It's Saturday morning, 6:00 and I've had a good night's sleep. My roommate never did show up so it looks like I may have traded my large single with a king bed for a slightly smaller one with two queen beds and a kitchenette. I'm sipping my Folgers single serving coffee from a stash I keep in the closet with my travel stuff. I bought it in 2010 before my first Op Smile mission, but since I'm not really a coffee geek, it tastes fine to me.
I wanted to say a bit more about the patients we saw yesterday. It's always interesting to see where the families have come from and what their medical experiences have been. On some missions, the in-country team has been traveling for weeks ahead of time, spreading the word to remote villages about the free surgery for cleft lip and palate that is coming. Many families are unaware that their baby's or child's cleft can be repaired. They assume the child and usually the mother have been cursed, and they just hide the child away. The volunteers use word of mouth, posters with before and after photos, and radio spots in addition to going from village to village. Once they have found the patients, the volunteers arrange for busses to go to pickup sites where the families can gather. The bus ride may take hours, but at least the families don't have to try to make it to the actual surgery site on their own. On those missions, we see children and adults of all ages who have never had surgery, and it is amazing to watch when they first see themselves with their faces put back together. Although all of the trips bring life-changing surgery to patients, I find I am most moved by the ones where the patients never dreamed it could happen.
Having said that, I had a great time seeing yesterday's patients. Most of them were from Santo Domingo or within an hour of the city. There were lots of babies around five to six months old who were there for the first surgery to repair their cleft lips, and quite a few one year olds who were returning to have their palate's repaired. They were uniformly well-nourished as the families, while relatively poor, are able to feed their children. They have also been receiving the services of the Dominican Republic's Operation Smile program since birth. They provide nutrition counseling, special bottles when needed, palate obturators to improve sucking, vitamins, etc. Their local program is four years old, and their plastic surgeons and anesthesiologists often travel to other countries on Op Smile teams.
In the photos you'll see a five month old face to face with his mother; both are smiling and clearly connecting. The two of them were carrying on a conversation, for about five minutes that stopped the whole interview and exam. He had been a bit fussy waiting his turn, so the mother had started talking to him. He responded with this wonderful back and forth interchange - watching her intently while she spoke, then laughing, babbling a long string of "words" - perhaps something profound - and then pausing and waiting for her to respond. Finally, reluctantly, we had to interrupt the exchange and do his exam as the line was backing up.
There was a three year old girl whom you'll see sitting on the floor with her feet up in the air playing with a volunteer's shoe. She was there for a palate repair. I take small maracas along to distract the babies while I do my exam, and she took one and began dancing around the pavilion. She had some great dance moves and entertained the crowd for about 15 minutes before I finally asked her mother to corral her for her exam.
Finally, there were three young men in their twenties and one in his thirties who were there for rhinoplasties. Many times in poorer countries, patients aren't able to travel back for the "refinements" that children with cleft life and palate would receive in the U.S. or other developed countries. Evening out a lip scar or in these cases, giving them a nose with symmetric nostrils and a straight septum is very important. The plastic surgeons were very excited to see them. At one point, three surgeons were gathered around one young man, peering up his nose and discussing the best approach while he sat there, grinning. Perhaps the grin was embarrassment, or perhaps he was just happy that three surgeons were fighting over the chance to give him a great nose. Later one of the surgeons told me that he sees doing these "cosmetic" procedures on the teens just as rewarding as closing the widely cleft lips of the babies. Those, he said, are also cosmetic, but he sees them as mainly medical as the cleft affects nutrition and therefore general health. Also, without the surgery, the child will be shunned and unable to go to school, so that surgery, he feels, has many consequences. When he does the final "touch up" surgeries on the teens, he feels he's finally "making them feel normal, beautiful, handsome," and that is his biggest joy.
I wanted to say a bit more about the patients we saw yesterday. It's always interesting to see where the families have come from and what their medical experiences have been. On some missions, the in-country team has been traveling for weeks ahead of time, spreading the word to remote villages about the free surgery for cleft lip and palate that is coming. Many families are unaware that their baby's or child's cleft can be repaired. They assume the child and usually the mother have been cursed, and they just hide the child away. The volunteers use word of mouth, posters with before and after photos, and radio spots in addition to going from village to village. Once they have found the patients, the volunteers arrange for busses to go to pickup sites where the families can gather. The bus ride may take hours, but at least the families don't have to try to make it to the actual surgery site on their own. On those missions, we see children and adults of all ages who have never had surgery, and it is amazing to watch when they first see themselves with their faces put back together. Although all of the trips bring life-changing surgery to patients, I find I am most moved by the ones where the patients never dreamed it could happen.
Having said that, I had a great time seeing yesterday's patients. Most of them were from Santo Domingo or within an hour of the city. There were lots of babies around five to six months old who were there for the first surgery to repair their cleft lips, and quite a few one year olds who were returning to have their palate's repaired. They were uniformly well-nourished as the families, while relatively poor, are able to feed their children. They have also been receiving the services of the Dominican Republic's Operation Smile program since birth. They provide nutrition counseling, special bottles when needed, palate obturators to improve sucking, vitamins, etc. Their local program is four years old, and their plastic surgeons and anesthesiologists often travel to other countries on Op Smile teams.
In the photos you'll see a five month old face to face with his mother; both are smiling and clearly connecting. The two of them were carrying on a conversation, for about five minutes that stopped the whole interview and exam. He had been a bit fussy waiting his turn, so the mother had started talking to him. He responded with this wonderful back and forth interchange - watching her intently while she spoke, then laughing, babbling a long string of "words" - perhaps something profound - and then pausing and waiting for her to respond. Finally, reluctantly, we had to interrupt the exchange and do his exam as the line was backing up.
There was a three year old girl whom you'll see sitting on the floor with her feet up in the air playing with a volunteer's shoe. She was there for a palate repair. I take small maracas along to distract the babies while I do my exam, and she took one and began dancing around the pavilion. She had some great dance moves and entertained the crowd for about 15 minutes before I finally asked her mother to corral her for her exam.
Finally, there were three young men in their twenties and one in his thirties who were there for rhinoplasties. Many times in poorer countries, patients aren't able to travel back for the "refinements" that children with cleft life and palate would receive in the U.S. or other developed countries. Evening out a lip scar or in these cases, giving them a nose with symmetric nostrils and a straight septum is very important. The plastic surgeons were very excited to see them. At one point, three surgeons were gathered around one young man, peering up his nose and discussing the best approach while he sat there, grinning. Perhaps the grin was embarrassment, or perhaps he was just happy that three surgeons were fighting over the chance to give him a great nose. Later one of the surgeons told me that he sees doing these "cosmetic" procedures on the teens just as rewarding as closing the widely cleft lips of the babies. Those, he said, are also cosmetic, but he sees them as mainly medical as the cleft affects nutrition and therefore general health. Also, without the surgery, the child will be shunned and unable to go to school, so that surgery, he feels, has many consequences. When he does the final "touch up" surgeries on the teens, he feels he's finally "making them feel normal, beautiful, handsome," and that is his biggest joy.
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