Walk alongside Shijun

boy with cleft lip and palate looking at camera
Thirteen-year-old Shijun, before surgery. Photo: Zute Lightfoot.

Our promise of improving health and dignity during the COVID-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

As a fifth grader, the one thing Shijun wanted most was to study his favourite subjects of literature and maths.

But being born with a cleft lip and palate in the Guangdong Province of China, he struggled to enjoy his time at school with the bullying he faced on a regular basis.

Although the harassment he received made him angry, Shijun chose to walk away instead of fighting with those who treated him badly.

It pained Shijun’s parents to witness their son endure the hurtful comments and isolation. But there was something that always gave them hope: They knew surgery to repair Shijun’s cleft condition was possible.

Paidong, Shijun’s dad, had a cousin who received surgery to repair his cleft condition and now lives a happier life.

This knowledge of a solution motivated Paidong to search tirelessly for the care his son needed.

But for years, Paidong was left disappointed after each attempt: The cost of surgery was beyond his means and impossible for his family to pay despite his yearly salary as a construction worker.

During one of his attempts, Paidong travelled to Guiyang to see a doctor who he hoped could help. The transportation to the city cost approximately 10% of Paidong’s annual income. And even after the immense cost, Shijun couldn’t receive surgery, and the family once again returned home with no results.

Operation Smile believes that parents should never have to choose between keeping a roof over their family’s head or the care that their child needs to stay healthy.

boy with a cleft walking with his father
Shijun and his dad, Paidong, walk side by side to the hospital. Photo: Zute Lightfoot.

This cycle of frustration and heartbreak came to an end when Shijun’s uncle discovered new information while visiting a friend at a local hospital in Bijie City.

After mentioning to the nurse that his nephew had a cleft lip, they immediately told him about Operation Smile China.

Learning that the organisation had a surgical programme scheduled in Dafang in the coming weeks, Shijun’s uncle rushed home to tell his family the exciting news.

Just like every other attempt at getting his son surgery, Paidong felt both hopeful and anxious in the weeks leading up to the Operation Smile China surgical programme. But he was filled with relief knowing that his family wouldn’t be responsible for the cost of transportation to the mission site and the surgical care Shijun would hopefully receive.

Soon, it was time for Shijun and his uncle to travel to the mission. Paidong made plans to return to Dafang County to meet them at the mission site – there was no way he would miss this opportunity.

boy with his father and uncle
Paidong, left, registers Shijun for screening during a 2016 Operation Smile China surgical mission in Dafang. Photo: Zute Lightfoot.

After a comprehensive health evaluation, Shijun was cleared for surgery by our volunteer medical team and scheduled for his operation to repair his cleft lip.

When it comes to our work of delivering exceptional cleft care to people around the world, the safety of our patients has been, and will always be, our greatest priority.

Throughout the screening process, medical volunteers take patients’ blood pressure, temperature and other vitals to ensure that there are no underlying health concerns that would risk the patient’s safety during surgery.

boy being escorted by medical team for cleft surgery
Shijun bravely walks into the operating room with anaesthesiologist Dr. Daniel Kim of Brazil. Photo: Zute Lightfoot.
surgery team performing cleft surgery
Volunteer plastic surgeon Dr. Shu Maoguo of China, centre, and plastic surgeon observer Dr. Brad Gandolfi of the U.S., left, perform surgery on 13-year-old Shijun. Photo: Zute Lightfoot.

On the morning of his scheduled surgery, Shijun was excited and couldn’t wait to see his new smile for the first time. He began to think of everything he wanted to do after surgery including play basketball with his friends without fear of being teased.

When he looked in the mirror and saw his smile for the first time, he said, “Thank you, thank you I feel good.”

boy looking at himself in a mirror after cleft surgery
Shijun stares at his new smile in the mirror the morning after his cleft surgery. Photo: Zute Lightfoot.

A few days following his surgery, Shijun returned to his grandparents’ home where family and neighbours were thrilled to see how much of a difference one surgery can make.

There were weeks filled with happiness among his family and friends. But a tragic accident halted all celebrations when Shijun fell and broke his leg, delaying his cleft palate surgery.

Paidong shared with us that he works hard to earn enough money to pay for the surgeries Shijun needs to recover from the compound fracture.

But he’s grateful to Operation Smile China and its devoted community of volunteers who took care of his son. Paidong knows that when it’s time, he will not have the financial burden of also paying for Shijun’s cleft palate surgery.

Looking at Shijun today, it’s difficult to tell that he once had a cleft lip.

Operation Smile is committed to providing patients with health that lasts – we look forward to providing Shijun with the additional surgery he needs for his cleft palate and any other essential treatments he needs to live a happier and healthier life.

Help us to continue keeping our promise to patients like Shijun amid the Covid-19 pandemic. Your support today means we can help patients through these uncertain times and provide them with the care and surgery they deserve when it’s safe to resume our work.

boy smiling after cleft surgery
Shijun smiles wide one year after surgery. Photo: Zute Lightfoot.

A Second Chance at a New Smile

woman holding baby with a cleft lip
Seven-month-old Mohamed with his mum, Benjebi. Photo: Margherita Mirabella.

Our promise of improving health and dignity during the COVID-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

Holding her 3-week-old child in her arms, Benjebi tried to process the news she’d just received: Her son, Mohamed, was too young to receive cleft surgery.

After travelling more than 370 miles to attend an Operation Smile Morocco surgical programme in Oujda, Benjebi felt devastated to learn that Mohamed would return home without a new smile.

As thoughts of what Mohamed’s future would be like began racing through her head, Benjebi received news that made her feel hopeful once again.

The volunteer medical team told her that an upcoming Operation Smile Morocco mission was scheduled to take place in Dakhla six months later.

Benjebi clung to her renewed hope on their long journey back home. In six months, Mohamed would be old enough for surgery.

Remembering back to the day she gave birth, Benjebi never imagined she would have a child with a cleft lip. Unaware that this condition affected so many people, Benjebi felt isolated seeing her baby for the first time.

baby with cleft lip
Mohamed, before surgery. Photo: Margherita Mirabella.

