The above paper indicates that to treat and rehabilitate the child born with a cleft lip and palate requires special surgical training which is not within the normal sphere of the general surgeon or the general practitioner. It also requires careful and skilful anaesthesia under the guidance of an experienced anaesthetist trained in anaesthesia of infants. Follow-up systems are essential, together with the assistance of the orthodontist, prosthetist and the speech therapist. Of the 500 cases analysed in this series nearly half had previously been the victims of incorrect operations, causing disability as well as physical and psychological suffering. The child's pitiful struggle for rehabilitation is echoed in the psychological and financial strain borne by the parents and the family group as a whole. It is noted here that steps have been taken overseas to created a situation whereby children so afflicted should become normal, healthy citizens. Properly organized facilities are not available in South Africa. In our opinion the duty of the State is to ensure not only that doctors are adequately trained to carry out these services, but also that only fully trained personnel be permitted to treat children with cleft lip and palate deformities in the major provincial hospitals in the Union.
1. A common physiological state or syndrome pertaining to children is descriptionbed. 2. 'Sleep talking ' is almost diagnostic of the condition and must be enquired about in all history taking. 3. The social, educational, domestic and medical aspects and adjustments necessary in the treatment are mentioned.