Unusual Clefts

Ramil has a lateral facial cleft

Ramil is 12 years old and lives with his parents and 7 siblings. His father is a carpenter and his mother a housewife. He has a lateral facial cleft which makes his mouth very large on one side. Because the muscles are disrupted he drools from that side.

The mouth is asymmetrical

As is common with this condition he has unusual ears.

The facial cleft and ears were repaired by Drs Maguina and Dyleski

















Ramil now has a symmetrical mouth and his ears appear more normal. When he heals he will be back to he normal happy self.

The Pediatric Ward

How can anyone can sleep?

The ward is made up of 24 cots. One cot per patient and family. Sometimes the patients  must double up and have two per cot. Where do the parents sleep you must be thinking. As we all know, life as a parent can at times be difficult.  We can all remember the night when our child had an ear infection and know one got any sleep. This brings a new meaning to not getting any sleep.

Rounds are a little different than in the US

Each morning and evening we make rounds on the patients. As needed we come during the day. One of the members of the team, Joy Zane, is a pediatrician who cares for the patients along with the Filipino nurses. Fortunately, the patients are strong and seem to complain less than their US counterparts.

Brother and Sister

It looks a little like camp

I am sure these two patients will be happy to only spend one night

First Day in OR

Today we had 16 patients scheduled for their cleft repair and we did all 16 cases. Eight cleft lip repairs and 8 cleft palate repairs.

We  finished this last case at 6:15. Then the patient has to awaken and go to recovery. It takes about an hour to recover a patient. It is a long day! But it is all worth it.

When you look at this child it can be hard to imagine how we have changed his life……Until you meet an adult who has lived with the condition their entire life. We all know fitting in as a teenager can be hard. We saw many patients with a recurring theme.


They stopped attending school because they were teased. They live with their parents. They did not have jobs. How will they support themselves?