Editorial, by Laura Chabbey and Marie Charpy, MIDE students, 24 october 2018

The "hare's beak", more scientifically called the "cleft lip and palate", is the most common facial anomaly in humans. It is a malformation in the upper lip and palate, revealing an indent in the middle of the face, more or less markedly depending on the degree of severity of the deformity. It occurs relatively early, during embryogenesis.

Such an event has various repercussions: the issues for the infant with a cleft lip are as much morphological and functional as psychological and social. Although surgical management is now becoming more widespread in order to overcome the painful and unfortunate physical consequences of the malformation, this procedure is neither systematic nor miraculous.

The existence of a cleft lip and palate can cause deep identity and emotional wounds. Reactions to malformation can be extreme, such as child abuse and violence. These are radically contrary to the fundamental principles of the Convention on the Rights of the Child, including the "best interests" of the child, as well as the rights to "life, survival and development" and "non-discrimination" of which the child is a holder. Thus, in some parts of the world, it is not uncommon for infants with deformities to be considered as witch children or demon carriers. If this is the case, the child can be completely excluded from a community, hidden, isolated or even abandoned. As a result, community pressure leads to the death of many children.

Apart from these excessive treatments, the presence of a facial malformation such as a cleft lip and palate also leads to behaviours that may seem less serious, but whose incidence is not negligible.

Let us think of the identity and original role of a person's face: it distinguishes him, it is the first impression during an encounter. A malformation on a face can transform the encounter further into a confrontation, a source of contradictory feelings. How will the child’s mother and father look at their malformed child? Will the child be perceived as a person, or reduced to his malformation which then becomes a handicap? Malformation is not well accepted, and may turn into relationship difficulties that can quickly lead to a disinvestment in the parent-baby relationship, resulting in profound discomfort and concerns for the child.

The infant mainly has emotional relationships with his or her environment, and the child's development depends significantly on parental and external encouragement. Thus, it is important to look at the child as a person, whose malformation is not a defect but a simple bodily element, which makes him unique in the same way as every human being.

pdfFull article and bibliography (in French).

Picture: Pedro Ribeiro Simoes, flickr/CC

NB: The editorial does not necessarily reflect the opinion of IDE board and team.

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