After Mohamed’s birth, Benjebi became anxious as she watched her husband, Hamid, intensely stare at their new baby boy. She worried he wouldn’t accept their son because of his cleft condition.

But that was not the case.

Hamid loved his son, but he was confused by his son’s condition. It was like nothing he had ever seen before. Calming his wife’s fears, Hamid reassured Benjebi that he loved Mohamed and would always love him despite his cleft lip.

Sadly, their families did not show the same support.

Lacking access to education on the potential causes of cleft conditions, which can be environmental, hereditary or a combination of both factors, Benjebi and Hamid’s families blamed Benjebi.

They believed that Mohamed’s cleft condition was caused by Benjebi looking at a bad spirit during her pregnancy.

Despite the hurtful comments from family members, Hamid and Benjebi knew that nothing anyone said could diminish the love they both had for Mohamed.

This unconditional devotion motivated Benjebi and Hamid to overcome any obstacle that threatened to stand in the way of Mohamed receiving the smile he deserved.

In the months that followed their first attempt at getting Mohamed surgery in Oujda, Benjebi worked tirelessly to ensure that he would be healthy enough for surgery when the mission in Dakhla arrived.

As she boarded the bus that Operation Smile Morocco provided to transport families on the 32-hour journey to Dakhla, Benjebi hoped that her commitment to Mohamed’s health had paid off.

Surrounded by hundreds of families who’d also travelled to the surgical mission with hopes of their child receiving a new smile, Benjebi felt connected to the other mothers of children born with cleft conditions.

It felt as though for the first time, she wasn’t alone.

dentist smiling at baby with cleft lip
During Operation Smile Morocco's 2015 surgical mission in Dakhla, volunteer dentist Dr. Lo Hanane of Morocco examines Mohamed during the screening process. Photo: Margherita Mirabella.

Each patient underwent a comprehensive medical evaluation to ensure that they were healthy enough to receive surgery.

After Mohamed was examined by our volunteer paediatricians, dentists, anaesthesiologists and other medical professionals, Benjebi cried tears of joy when the team told her the words she’d been waiting to hear since first learning about Operation Smile Morocco: Mohamed was healthy enough to receive surgery.

smiling boy with repaired cleft lip
Mohamed, one year after surgery. Photo: Margherita Mirabella.

The following day, upon laying eyes on her son for the first time after surgery, Benjebi said it was as if Mohamed had been reborn. She took photos of her son and sent them to Hamid, who could not believe his son’s transformation and was eager to see Mohamed in person.

“I would like to thank Operation Smile for everything,” Benjebi said. “I want to encourage all doctors to volunteer and help the mothers who need help.”

When they returned home, many people from their community came to see Mohamed and share in the family’s celebration.

With Mohamed potentially being too young to remember his life before surgery, Hamid and Benjebi hope he will grow up happy and have the confidence to chase after his dreams without fear of the harmful treatment they once endured.

smiling boy with repaired cleft lip
Mohamed, 5 years old. Photo: Lorenzo Monacelli.

We caught up with Mohamed and his family again three years later. He is now in school and enjoys singing and playing ball.

Today, Mohamed is living a life that’s no longer defined by his cleft condition.

Help us to continue keeping our promise to patients like Mohamed amid the Covid-19 pandemic. Your support today means we can help patients through these uncertain times and provide them with the care and surgery they deserve when it’s safe to resume our work.

smiling boy holding a photo of himself before cleft surgery
Photo: Lorenzo Monacelli.

A Chance Encounter Brings Tiyamjane a New Smile

woman with a cleft lip
Eighteen-year-old Tiyamjane, before surgery. Photo: Jasmin Shah.

Our promise of improving health and dignity during the COVID-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

Growing up with a cleft lip in a rural village in Malawi, Tiyamjane fought – and overcame – many struggles throughout her life.

Some of the unthinkable challenges she experienced, including the death of both her parents at a young age, drew sympathy and compassion from those closest to her. While other hardships, like the burden of living 18 years with an unrepaired cleft condition, resulted in painful stigma, unfair treatment and being shamed by people in her community.

Enduring torment, teasing and name-calling because of her cleft condition not only made Tiyamjane sad, but she also felt angry. She was angry that she was being bullied solely based on her appearance. Lacking awareness of organisations like Operation Smile Malawi, Tiyamjane believed that there was nothing she could do to change how she looked or how people treated her.

To avoid the harassment, Tiyamjane decided to leave school at 11 years old and settle into life living with one of her sisters and working on their farm.

Every day for 18 years, she carried the weight of believing her cleft lip – and the pain and anger that came with it – was permanent.

woman with cleft lip
Photo: Jasmin Shah.

For Tiyamjane, living with a cleft lip was isolating, and she often felt alone. But cleft conditions affect more people than she ever realised: Worldwide, it’s estimated that every three minutes a child is born with a cleft condition.

Believing that she was the only person born with a cleft condition, Tiyamjane’s mindset pivoted instantly after seeing the cleft lip of a close friend’s newborn baby. Unlike Tiyamjane’s parents, her friend learned about Operation Smile Malawi and the possibility of surgery shortly after giving birth. After living her entire life with a cleft condition, Tiyamjane was shocked to discover that the solution she never knew existed was suddenly within reach.

Once learning the details of an upcoming surgical programme in Blantyre, it wasn’t long before Tiyamjane, her sister, her friend and baby set off together to travel by bus to the mission site. As she made the journey, Tiyamjane was hopeful a brighter future lay ahead and that she could live the rest of her life free from the pain of her cleft condition.

Even after arriving at the mission site, the surprises continued to follow: Tiyamjane couldn’t believe the number of adults and children she saw during screening who also had a cleft condition. After passing her comprehensive health evaluation, Tiyamjane was deemed healthy enough for surgery by a team of medical volunteers. Though Tiyamjane was nervous on the day of her long-awaited surgery, she bravely walked through the doors of the operating room and toward a brighter future.

smiling woman after cleft surgery
Tiyamjane, after surgery. Photo: Jasmin Shah.

