In a room of the hospital surrounded by mothers and babies we met Ahamed. Ahamed was 18 years old and the only patient who had travelled alone on this particular cleft mission. Ahmed is from a remote area West of the Haraghe zone in Oromia, his family are farmers and he is the eldest of 6 other siblings. 

Ahamed told us he had lived his whole life with out being able to access treatment for his cleft lip, mainly because of the lack of awareness in his village that there was treatment available for his cleft. He has never been able to travel outside of Harar and he has never attended school because of the health complications from his cleft lip and social stigma. He is not married, in the area that he lives this is unusual for a man of his age.
 
Ahamed called his Mum after the surgery and she said she was celebrating the news.
 
He now wishes to enrol in school – even though he might be the eldest in his class, He also wishes to get married.


Ahmed at the back of the photo, with other patients from the cleft mission and their families. Project Harar Programme Officer Abraham at the front

Project Harar's Outreach programme in Ethiopia operates year round, to reach difficult to travel to villages in Ethiopia, where the fact that a cleft is a very treatable condition is not common knowledge. Unfortunately because a cleft is still heavily stigmatised in rural Ethiopia, people like Ahmed are sometimes hidden away by their families as children, mainly because their families fear them facing bullying by others. Project Harar programme officers have reported sometimes having to knock door to door to find a patient in a village to make arrangements once the cleft has been identified by a health extension worker or local health clinic. Consequently some children grow into adult-hood without having accessed treatment for their cleft lip or palate, meaning they grow up with a significant disadvantage in their health and social life to the rest of their community. These rural communities are some of the poorest in Ethiopia, so food and nutrition is a common issue amoungst most families, families in farming communities will sell the most nutrient rich foods at the market, as it is these food that are more profitable for them. children with cleft are faced by the existing disadvantage of food in their area combined with the physical complications a cleft has on their nutrition from birth. Due to an incomplete mouth seal for babies born with cleft, breast feeding is very difficult as they are unable to form their lips to suckle, as they grow and move onto solid food they often have difficulties chewing and swallowing. In the case of a cleft palate the food can sometimes be regurgitated through the nose. All of these issues with food can often lead to malnutrition. 
Please consider supporting Project Harar so more people like Ahmed can access treatment for their cleft lip and palate and reach their full potential. 
(Spot Ahmed at the back of the photo!)