Dr. Ifeanyichukwu Onah became interested in medicine through the influence of books he read about medical missionaries such as the late England-born doctor and author Helen Roseveare, who served in Africa.

But his decision to focus on cleft surgeries grew out of a passion to rub smiles on the faces of both children and adults with the deformity. A cleft is used to describe a congenital malformation of the lip, palate or both.

“My first information on cleft surgeries came from Readers Digest, which my mum constantly made available to us in secondary school,” Onah told this reporter. “I read stories of surgeons involved in cleft care and cleft missions, which made a deep impression on me.”

The passion influenced his choice of plastic surgery when considering work at the National Orthopaedic Hospital Enugu (NOHE), having trained at the University of Nigeria Enugu Campus, where he graduated in 1990.

Although he was born during the civil war in Port Harcourt, Rivers State, Onah – the last child in a family of three – grew up in Enugu State and later moved to Lagos with his family in 1977. He schooled at King’s College Lagos from 1978 to 1983 and came back again to Enugu to further his studies.

He started working at the NOHE in June 1994 after his university education and National Youth Service, and rose to become a consultant in December 2002, having completed a fellowship with the West African College of Surgeons in October 2001.

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OPPORTUNITIES FOR CLEFT SURGERIES

Three years after he became a consultant, having been trained as a senior resident in plastic surgery, the opportunity came to partner with Smile Train, the world’s largest charity solely dedicated to comprehensive cleft care, in 2006.

Onah’s application for a Smile Train partnership after his Part 2 fellowship (completion of his postgraduate diploma and qualification to be a consultant plastic surgeon) had failed.

In 2006, after the Pan African Congress on Cleft Lip and Palate in Ibadan (when Smile Train was keen on more partners from Nigeria), he applied again and was taken.

That was how he started a partnership with Smile Train, operating on children with cleft deformities. Since then, Onah has undertaken about 900 cleft surgeries, with over 90 percent of them sponsored by Smile Train.

Onah has been operating from the NOHE. In 2014, the hospital was designated Global Leader in Cleft Care by Smile Train. It has also won other awards for excellence in cleft care.

With his experience over the years, Onah (who is the head of the department of plastic surgery at the hospital) now trains other surgeons from within and outside the country on several aspects of cleft care. The hospital is accredited by the West African College of Surgeons for this training.

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TRIPS, TRAININGS, SURGERIES

Onah has been to different countries, including Taiwan, Uganda, the United States of America, for observerships and to attend workshops on improving his skills to carry out cleft surgeries, some of which were sponsored by the nonprofit organisation.

In 2016, he also travelled to Liberia to treat patients and train the surgeons at ELWA Hospital. Now, regular surgery takes place by indigenous surgeons. In 2021, Onah was in Togo to treat patients and train the paediatric surgeon at Aneho, in cleft care.

In 2022, he was in Cameroon to treat patients and train the ear, nose, and throat (ENT) surgeons in Douala. Then, in 2023, he was in Bambari, the Central African Republic, to treat patients and train paediatric surgeons in cleft care.

Back in Nigeria, he has been to Ebonyi, Benue and the Federal Capital Territory to carry out outreaches with a healthcare team, operating on over 120 patients as old as 55 years until COVID-19.

“All these trips brought joy to patients and carers and helped improve the skills of consultant surgeons and their trainees in cleft care,” Onah said.

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CHALLENGES

Onah said that his work in cleft surgery has not come without challenges, including some deaths on a few occasions, which he said were crushing blows but prepared him for service than ever.

He also said that there was a challenge of low public awareness of free comprehensive care provided by organisations such as Smile Train.

“The significant backlog remains; some children died before care got to them,” he said. “Attempts at mobilisation have had mixed results so far, but we are hopeful and keep pushing.”

He noted that there had been challenges with equipment, infrastructure, power and brain drain. He added that the pandemic and security challenges had greatly affected the nature of outreaches and mobilisation.

“Some individuals are more interested in pecuniary dividends of service than the service itself, and no man can work in a vacuum,” he said. “However, none has been indispensable.”

The joy of participating in definite life-transforming care for his patients and the opportunity to impact needy people and leave his institution and the world a better place is what keeps Onah going.

“Seeing a great number of patients access cleft care and have their lives transformed remains my greatest professional achievement,” said Onah, who is currently involved in ongoing research into how to make palate surgery in infants safer with less blood loss.