By Bunmi Yekini
A groundbreaking study has linked indoor cooking smoke from firewood and charcoal stoves to a sharp rise in cleft lip cases, urging urgent adoption of cleaner cooking methods to curb the birth defect.
Presented at the ongoing Pan-African Surgical Conference (PASC2025), the study titled “The Role of Smoke from Cooking Indoors Over an Open Flame and Parental Smoking on the Risk of Cleft Lip and Palate” reveals that children born to mothers exposed to wood stove smoke are 49% more likely to develop cleft lip.
“We conducted a population-sampled case-control study in seven low-resource countries—Vietnam, the Philippines, Honduras, Nicaragua, Morocco, Congo, and Madagascar. In five of these countries, we found a significant association between indoor smoke exposure and cleft lip cases,” the study states.
Dr. Allyn Auslander, Associate Vice President of Research for Operation Smile and the study’s lead author, emphasizes the urgent need for intervention.
“Millions are living untreated due to a lack of access to surgery. Modifiable, patient-centric solutions, such as providing clean-burning cookstoves, will be critical in reducing the burden of cleft globally,” Dr. Auslander said.
Cleft lip, one of the most common birth defects, affects approximately one in 700 live births worldwide. In low-resource countries, where 80% of rural households rely on biomass cooking fuels, the number of cleft cases is significantly higher than in developed nations where LPG and electric stoves are common.
Beyond cleft lip, biomass fuel smoke has been associated with stillbirths and other serious health issues.
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The study, based on 4,000 children and their mothers recruited through Operation Smile’s surgical missions, recommends alternative cooking methods to reduce exposure to harmful fumes.
“Prevention of surgically treatable birth defects is a necessary goal, as universal surgical treatment for all patients is unlikely—especially for conditions like orofacial clefts that require complex multidisciplinary care,” the report states.
The challenge is further compounded by a global shortage of surgical providers, with 2.2 million additional experts needed to meet the current demand.
The Pan-African Surgical Conference, convened by Operation Smile under the theme “Building Resilient and Sustainable Surgical Services in Africa: A Surgeon in Every District Hospital,” aims to address this gap by strengthening Africa’s local surgical workforce.
“With individuals in low-resource settings at the highest risk of living with untreated conditions, public health interventions and education must prioritize clean cooking solutions to prevent lifelong medical and social consequences,” the study concludes.