The moment that Tiyamjane saw her new smile, she knew in her heart that her life had permanently changed. This newfound feeling of happiness deepened further when she returned home and received a warm welcome from the community that once mistreated her.

“I am always happy now,” Tiyamjane explained when Operation Smile Malawi volunteers visited her village a few months after her surgery. “Thank you for everything you did for me. Please continue to help others like you helped me.”

Help us to continue keeping our promise to patients like Tiyamjane amid the COVID-19 pandemic. Your support today means we can help patients through these uncertain times and provide them with the care and surgery they deserve when it’s safe to resume our work.

woman smiling holding a photo of herself before cleft surgery
Photo: Jasmin Shah.

The Sounds of Small Victories: Q&A with Phonoaudiologist Olga Sarmiento

Operation Smile Colombia volunteer phonoaudiologist Olga Sarmiento. Photo: Jasmin Shah.

Through creating speech therapy programmes that are structured around each child’s individual communications needs, volunteer phonoaudiologist Olga Sarmiento ensures patients are given every opportunity to thrive in life long after leaving her care.  

After meeting and studying with a phonoaudiologist during college, Olga was introduced to the world of Operation Smile Colombia when she was invited to join the organisation in Duitama. While initially hesitant, Olga realised that by providing speech therapy, she could directly impact the lives of children who are living with cleft conditions in the country.

“I accompanied her to work as a volunteer and began doing hearing exams. After that, a position opened. I was available, my resume was accepted and they called me,” Olga said. “It’s been nine years, and I feel like it’s been a month.”

When patients are living with a cleft palate – and even after a palate repair – they can experience difficulties with speaking clearly. Working as a phonoaudiologist at Operation Smile Colombia’s care centre in Bogota, Olga specialises in identifying those challenges, understanding the stages of communication development and providing specific skills and techniques that her patients require.

Whether it’s hearing, comprehension or the pronunciation of words, Olga works to prevent disruptions in a patient’s progress while also improve their abilities during the early stages of growth.

For Olga, the small moments with her patients are what motivate her to continue working with Operation Smile Colombia.

“A simple ‘sss,’ or simply making a ‘p’ – I know that if the child can do that, they can use it for life,” she said.

We recently sat down with Olga to learn more about how her role serves as a vital part to comprehensive care and how reaching children at the ideal developmental stage makes a big difference.

Photo: Rohanna Mertens.

Q: What motivated you to become a volunteer?

A: “The expectations of what I would be able to do, not having a point of reference of what I would encounter. Because really what I have learned from the children, the closeness I have been able to have with them has been incredible and my work fascinates me.”

Q: In your own words, why it is so important for patients to receive all of the multidisciplinary services here, including speech therapy?

A: “Our goal is that the children live each stage the same as children without a cleft condition. If they come here (Operation Smile Colombia), they achieve that.”

Q: What is special and different about working with children with a cleft in comparison to working with children with other speech difficulties?

A: “It’s more difficult. You really don’t know what you’re up against. So, it’s difficult, but at the same time it’s lovely – the sounds. When you don’t know what you’re hearing and don’t know how much the patient is improving. For me, when I’m talking to fathers and mothers around the world, they think that once the palate is closed, the baby will speak perfectly well. That’s not true. Therapy is also necessary.”

Photo: Rohanna Mertens.

Q: What is the dynamic of working with all the other specialties in the foundation and working together for each individual child?

A: “I consider the key to making it work is the respect for the other areas. I know that you’re the expert in that area, and I respect your procedure and your process as you go along. Personally, I’m very involved, and I’m aware of why they do this in this specialty. I’m always informed of the protocol that each specialty follows to inform the parents of the different areas so they don’t feel like there are so many pieces, but see a sequential order.

“That allows us to work. Let’s say that each area has its focal point where it’s the protagonist and other areas where it’s another professional, but the dynamics are that. We haven’t had such complex cases where we’ve had to meet to determine what’s best, because all the little ones go along with their respective process within each area, and each one has its objectives. When one goal implies or affects or improves another, then we meet and talk in a very informal way like, ‘Hello, this patient, I think … what do you think?’ We agree, and that’s how it works.”

Q: For the parents who come in, do they respond well and follow the specific programmes you provide their children at home? Do you notice the difference when the child comes in?

A: “If they have a goal for what they hope for their children, and that goal is perfection, they work it. If they aren’t clear with which way they are going, they don’t work on it because they don’t see the results that they want. But those who have their eyes and ears open, they do see the small gains. They get excited and work diligently at home. The clarity about what they have to do, that also motivates them.”

Q: How do you feel when a child graduates from the programme?

A: “I feel satisfaction immediately. During the consultation, with each sound that I know would never have happened in the child’s life, thanks to my help, they were able to achieve that. So, the child isn’t talking well but has now made a new sound, that fulfils me.

“With that, I’m happy because I know that from session to session, the child will be demonstrating this. And some day, not too far ahead, we will be getting to the graduation. I make a big deal for the child and their parents. I get so excited, and it’s not even my child.”

Operation Smile Colombia volunteer phonoaudiologist Olga Sarmiento works with a young patient at the Operation Smile Colombia care centre in Bogotá, Colombia. Photo: Jasmin Shah.

Persevering through uncertainty, tragedy and the unexpected

Our promise of improving health and dignity during the COVID-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

Throughout the COVID-19 pandemic, health systems in developed countries were pushed to their limits while the healthcare inequities in low- and middle-income countries became further exposed. 

The communities that were already vulnerable were hit hardest by the virus. Access to help was limited, personal protective equipment was scarce, and the already-restricted capacity of healthcare systems were overwhelmed with patients.

But, throughout these times of uncertainty and fear arose stories of people around the world who, despite all odds, found a way to persevere in the face of so much adversity.

Lilia and her mom, Valeria, moments after receiving their COVID-19 test during Operation Smile Mexico's 2021 surgical programme in Puebla. Photo: Henry Cuicas.

As a 27-year-old nursery school teacher, Valeria’s entire world was turned upside down when the pandemic forced the closure of schools across Mexico.

Expecting the birth of her first child, Valeria suddenly found herself without a job and without financial means to help support her family.

