Four-year-old Mamet had a congenital cleft of the lip, nose, and left side of his face. His parents had kept him inside his home in Bangladesh throughout most of his life. They did not allow him to interact with other children because they feared the stigma of his misshapen face.

“This type of cleft, called Tessier No. 4, results in severe malformation of the nose, lip, and eyelid – often resulting in the inability to protect the affected eye and leading to corneal scarring and blindness,” said Gregory Borah, MD, DMD, a WVU Medicine plastic and reconstructive surgeon.

Gregory Borah, MD, DMD, operates on a patient in Bangladesh.

But during one operation, Dr. Borah and a team from an organization called Smile Bangladesh reconstructed Mamet’s lower eyelid to protect his cornea and repositioned his nose to improve his breathing and appearance. They also repaired the small cleft in his lip.

“In addition to his functional improvement, Mamet no longer needs to be kept away from other children,” Borah shared. “He now has a chance to be an accepted member of his clan and lead a more normal life. This chance to make a meaningful change in a child’s life is what makes the long trip to Khulna worth all the inconveniences of traveling halfway around the planet.”

Mamet is just one of thousands of children in Bangladesh who need care from surgeons like Borah, who served as a visiting professor at Khulna Medical College. Borah worked with a team of surgeons from across the United States to perform surgery for children with facial deformities.

“On this trip, Smile Bangladesh – a volunteer group of plastic surgeons, oral and maxillofacial surgeons, anesthesiologists, nurses, surgical technologists, and residents from West Virginia, New Jersey, Texas, and Illinois – treated 48 children and adults with a variety of congenital cleft lips and palates, and hand deformities,” Borah said.

Dr. Borah meets an 8-year-old patient in Bangladesh before performing surgery.

These patients’ lives were transformed, but the ultimate goal is to help the healthcare system in Bangladesh become self-sufficient in providing for the people there.

“While the incidence of cleft lip and palate in this part of South Asia is somewhat high, the real problem is that the country has a very large population and very limited medical resources, with remarkably few surgeons,” explained Borah, who is a professor of surgery and the chief of the Division of Plastic and Reconstructive Surgery at the WVU School of Medicine.

Just east of India, Bangladesh has a population of about 160 million people in a geographic area about the size of Illinois. The country is largely rural, with most people leading a subsistence lifestyle.

“Its medical care system is not well developed, especially outside of the cities,” Borah said. “The number of plastic surgeons – 22 – in Bangladesh is the same as the number in West Virginia, with 100 times the population. So there is a huge need to help educate local surgeons to treat these children and adults.”

Borah’s team estimated that during the recent surgical mission, the number of children born with clefts across the country equaled those the team repaired.

“The ideal solution is to train local surgeons to manage these children, not just depend on volunteer teams from abroad,” Borah added. “Two Bangladeshi surgeons from Khulna and Cox’s Bazar participated in the surgical mission, learning new techniques they can use in their hometown practices.”