Surgeon Special

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Seven years ago, when Dr Shakeel, a maxillofacial surgeon from Srinagar, started doing cleft surgeries, he was shocked by such high prevalence.  Bilal Handoo profiles the surgeon who has so far performed more than 1300 surgeries at his private clinic, free of cost

Dr Shakeel

Dr Shakeel

Another kid with cleft-laden face is being taken inside a private operation theatre in city outskirts for a facial correction. Leading a team of surgeons – donned in green aprons, is a man who has performed above 1300 cleft surgeries in less than seven years. With an experience of more than 15 years as an operating surgeon, Dr Shakeel, 42, has done all these surgeries free of cost!

Heading the department of Maxillofacial Surgery SKIMS, Bemina, Dr Shakeel has performed cleft and palate surgeries of patients from every part of the valley. “I started the maxillofacial surgery in Kashmir seven years ago,” says Dr Shakeel sitting inside his private hospital on the outskirts of Srinagar. “And I am the first surgeon who has done above 1300 such surgeries.”

In Dec 2007, when he started performing cleft surgeries, the number of patients wasn’t huge. But as a word spread that he is performing these surgeries without charging anything, soon a barrage of patients showed up. “I thought there might be 20 to 30 such cases in all,” he continues. “But I was wrong. Kashmir houses large population of people born with cleft and palate deformities.”

Dr Shakeel says elsewhere the frequency of cleft born babies is 1 out of every 700 births. But in Kashmir, it is 1 in every 600 births. High frequency of such cases in the valley, he says, is due to higher rate of consanguineous marriages (marriage within same ancestry), malnutrition (especially within peripheral population), heredity, self-medication and exposure to radiations.

A person born with cleft deformity has to undergo through a multiple surgeries. Cleft surgery is not one step procedure, rather involves series of surgeries at different stages of life. Right from a birth till eighteen years, a patient has to undergo seven to eight surgeries. It is quite unlike other surgeries, which involves one time course of action. A team of surgeons, dentists, child specialist and many other specialists keep fixing up different facial aspects of these patients.

Previously when there was no awareness, less people would turn up for cleft correction. But now when awareness is building, scores of patients are coming to Dr Shakeel’s private health care center. These patients mainly hail from areas like Kupwara, Lolab, Tangdhaar, Banhal, Ashmuqam and other parts of the valley.

A post-graduation in maxillofacial surgery from Mangalore (1997), Dr Shakeel is also performing these surgeries at SKIMS Bemina, but not in great number. With scores of fellowships in cleft surgery under his belt, he started doing these surgeries in great numbers after noticing that these surgeries are being shrugged off at Government Hospitals.

“Since cleft surgeries don’t figure in an emergency medical care list, therefore such patients are being ignored at Government health care centers,” he claims. “This neglect triggered a sense of responsibility in me and soon I started performing these surgeries without charging anything at my private center.”

Dr Shakeel has a special cleft theatre exclusively from these patients in his private center. “Nowhere in J&K you will come across such a separate theatre and ward for these cleft patients as I have in my center,” he claims.

Apart from facial distress, cleft patients have speech and dental problems. They aren’t acceptable neither to themselves nor to society owing to deformity they dress on their faces. Such patients face social isolation problems and suffer crisis in self confidence. But once surgery is done, all these problems vanish. “In a way, you can say that surgery infuses a spirit of life in such patients,” Dr Shakeel says.

Since a patient need to pay multiple visits to a surgeon for face correction, many underprivileged families are being provided transportation and accommodation charges by Dr Shakeel. “Well the only aim behind doing that is to keep them motivated for the completion of treatment. Otherwise, these patients leave the treatment in midway owing to poverty,” he says.

Dr Shakeel is heading the project by the German Cleft Children’s Aid Society, which is currently active in ten countries. In the fall of 2007, the society started the Cleft Centre Srinagar. “Started in 2002, the German Cleft Children’s Aid Society has so far financed above 1300 cleft operations and 83 operations on craniofacial anomalies in India,” Dr Shakeel says.

Like in case of other deformities, there are myths attached with cleft and palate deformities as well. Many people believe that these deformities surface in new born due to ill fate or unwanted solar exposure. But Dr Shakeel rubbishes all these theories otherwise popular among local populace.

“Look, I call these theories as ‘signs of ignorance.’ Scientifically these deformities only occur due to heredity, malnutrition, self medication by a pregnant lady, and mostly due to consanguineous marriages among Muslims,” he says.

Consanguineous marriages among Muslims is said to be the primary reason behind the deformity. Dr Shakeel says cleft cases are greater in Muslim population of Kerela where such marriages happen at great number.

Cleft is one of those health deformities which can’t be corrected at prenatal stage (during pregnancy). Besides, in case a father has had some history of cleft, chances of having a cleft baby increases.

Ideally, the first surgery should start after three months of birth, but Dr Shakeel has also tackled some cases wherein the first surgery was performed when a patient had already turned grandparent.

“Like in case of an aged lady from Bandipora,” he says. “I performed her first surgery at the age of 67. Even delay can’t rule out treatment in these deformities. They can be fixed up anytime.”

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