While still attempting to navigate through those challenges, Valeria was once again faced with the unexpected.

“When I was eight months pregnant, they told me,” Valeria explained. “It was clear that she had a cleft lip on the right side.”

Photo: Henry Cuicas.

Though consumed with a mixture of shock and guilt, Valeria and her husband, Daniel, refused to give up and soon began preparing for their daughter Lilia’s birth.

Sadly, Daniel would never get the chance to meet his daughter. He tragically passed away just before Lilia was born.

“If my husband were here, I would tell him that we will come out of this together, that we stand by my daughter, that we need to be strong,” Valeria said. “When I had her in my belly, he used to say that she is daddy’s princess.”

It took all of Valeria’s strength to persevere through the seemingly endless list of hardships that she faced, but she was determined to overcome any obstacle for Lilia, who would be born soon.

“I had to give it all for my daughter,” Valeria said.

The local hospital’s COVID-19 restrictions prevented visitors from being in the delivery room.

So, when it was time to deliver her baby, Valeria was alone.

Although Valeria knew that her daughter would be born with a cleft condition, she was still in shock when she saw Lilia’s smile for the first time.

Initially, Valeria blamed herself for Lilia’s cleft condition. Questions and doubt swarmed her thoughts. Had she not taken proper care of herself? Maybe it was something she ate.  

Valeria knew that Lilia would need surgery to repair her cleft condition, but since she was born in the peak of the pandemic in June 2020, many medical procedures, including cleft surgeries, were on hold in Mexico for the foreseeable future.

What Valeria wanted most was to give Lilia a happy life; however, with the challenges of the pandemic, her dream for her daughter seemed out of reach.

Photo: Henry Cuicas.

But soon, with the help of her sister, Valeria discovered Operation Smile Mexico.

It was after connecting with the organisation that Valeria not only learned she wasn’t at fault for her daughter’s cleft lip, but that the local volunteer team would provide Lilia with ongoing comprehensive care until it was safe to resume surgeries.

Due to Lilia being born with a cleft lip and palate, feeding was an exceptionally difficult task during her first month of life.

Dr. Daniel Zunzunegui, a volunteer dentist for Operation Smile Mexico, fit Lilia with a feeding plate. Molded to the roof of a baby’s mouth, the plates serve as a first step toward surgery, leading patients like Lilia away from starvation and malnutrition.

Learning that Lilia wouldn’t have to live with her cleft condition motivated Valeria. From her first appointment with Operation Smile Mexico, Valeria knew this organisation would support her and her daughter.

After months of Valeria feeling alone and discouraged, the Operation Smile Mexico team offered safety, hope and stability in her pursuit of surgery for Lilia.

While the pandemic made it temporarily unsafe to provide surgery, the local team in Mexico worked tirelessly to provide care, including speech therapy, throughout the pandemic and began seeing patients on a limited scale toward the end of 2020.

“Virtual speech therapies are a tool we had to develop due to the pandemic to reach the patients who need these therapies,” said Elidé Romero, Operation Smile Mexico volunteer speech therapist.

Lilia with Operation Smile Mexico volunteer speech therapist Elidé Romero during screening day. Photo: Henry Cuicas.

For patients like Lilia who are born with a cleft lip and palate, speech therapy before and after surgery is a vital component of comprehensive care. Even before they begin to form words.

Speech therapists provide children like Lilia with palate-strengthening exercises and techniques to help improve the surgical outcome.

But the work before surgery is just as important as receiving continuous care afterward. Their ongoing speech therapy care helps patients speak more clearly as they grow.

“(Lilia’s) main improvements include, one, reducing the risk of having a development gap,” Elidé said. “On the other hand, we teach mums how to interact with their babies in a way that’s enriching for the babies’ speech and complete development.”

Valeria made sure that Lilia never missed an appointment or therapy session.

“The speech therapy support is very impressive. My daughter has progressed well,” Valeria said. “I have seen a change in my daughter during the therapies. She does many little things like babbling, moving around, screaming, playing. Things she almost didn’t do at all before.

“She no longer has the sadness she felt at the beginning.”

Photo: Henry Cuicas.

As the world began to adjust to the new reality posed by COVID-19, Operation Smile Mexico began to resume surgical programmes.

When it became safe to do so, volunteers resumed delivering surgery to families like Valeria’s who hadn’t been able to access the timely surgical care they needed and deserved.

With strict COVID-19 protocols in place to ensure the safety of all volunteers, staff and patients, Operation Smile Mexico hosted a surgical mission in Puebla in March 2021.

“When I saw the other families with their babies with cleft conditions, I thought, ‘I’m not the only one. There are more families besides me.’”

After a comprehensive medical evaluation, Valeria was told that 9-month-old Lilia would be receiving surgery the next day.

“Honestly, I didn’t expect it,” Valeria said with tears in her eyes. “I thank God because I asked for it a lot. I have gone through a lot since my daughter was born.”

Valeria kisses Lilia once more before the medial team takes Lilia into the operating room where she will receive her free cleft surgery. Photo: Henry Cuicas.

Having a child with a cleft condition is often a scary experience – especially for a first-time parent.

This fear was compounded for Valeria because she was going through this experience in the midst of a global pandemic.

But, despite the obstacles, setbacks and tragedy of losing her husband, Valeria did everything possible to make sure her daughter would receive the cleft care that she deserved.

Lilia successfully received surgery to repair her cleft lip, but her cleft care journey is still ongoing.

Valeria reunites with Lilia moments after her successful surgery. Photo: Henry Cuicas.

She will need continued speech therapy and another surgery to repair her cleft palate.

Operation Smile Mexico is committed to providing Lilia and Valeria with health that lasts and can’t wait to see how Lilia progresses as she continues to grow.

Photo: Henry Cuicas.

The love Valeria has for her daughter gave her the strength to make incredible sacrifices. Due to her determination and perseverance, Lilia will have a happier and healthier life.

“I will always be there for her, and I will always fight for my daughter,” Valeria said. “No matter what I have to do for her, I will always be there for Lilia. She will always be my child.”

