Wednesday, August 22, 2012

Operation Smile 2012

Every year, Operation Smile South Africa sponsors a mission to Madagascar, and lucky for us work-starved Peace Corps volunteers, we get to help out with the translating! Back in early June at the beginning of all the strikes, I heard that Op Smile was coming and I essentially harassed my Peace Corps boss until he relented and let me participate. Like I always say, demanding things always pays off! A little bit about Operation Smile, it’s an international NGO that sponsors missions in developing countries to operate on and fix cleft lips and cleft palates for free. Doctors, nurses, dentists, child life specialists, speech therapists and many others all donate their time, skills, and resources to give this really amazing gift to children and adults born with a cleft lip or cleft palate. Basically, it’s a really cool organization that is doing good in the world. Publicized through radio, television, posters, and word of mouth, over 260 families showed up for the first day of screening. That was a crazy day! I really didn’t know what to expect going into it, so day one was kind of madness. The Operation Smile Team consisted of around 60 people, plus 20 Peace Corps volunteers, and a number of other Malagasy translators. So a lot of people! The initial days consisted of screening kids and adults with cleft lips and cleft palates on their candidacy for surgery. Our job as translators involved working with the medical staff to communicate to the patients exactly what was going on and to get the proper medical history to assess the patient’s priority level for surgery. Each part of the medical team had to assess every patient, so it took a long time. The first two days were very long and very hectic, but still pretty awesome. Families has come from near and far and waited upwards of 12 hours, just for their chance to get a surgery for their child or brother or friend. Commitment.


Surgery week was one of the coolest and most magical things I’ve been privileged enough to be a part of, not only during my Peace Corps service, but also during my life. 136 patients were chosen from the 260 or so that were screened. The medical team operated on 30 patients a day for 4 days and finished up the week with 16 on the final day. I tried to do a little bit of everything, but spent the bulk of my time working in the Recovery Room and the Post-Operation wards. The Recovery Room was pretty much exactly what it sounds like: the place patients were brought to immediately post-surgery when they were coming out of the anesthesia. So it involved explaining to patients or parents what was happening: the surgery went well, there were no problems, you need to drink juice and hydrate, you can’t touch your mouth or the stitches, etc, etc. But the coolest part of that job was bringing in the parents from the waiting room to see their kids post-operation. Culturally, Malagasy people are not very expressive. They don’t hug, there are not public displays of affection, and they don’t get overly excited. But in the Recovery Rooms, moms cried with joy and cried with fear, some hugged every nurse, doctor, and volunteer they could get their hands on, and for the first time in the entire year that I’ve been here, they talked about their feelings. Moms no older than me tried to hold in all the emotion that comes with having to sit by and watch your baby get surgery, and watch him or her hurt, but not be able to comfort them, while at the same time knowing that this surgery will change their little life. Probably the most memorable conversation I had with a mother on this topic happened on day three of surgery. As she watched her child get led by the hand back to the Operating Room, she burst into tears. After a little coaxing by myself and another volunteer, she started talking. She told us how scared she was and how she can’t bear to watch her baby cry, but she knows that this surgery means everything for her child and how wonderful of an opportunity it is. She told us how the rest of her family disowned her and her child because of his severe cleft lip, and they’ve been on their own since. She said that they’ve been waiting for years for this chance, and even though she knew she shouldn’t cry, she couldn’t help it. I definitely got choked up listening to that story. But seeing that mother’s face when I brought her back to see her child post-surgery was magical. Joy mixed with confusion mixed with a desire to remain emotionless was splayed all across her tear-streaked face. BOOM. Life changed.

A happy mom

It was really cool to be that direct link between the medical team and patient, because a lot of the cases started to feel personal to me. Especially working in the Recovery Room and then the Post-Operation wards, I got to follow patients all the way through their experience with Operation Smile. From pre-surgery to recovery room to the post-operation wards and then patient discharge, I got to see it all! I even was able to observe a procedure! I followed this little guy all the way through, and look how beautiful he is!

The most amazing part of this experience was patient discharge, when everyone got to go home. What a lot of people don’t realize about cleft lips and cleft palates is that it’s not just cosmetic. Yes, there absolutely is a huge cultural stigma against cleft lips and palates all across the developing world. But, a patient with a cleft palate often can’t eat or speak properly. Imagine missing a part or most of the roof of your mouth…that’s a cleft palate. Now imagine trying to eat and talk and drink with that deformity. Food and water comes out of your nose. You can’t pronounce certain sounds and therefore words. Imagine trying to go to school and learn and socialize. Now think about how amazing and life changing it is to get that deformity fixed. BOOM. Operation Smile.

A patient with a cleft lip often can’t nurse properly. They have teeth that seem to come out of their nose because of their cleft. They can’t close their mouth. They can’t say certain sounds and therefore certain words. How would you communicate? How would you learn, or get a job, or find a husband or wife? Imagine a baby who gets his cleft lip fixed. He can nurse. He’ll be able to speak. Often, you won’t even be able to notice the scar. BOOM. Operation Smile. Now imagine an adult who has gone their entire life with a cleft lip. Now they can annunciate properly. Now they can socialize, and date, and get married without any cultural stigma. Now, when they look in the mirror, they don’t even recognize who is looking back at them. BOOM. Life changed. I assisted a nurse in discharging an adult patient on the last day of surgery. The woman was 30 years old, unmarried, and lived with a friend. She had spent the night in the hospital after her surgery, and was to be discharged the next morning. Part of the discharge process is cleaning of the wound where the lip was stitched up. A lot of times, blood and other dirty stuff collect on the incision area. This woman in particular had had a decent amount of residual bleeding that hadn’t been cleaned up yet. I explained to her what the nurse was doing, and she sat perfectly still and stoic while her lip was cleaned. And then we showed her a mirror. I couldn’t hold back my own tears watching this adult woman look with disbelief at her own reflection. Cleaned up of all the dried blood and such, there was a perfect little stitched up incision that was already healing nicely. She couldn’t even believe what she was saying and just kept repeating “Thank you, thank you, thank you” as she tried to control her tears. BOOM. Life changed.

Working with Operation Smile was a pretty awesome experience. The entire team is really committed and dedicated to what they’re doing and they all work very cohesively together, despite their different backgrounds. I feel very lucky to have been part of a project like this. I’m headed back south to Fort Dauphin today and am looking forward to returning to coastal life! Now that (hopefully) the strikes are over for good, my projects will be starting back up. PHELT lives on! And happy back to school week for everyone in the U.S., especially Ian who is starting his senior year. Wowzaaa.

Spreading positive vibes in the Post-Op Ward!

If you’re interested in the Operation Smile program I participated in, check out their website:

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