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Rehabilitation in South Africa MARGARET MARKS , M.A. Assistant Supervisor, Speech, Voice and Hearing Clinic, University of the Witwatersrand "A cleft palate is a fissure located in the palate and completely surrounded by a human being." (1) tion of persons with cleft lip and associated The problems which a cleft palate* creates are numerous. The condition can affect the function ot eating, the normal production of speech, and the physical appearance of the individual. Added to these are the possibilities of allied anatomical and functional disorders which can accompany the inadequate structure, and emotional difficulties which arise from the individual's awareness of his differences. Whose then is the cleft palate "baby"? His complex problems must land him, fairly and squarely, in the capacious lap of a team of experts who are co-operating for the best for this particular child. It is the task of the specialists involved to remember that they are working with a hole, surrounded by a palate, surrounding by a child; and not in a vacuum. More and more workers have realised the lack of economy in working as individuals on a problem which demands a co-operative approach. McCue, writing on team relationships in the rehabilitation process discusses the difficulties of the patient having to be "shared" among specialists who are "patient or client focused" and not "other discipline focused". She sees corrective approaches as first, sufficient knowledge of each other's role and contribution and, second, appropriate use of the knowledge. With this knowledge, one can relinquish certain activities to another discipline without loss of face, since the other may at a given time have the principal contribution to offer. Knowledge and respect will enable us to communicate with a minimum of time, which is always at a premium. They will allow us to differ and discuss, rather than listen and take orders we disagree with . . . relationships must be horizontal with each other as well as vertical with the patient or client. (2) It is the purpose of this article to consider the possibilities of a team approach to the problem of the cleft palate individual, particularly in a country such as South Africa. The aims of an association such as the American Association for Cleft Palate Rehabilitation could serve as a guide for a discussion on how a team approach could be directed. " 1. To encourage scientific research in the causes and nature of cleft palate and lip. 2. To promote the science and art of rehabilita-

A team-work approach to cleft palate rehabilitation in South Africa