Help us to continue keeping our promise to patients like Lilia amid the COVID-19 pandemic. Your support today means we can help patients through these uncertain times and provide them with the care and surgery they deserve when it’s safe to resume our work.

Lilia, after surgery. Photo: Henry Cuicas.

A family’s journey towards healing

Eight-month-old Annika with her mum, Justina. Photo: Margherita Mirabella.

Our promise of improving health and dignity during the COVID-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

Rather than having feelings of joy and relief, the birth of her daughter led to some of the most frightening moments of Justina’s life. 

Seconds after being born, Annika needed immediate mouth-to-mouth resuscitation.

After watching her daughter spend two weeks being fed with a feeding tube in the hospital’s intensive care unit in La Paz, Bolivia, Justina no longer knew what to do or who to believe.

The weeks after Annika was born were filled with a whirlwind of emotions and inconsistent opinions from medical professionals.

One doctor told Justina that her baby would be a child with special needs. Another said that Annika was sick.

But the reality was that Annika was born with a cleft condition.

Photo: Margherita Mirabella.

For Justina, it seemed like a lifetime ago that she was enjoying the happy memories of finding out she was pregnant. She believed she was starting menopause at 37 years old when, much to her surprise, she was actually expecting her third child.

Those nine months waiting for Annika to arrive were filled with joy and anticipation for the entire family.

When that day finally came, Justina’s happiness and excitement were replaced with sadness.

Diagnosed with postnatal depression, Justina felt devastated at the thought of Annika not being able to live the life her daughter deserved because of the cleft condition. She often cried, wondering if it would’ve been better if Annika had died, and at times, she wanted to die herself.

But with the support of her husband, Asencio, two older daughters and the help of her therapist, Justina found the strength she needed to persevere for herself and for Annika.

More importantly, she realised that Annika was just like any other child beyond her cleft condition. With a resolve to do everything in her power to provide a good life for her family, Justina turned her all of her focus toward getting her daughter the care she needed to repair her cleft condition.

At the school of one of Justina’s older daughters, a teacher heard that Annika was born with a cleft condition and told Justina about Operation Smile Bolivia.

The teacher explained the organisation’s mission of providing free life-changing cleft repair surgeries to those who need it most. Initially, Justina thought the idea of free surgery was too good to be true, but she soon realised that this was the solution for which she’d been searching.

With a new sense of calm, Justina contacted Operation Smile Bolivia.

From that moment on, everything began to look different for Justina and her family. Finally, there was hope for Annika’s future.

The family attended a pre-mission screening the week before the medical programme was set to take place. Annika was seen by a surgeon and anaesthesiologist who gave her a comprehensive medical evaluation to ensure that she was healthy enough for surgery.

For the first time, Justina didn’t feel so alone.

Annika was approved for surgery in Santa Cruz – 18 hours away from their home in La Paz.

While she was thrilled that Annika was cleared for surgery, Justina began to worry about how she would afford the cost of transportation to the Santa Cruz mission site.

It was soon after that Operation Smile Bolivia informed her that all transportation fees came at no cost for patients and families.

With bus tickets and travel supplies in-hand, Justina, Annika and many more families boarded the bus for the long trip.

Justina, Annika and many other families wait with hopes that their child will receive life-changing surgery during a 2018 Operation Smile surgical programme in Bolivia. Photo: Margherita Mirabella.

Once in Santa Cruz, the families staying at the patient centre were taken to the zoo for a day of fun before surgeries began. For many, this was the first time leaving their communities. The fun activity hoped to ease the stress and anxiety of being in an unfamiliar environment.

“Everything is wonderful – the care, the shelter, the trip to the zoo,” Justina said. “Everyone is so warm and kind.”

Justina remembers the day of Annika’s surgery as one filled with many nerves. But she also can’t forget the joy of seeing her daughter for the first time in the recovery room.

Volunteer pre- and post-operative nurse Asa Ostberg of Sweden checks on how Annika is feeling after her surgery. Photo: Margherita Mirabella.

Justina and her family had endured so much since Annika’s birth. But the conflicting doctors’ diagnoses, hospital visits and feelings of uncertainty were all left in the past as Justina held her daughter in her arms.

Annika, after surgery. Photo: Margherita Mirabella.

After a few days of recovering, an overjoyed Justina and Annika boarded the bus for a long journey home.

With Annika’s cleft condition repaired and her health in good standing, her family could finally begin living their lives without fear, doubt and uncertainty.

“I’m never going to stop thanking Operation Smile and God,” Justina said.

Help us to continue keeping our promise to patients like Annika amid the COVID-19 pandemic. Your support today means we can help patients through these uncertain times and provide them with the care and surgery they deserve when it’s safe to resume our work.

Annika seven months after surgery. Photo: Margherita Mirabella.

Today’s training, tomorrow’s solutions

Our promise of improving health and dignity during the COVID-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

Rwanda faces dire challenges when it comes to the number and skill of its healthcare professionals: Only two reconstructive plastic surgeons and 18 anaesthesiologists serve the country of nearly 12 million people.

And the need extends far beyond cleft conditions. In Rwanda, much of the surgical demand results from trauma and burn wounds. The lack of adequately trained surgeons forces some patients to wait for years before they’re able to receive treatment, which worsens their conditions and further burdens the health system.

However, Operation Smile is helping to alleviate this needless suffering by empowering local healthcare workers with training and education.

Starting in 2015, Operation Smile has partnered with the University of Rwanda, Partners In Health and the Rwandan Ministry of Health to host twice-annual surgical training rotations. Now the organisation’s primary focus in the country, the rotations became formalised after a series of international medical missions conducted from 2010 through 2015.

Since then, more than 25 Rwandan general surgery residents have received hands-on training and education through the rotations.

Dr. Faustin Ntirenganya, the head of the surgery department at the University of Rwanda. Photo: Margherita Mirabella.

Dr. Faustin Ntirenganya, head of the surgery department at the University of Rwanda and one of the country’s two plastic surgeons, said: “Don’t fish for us, teach us how to fish — I like that approach. I used to be involved in cleft surgeries and missions with people coming from abroad. The old way of doing business was to come, operate and go. Then I heard Operation Smile was looking at something more sustainable, which meant coming to train residents.”

