Gender Matters

Last Tuesday was International Women’s Day, commemorated by thought-provoking news stories and Daniel Craig in drag. Gender is an important issue for us, working in a country where boys are a third more likely than girls to enrol in secondary school (UNICEF). We thought it merited a brief description of how we take it into account in the design and evaluation of our programme in rural Ethiopia.

Women in traditional communities are often expected to get married young and their principal role is seen as bearing and raising children. Being born with or acquiring a severe facial disfigurement, therefore, makes a big difference to their sense of place in their family and their community. One study in Africa found that women with cleft lips or palates frequently become a second or third wife – rarely first and foremost. Children – especially girls – are sometimes hidden away, and not allowed out of the house. Given this, we are proud of the strides we have taken in our outreach, so that almost 60% of our recent complex patients are female.

Cleft lip and cleft palate programmes are slightly different. Boys are more likely than girls to be born with a cleft lip, and this is reflected in our gender balance. However, advances in Ethiopian cleft treatment allow us to reach many more cleft palate patients, and girls are more likely to suffer cleft palate only. Since we started offering cleft palate treatment six months ago, female participation in our programmes has increased by 12%, and now is 41% in total.

We treat everyone who has a facial disability, regardless of gender. Our rural outreach team gain the trust and support of the communities we work with, allowing us to reach children otherwise hidden away from outsiders. Our unique rural access programme means we really can get help to everyone who needs it.