occurs when the tissues of the upper lip fail to develop properly in the womb, often the result of folic acid deficiency in the mother or caused by her smoking or drinking during pregnancy.

ISOP, headed by plastic surgeon Shankar Man Rai, is the Nepali branch of an American organisation, Interplast USA, providing free surgery for cleft lips and palates, burns and for those children born with extra or conjoined fingers and toes.

Rai's teams of surgeons, nurses and speech therapists have carried out more than 7,000 operations on cleft lips and palates since he set up ISOP in 1999, and now operate outreach camps across 60 districts each year from their base at Kathmandu Model Hospital.

Another doctor who has been working on cleft lip surgery in Nepal for the past 26 years is Narayan Bahadur Thapa who has carried out 4,000 cleft lip surgeries, first at Kanti Children's Hospital and later at the Council for Cleft Lip and Palate Centre in Banepa.

Thapa and other doctors even raised money by organising annual Volkswagen Beetle rallies through ANBUG, but lately funding has dried up. The Adventist Development and Relief Agency (ADRA) helped by supporting more than 1,100 operations for 12 years.

There are costs for surgical material, but Thapa offers his surgical skills for free. He hopes to set up a Cleft Centre in Nepal, and says: "We are looking for any donations, even the smallest amount will be welcome. All I need is the chance to help."

Pranaya SJB Rana

(11 JAN 2013 - 17 JAN 2013)