Dr. Steve Naum, an Operation Smile volunteer surgeon who’s helped spearhead the development of the rotations, said: “We have witnessed some of the graduated residents going out into the district hospitals and continuing to do reconstructive procedures for wounds and burn patients. This is evidence that their experience with Dr. Faustin and with us has given them the training, confidence and interest to continue practicing reconstructive procedures as general surgeons in the community.”

Dr. Steve Naum, Operation Smile volunteer surgeon educator. Photo: Margherita Mirabella.

The rotations have also strengthened the skills of residents in anaesthesiology, another area of massive need in Rwanda, with five graduates completing the programme since its inception.

According to Dr. Paulin Banguti, director of the postgraduate anaesthesia programme at the University of Rwanda, that number represents the initial surge of a new wave of future Rwandan anaesthesiologists. He hopes to have 60 active anaesthesiologists practicing in the country by 2024.

“We have 30 residents in the (University of Rwanda) programme now with a commitment to recruit between 10 to 15 new residents per year,” Paulin said. “Starting in August 2019, we will be producing an average of eight to 10 anaesthesiologists per year. This brings us very close to our goal.”

Dr. Paulin Banguti, director of the postgraduate anaesthesia programme at the University of Rwanda. Photo: Margherita Mirabella.

The future of reconstructive plastic surgery in Rwanda is looking brighter than ever.

Through a grant secured by Operation Smile Sweden through the Swedish Postcode Lottery, Operation Smile will help establish the country’s first-ever postgraduate reconstructive plastic surgery certification programme in partnership with the University of Rwanda and Rwanda’s ministries of education and health.

The programme began in September 2019 with its first graduates expected to receive their certifications in 2022.

Help us to continue keeping our promise to patients amid the COVID-19 pandemic. Your support today means we can help patients through these uncertain times and provide them with the care and surgery they deserve when it’s safe to resume our work.

Photo: Margherita Mirabella.

Scenes of hope and healing: Surgical training rotations in Rwanda

Photo: Zute Lightfoot.

Nearly 12 million people live in Rwanda, one of Africa’s most densely populated nations. But with only two certified reconstructive plastic surgeons serving the entire population, the country lacks the surgical capacity to keep up with patient demands, forcing many people to wait months or even years to receive the care they need.

After witnessing this gap in the country’s healthcare system during a 2010 medical mission, Operation Smile volunteer surgeons Drs. Steve Naum and Bruce Ferris of the United States refused to stand by and watch as people suffered without proper care. Thanks to the initiative and commitment of Steve, Bruce, Rwandan plastic surgeon Dr. Faustin Ntirenganya and Rwandan anaesthesiologist Dr. Paulin Banguti, Operation Smile and the University of Rwanda now conduct three-week surgical training rotations twice a year at Rwinkwavu Hospital.

Throughout the three-week sessions, Rwandan general surgery and anaesthesia residents learn skills, gain knowledge and practice techniques they will use to perform safe and effective reconstructive plastic surgery procedures. Ready and willing to serve their country, these surgical residents will become part of the solution addressing the country’s massive surgical backlog.

Photo: Zute Lightfoot.

At Rwinkwavu Hospital, potential patients wait to receive their comprehensive health evaluations during the second week of Operation Smile’s April 2019 surgical training rotations in Rwinkwavu, Rwanda. At these medical programmes, it’s not unusual for more than 200 – or even 300 – people to arrive at the hospital hoping to have the surgery that they’ve been waiting years to receive. Through the empowerment and education of local surgeons, anaesthesiologists and other healthcare professionals, sustainable solutions are being built so more patients can receive timely surgical care closer to home.

Photo: Zute Lightfoot.

Donatille lovingly holds her 4-year-old son, David, in her arms as she waits for medical volunteers to examine him before surgery. A typical Operation Smile medical mission aims to provide the highest-quality of surgical care to patients living with unrepaired cleft conditions. But during surgical training rotations, patients arrive at the programme site with various surgical needs – wounds, burns, cleft conditions and other congenital conditions – that require reconstructive plastic surgery.

David was born with a bilateral hand syndactyly, a surgically treatable condition where the toes or fingers of a newborn are fused together. Back home, David has friends, but many of his peers tease him about his hands, often calling him “ibimane,” which means “fused.” After an exhausting 9-hour journey – six hours by bus, two hours by foot and one hour by bike – Donatille arrived at Rwinkwavu with David. But every step they took together was worth it when Operation Smile medical volunteers told Donatille that her son was healthy enough to receive surgery.

“My child will be happy now that his fingers will be like all other children’s hands. He won’t want to hide his hand anymore,” Donatille said. “He will want to show everyone his new hand. If my son is happy, then I am happy.”

Photo: Zute Lightfoot.

Seventeen-month-old Sandrine and her mother, Angelique, arrived at the surgical training mission in Rwanda hoping to hear the answer for which they had been searching for more than a year. When Angelique saw her baby’s cleft lip for the first time, she was devastated, but she never stopped loving her daughter. Sadly, Sandrine’s father, Vincent, didn’t share his wife’s devotion after Sandrine was born. Unable to cope with the stigma associated with Sandrine’s cleft, Vincent refused to accept her as his daughter and forced both Sandrine and Angelique to leave their family home.

With time, Vincent eventually saw past that stigma, and the family agreed to reunite. But many unforeseen challenges would soon follow. In April 2018, Angelique and Sandrine travelled to Rwinkwavu Hospital for screening during an Operation Smile surgical training rotation. However, at just 3 months old, Sandrine was too young for surgery. During another rotation in October later that year, the family was met with heartbreak again when Sandrine’s comprehensive health evaluation determined that she was too malnourished. The pain and disappointment of enduring yet another unsuccessful medical evaluation was too much for Vincent to bear, and he convinced himself that surgery would never happen for his daughter. Once again, he chose to abandon his family.

Photo: Zute Lightfoot.

