While it is not totally clear what causes a facial cleft, genetic and environmental factors likely play a role in its formation. The entire face forms in the first trimester of pregnancy and there are 10 genes that have been isolated that prove to have some function in forming a cleft palate. Magee III said perinatal care should be a focus to avoid facial clefts.
"Folic acid has jumped out as something that is extremely important here, along with getting the right water," said Magee.
Pollution and smoke from fires, cooking and tobacco could also contribute to the facial abnormalities.
Magee III said the biggest obstacle doctors face is getting the specialized care to developing nations, so that more children have access to special surgeries and treatment for the condition.
"Rokaya's story represents an extreme example of this kind of dilemma," said Magee III. "We are currently trying to set up training so that hospitals around the world are capable of surgeries for their own children, and they don't have to travel all the way here to get the surgeries they need."