Operation Smile volunteer surgeon Dr. Steve Naum, centre, and plastic surgery resident Yves Nezerwa of Rwanda, left, sit with 14-year-old Solange as they detail their surgical process. Solange arrived at the rotation with a severe wrist contracture; a condition in which the wrist is pulled forward toward the palm or backwards toward the forearm due to the shortening of tendons or muscles.

While the condition is painless, a contracture can lead to restricted movement and sometimes results in complete immobility of the hand. But thanks to Operation Smile’s surgical training rotations, patients like Solange are receiving the reconstructive surgery that they need to live a more full and happy life.

Photo: Zute Lightfoot.

During these training rotations, reconstructive surgery is provided to patients living with a variety of surgically treatable conditions, free of charge. For many people living in Rwanda, paying for surgical care often means that an overwhelming financial burden will fall on an entire family. But thanks to the collaborative work of Operation Smile and the University of Rwanda, parents no longer need to choose between feeding their family and giving their child a better life.

Photo: Zute Lightfoot.

Operation Smile volunteer surgeon Dr. Bruce Ferris demonstrates different surgical techniques to general surgery residents during an operation. Through his experience with the programme, Bruce recognises how the rotations are drastically impacting the lives of people living in Rwanda.

“When I first started investigating doing rotations, it became very obvious to me that there were patients who needed surgical care that just weren’t getting it — languishing in hospitals for a very long time when they could have been cared for,” Bruce said. “It made sense that if we could develop the rotations, many of these patients would be taken care of and not have to be hospitalised for the long term.”

Photo: Zute Lightfoot.

Rwandan surgical residents observe Dr. Steve Naum perform surgery on a patient. Since 1998, Steve has volunteered with Operation Smile to help improve the health and dignity of patients living in Rwanda and around the world. But through his work with the organisation, Steve knew that ensuring the longevity of healthcare in Rwanda meant building sustainable solutions that could last long after a medical mission ended.

“It is easy for us to come to a place, do a number of cases, feel good about it and leave; but we don’t leave anything necessarily behind if we have not exchanged information or built some sort of knowledge or skill base for local surgeons to continue,” Steve said.

Photo: Zute Lightfoot.

Anaesthesiologist resident Bruce Nzobere of Rwanda carries Sandrine back to the recovery room where her mother, Angelique, anxiously waits to see her baby’s new smile. Soon after Sandrine was born, doctors at the local health centre explained to Angelique that cleft conditions are common and that surgery was possible to help her daughter. It comforted her to learn that she wasn’t the only mother experiencing something like this. She said that she no longer felt alone.

“My hope was that my child would get surgery,” Angelique said. And because of Operation Smile’s devoted medical volunteers, Angelique’s hopes were realised.

Photo: Zute Lightfoot.

Post-anaesthesia care unit and recovery room nurse Florence Wachira of Kenya, left, works with Rwinkwavu Hospital nurse Nikas of Rwanda, right, as Angelique holds Sandrine after her cleft lip surgery. Angelique experienced a mixture of emotions throughout the day of her daughter’s surgery: anxiousness, nervousness but, most importantly, happiness. After enduring the abandonment of her husband and the disappointment of being denied surgery twice, Angelique finally got Sandrine the care she needed for a brighter future.

“She’s going to grow up well. Her health is going to be good,” Angelique said. “All I can say is thank you. I can’t say any more than thank you.”

Updates from India – An interview with Abhishek Sengupta

In the past weeks we have all witnessed with concern how the second wave of Covid-19 was unfolding in India. Here’s an update about our programmes in the country from Operation Smile India Executive Director, Abhishek Sengupta.

How is the current situation in India?

The second wave of the pandemic have been brutal on India. In terms of absolute number of new infections per day and number of deaths per day, the second wave has been devastating, much more severe and sudden than the first wave. Health systems were on the verge of a collapse with a shortage of drugs and oxygen. The government of India scrambled all resources to plug the gap due to increased need for oxygen beds and ICU beds. At some places even military personal and doctors were deployed. Also several armed forces hospitals have been opened up for the general public to address the sudden increase in demand for hospital beds.

How has India’s second wave affected Operation Smile India’s medical missions and care centres?

After the first wave, we were able to restart our centres in November/December 2020. We had just gotten into the groove and the month of April was hugely successful month for us. We provided surgery to over 170 patients in April. However, unfortunately we had to completely shut down two of our centres from May 1. We have a total of four year-round care centres. Durgapur and Mumbai has been shut down till the end of June. The Bangalore and Srinagar centres continue to operate, but under reduced capacity. This decision was taken keeping in mind the surge in number of new infections per day and regional level lockdowns imposed by the government. Hospitals were instructed to increase their capacity to treat patients with Covid-19. Thus a lot of resources (especially manpower) from our cleft centres was diverted to meet this demand.

We are currently watching the situation very carefully. We hope to have all centres up and running from July, however a lot will depend on how things progress with Covid-19.

How have your teams been able to respond so far?

Throughout these tough times (for us as well as for our patients and volunteers) we have continued to stay in touch with our patients. In spite of the lockdown, our teams have been able to make home visits to deliver necessary food supplements and formulas to patients enrolled in our nutrition programmes. We have also been in touch with patients whose appointment for consultation (speech, orthodontics and dental services) had to be pushed. We have ensured that there isn’t any inconvenience to patients and the ones that are on a treatment pathway receive necessary advice and support virtually.

Given the massive shortage of oxygen in the country, Operation Smile has donated 100 oxygen concentrators to our partner hospitals in India. Purchasing oxygen concentrators in such a short time has been a challenge because of the sudden increase in demand and limited supply, but we were able to cut through a lot of the red tape and ensure there were purchased on time and delivered to partner hospitals. These 100 concentrators are being used in Covid-19 wards of 7 different hospitals today and have been instrumental in saving lives.

What is the current situation for children and adults with cleft conditions who were scheduled for surgery?

We have postponed all surgeries for now. We have been in touch with all such patients and are providing necessary guidance and advise virtually. These patients would be prioritised for surgery as soon as the centres reopen.

Do you have a personal message for Operation Smile donors?

These are difficult times, not only for the organisation but also for each of us personally. Almost everyone on the Operation Smile India team has either had Covid-19 themselves or have had close family members who have suffered. Most people on the team have also lost loved ones in this pandemic. The last year and half has been tiring. However, as a team and as an organisation, we all remain committed. During the first wave we stood by our partners and patients by providing food to over 15,000 families, this time we are supporting partner hospitals, patients and their families. In the future we wish to ensure safe and prompt vaccination for our patients and their families. It’s important to understand that we would not be able to do any of this without the help and support of our amazing donors and sponsors. In difficult times, as these, its generally the poor and marginalised that suffer the most and we at Operation Smile India are committed to stand beside them, but to be able to do this we need the continued support of kind-hearted individuals and like-minded organisations.

We hope that these tough times are behind us soon and we can quickly reopen out centres and start providing clinical services. Patients are waiting.

Scenes of hope and healing: Guatemala City surgical programme

Our promise of improving health and dignity during the COVID-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

Photo: Rohanna Mertens.

Alongside his mother, Carmelina, 10-month-old Juan Elias was examined by volunteer dentist Dr. Vilma Arteaga at screening during Operation Smile Guatemala’s May 2021 medical mission​ in Guatemala City. Juan Elias, who was later deemed healthy enough to undergo surgery, was one of 26 patients to receive comprehensive health evaluations.

Photo: Rohanna Mertens.

Three-year-old John Kenneth listens to anaesthesiologist Dr. Emilio Peralta’s heartbeat during his own health evaluation.

John Kenneth’s mom, Yesenia, left; paediatrician Dr. Samantha Wilts of the U.S., centre; anaesthesiology resident Dr. Ligia Atz of Guatemala and anaesthesia team leader Emilio join in on the fun and laughter.

Photo: Rohanna Mertens.

Yesenia and her husband felt many emotions when they learned their middle child, John Kenneth, was born with a cleft lip and palate. Looking at their son after his birth, John Kenneth’s mum and dad were scared, uncertain and sad.

But they also felt hopeful.

Unlike many of the parents we meet, Yesenia knew that surgery was possible for her son. Her mother’s cousin, who had also been born with a cleft condition, received surgery from another organisation.

While Yesenia connected with Operation Smile Guatemala’s volunteer team soon after giving birth, John Kenneth’s road to a new smile was long and full of unforeseen challenges.

Photo: Rohanna Mertens.

John Kenneth undergoes his cleft surgery and becomes one of 15 patients to receive life-changing care during the medical mission. Plastic surgeons Drs. Labib Samarrai of the U.S., right; Pablo Ramazzini of Guatemala, left; and operating room nurse Grecy Queche work together to ensure the highest quality of care possible.

Years before his surgery, when John Kenneth was just 15 days old, Yesenia took a four-hour bus ride to the Operation Smile Guatemala clinic, determined to get her son care she knew he needed. Driven by love and hope, she made that same journey every month until the local staff informed her of an upcoming mission in April 2020. It wasn’t until she learned that all medical missions had been cancelled due to the pandemic that Yesenia began to fear the worst.

“I was scared that they would never operate again and John Kenneth would have to live with his face like this for the rest of his life,” she said.

Happily, Yesenia’s hopes were realised and John Kenneth now has a new smile and brighter future.

Photo: Rohanna Mertens.

Christopher’s mom, Lesli, received five ultrasounds during her pregnancy, but she didn’t learn her son would be born with a cleft condition. It wasn’t until the day of his birth when the doctor hesitated to let her see him that Lesli knew something was wrong. Upon seeing Christopher’s smile for the first time, she was scared and shocked. With having relatives from both her mother and father’s side of the family receive surgery for their cleft conditions, Lesli knew surgery was possible. But she never imagined it would affect her child.

Christopher was born after the COVID-19 pandemic had began spreading across the country. When Lesli called Operation Smile Guatemala, the organisation had already postponed upcoming medical missions and was closed to in-person visits. But the local volunteer team never gave up on Lesli or Christopher. Over the phone, they explained to Lesli how to tape his lip, which would help with feeding and preparation for future surgery. From then on, she received calls from our team every two weeks.

Months later, when the Operation Smile Guatemala clinic reopened in March, Lesli began making the five-hour trip every 15 days to bring Christopher in for his appointments and evaluations. It was during one of these visits that she learned about this upcoming medical mission in Guatemala City. Following his comprehensive health evaluation during screening day, Christopher was scheduled for surgery.

Photo: Rohanna Mertens.

Training and education opportunities are vital components to increasing surgical capacity and building sustainable solutions that address the backlog in the countries we serve.

This programme was volunteer plastic surgeon Dr. Labib Samarrai’s 30th medical mission with the organisation. Labib, left, mentors Dr. Pablo Ramazzini of Guatemala, right, during surgery as part of his credentialing process with Operation Smile. Empowering medical professionals like Pablo instils a confidence in them to practice their new skills and perform the techniques they’ve learned to deliver safe and effective cleft surgery in their local communities.

Photo: Rohanna Mertens.

Operation Smile Chief Development Officer Kendra Davenport shares a special moment with 15-month-old Gerson Eduardo in the recovery room after surgery.

“I feel like my team in Virginia Beach is tremendous and people have done a lot to educate me about what happens on a mission and what the obstacles and challenges are. But to see it up close is to really believe and understand,” Kendra said. “I think certainly the obstacles and challenges are huge, but the joy that the whole team feels when a child comes out of the operating room is palpable. For me, as a parent of a child who had to be operated on, it’s a tremendous leap of faith to hand over your child for that operation.”

Photo: Rohanna Mertens.

Justa, 11-month-old Luis Antonio’s mum, sees her son for the first time in the recovery room right after his surgery. It’s the determination and resilience of parents like Justa that enable and inspire us to overcome seemingly impossible challenges amid the pandemic.

Help us to continue keeping our promise to patients amid the COVID-19 pandemic. Your support today means we can help patients through these uncertain times and provide them with the care and surgery they deserve when it’s safe to resume our work.