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

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 traveled 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.

With surgery, a weight was lifted

Zafilahy, 32 years old, before surgery. Photo: Rohanna Mertens.

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.

While routine in much of the world, surgery for many people living in low-income countries has misconceptions surrounding it, which can cause some to be fearful when it comes to receiving treatment.

That’s why when Virginie saw her husband, Zafilahy, for the first time after he returned home from his cleft lip operation, she had to be reassured that the doctors hadn’t stolen a part of his body during the procedure.

Instead, what the Operation Smile Madagascar volunteers had given him was a new smile.

Before his surgery, Zafilahy believed that he and the two other people from his community born with cleft conditions would be forced to live with an unrepaired cleft lip for the rest of their lives. None of them learned that a solution existed.

Throughout his life, Zafilahy was often called “Telo Moloha,” which translates to “three lips.”

But he never let the harassment prevent him from living a life of happiness.

During the 32 years he lived with an unrepaired cleft lip, he became a farmer, married the love of his life and had six children. But amid his joy, Zafilahy felt as though something was holding him back.

That was until Fidelis, a patient advocate with Operation Smile Madagascar, arrived in Zafilahy’s village spreading awareness about the non-profit’s work throughout the country.

Fidelis explained that all expenses from the surgery to repair Zafilahy’s cleft lip would be covered by Operation Smile. He felt immense relief because he knew it was a cost he wouldn’t be able to afford otherwise.

Alongside his brother and a large group of families, Zafilahy made the 13-hour bus trip to Antsirabe for the upcoming surgical programme.

It was the first time in 32 years that he’d left the comfort and familiarity of his village.

But Zafilahy wasn’t fearful of the long journey ahead. Instead, he felt eager because he knew something special awaited him at the destination.

Once they arrived, medical volunteers performed a comprehensive healthcare assessment to confirm Zafilahy was healthy enough to undergo anaesthesia.

For Operation Smile, patient safety is the greatest priority. To ensure that they receive the highest quality of medical care, each patient is screened for potential health issues that could impact their procedure or put them at risk.

When he was finally scheduled for surgery, Zafilahy was ecstatic.

A surgery that often lasts as little as 45 minutes changed Zafilahy’s life forever.

Zafilahy, after surgery. Photo: Rohanna Mertens.

Today with his new smile, Zafilahy is very happy and feels as though a weight has been lifted. He couldn’t wait to return home to his family and live a life free from the stigma of a cleft condition.

“Thank you, Operation Smile,” he stated. “Now, I do not worry about my health. I will be a happy man with no more worries.”

Help us to continue keeping our promise to patients like Zafilahy 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: Rohanna Mertens.

A link in the chain: Q&A with dentist Dr. Guillermo Cifuentes

Volunteer dentist Dr. Guillermo Cifuentes of Guatemala during screening day at a 2021 Operation Smile medical mission in Guatemala City. Photo: Carlos Rueda.

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 volunteer paediatric dentist, Dr. Guillermo Cifuentes understands the vital role in-person care serves when building trust between himself, his patients and their families.

Though the COVID-19 pandemic temporarily halted Guillermo’s ability to deliver dental care face-to-face, providing virtual services gave him and his fellow volunteers a greater regard of the harsh reality that many patients face when trying to access care in resource-limited communities.

“We can do so much more when being in direct contact with the patients, but remote consultations allowed us to gain a deeper perspective into our patients’ lives,” Guillermo said. “I got to see their humble houses and rooms. Their wooden walls and tin roofs made me more aware of their reality, of the poverty in which they live, and it’s encouraged me to help even more.”

According to Guillermo, not everyone has what it takes to donate their time and expertise as a volunteer for Operation Smile.

“The important thing about volunteering is that it must come from the heart. You can’t force someone to do it,” he said. “What I like the most about volunteering is interacting with the patients and their parents, witnessing their happiness.”

We caught up with Guillermo to learn more about where his passion to volunteer began as well as how adjusting to virtual consultations reinforced why many patients and families depend on the care Operation Smile provides around the world.

One-year-old Lizandro waits to receive his comprehensive health evaluation during an April Operation Smile medical mission that Dr. Guillermo Cifuentes attended in Guatemala. Photo: Carlos Rueda.

Q: Why did you decide to become a volunteer for Operation Smile?

A: “I’ve always liked helping others. It’s something I had as a family. We always carried out some type of social service to help those who needed it the most. When I became a dentist and found out about Operation Smile, I managed to apply my knowledge to help my team and the children who have cleft conditions.

“What I like the most about volunteering is interacting with the patients and their parents, witnessing their happiness and how they change throughout the process that we help them through. And then, after the surgery, seeing the happiness on the parent’s face when their child can smile properly.”

Q: Why is it so important that parents trust the treatment you’re delivering to their children?

A: “It’s of great help when the parents trust the treatments we choose, especially in pre-surgical orthopaedics. It’s very helpful for us when the parents know the procedure and that they know that the pre-surgical orthopaedics helps their child feed better, the development of the arches and the conformation of the nose.

“Babies can feel their parents’ mood. If the mum, mainly, is in doubt, nervous or apprehensive, it will be difficult for the baby to accept the obturator. It’ll take more time. We must notice when this happens to give the mother positive reinforcement and show her she has strength and security to transmit that to the baby.”

Q: How do you feel knowing that you are changing your patients’ lives for the better?

A: “You won’t believe me, but the truth is I don’t think much about the fact that I’m an instrument of change in the lives of these children. It’s not something that I think about often. I just like to come to examine my patients. Of course, deep down, I know I’m contributing, that I’m a link in a chain by doing my job.”

Screening day during an April 2021 medical mission in Guatemala City. Photo: Carlos Rueda.

Q: The COVID-19 pandemic has been very difficult for all of us. You had to start working in a virtual clinic, which is new for you. What has the pandemic taught you about yourself and Operation Smile Guatemala?

A: “The pandemic has taught me how to take care of patients even with the restrictions. It can be frustrating to have remote consultations because we lack that close contact with our patients, which is very much needed. We can do so much more when being in direct contact with the patients, but remote consultations have allowed us to gain a deeper perspective into our patients’ lives and homes.

“During the first calls that we made, I got to see their humble houses and rooms. Their wooden walls and tin roofs made me more aware of their reality, of the poverty in which they live, and it’s encouraged me to help even more. It’s encouraged me to go ahead with the remote consultations because even if I can’t touch them, it’s very valuable for them. They call me and say, ‘Doctor! Good to see you! Doctor, look at how much my baby grew!’

“They’re very happy. They have taught me so much. They lift my spirits and make me understand that those calls are very important, even if we only see each other through a screen.”

Q: You’ve been able to have that physical contact with them again and help your patients in person. How do you feel about being able to go back to the clinic?

A: “The night before going back to the clinic, it was like the day before an exam. I didn’t sleep well because of the excitement. I was expectant. I felt a bit nervous, but at the same time, I was happy. Being able to go to the hospital again was wonderful. It’s a part of me. It’s what I do. My second home. It completes me. I feel like myself again.

“Getting to see the patients, the team of volunteers, and being able to physically evaluate the patients, to see the mother’s eyes while I explain the treatment and its benefits, and how it’s the first step toward surgery.”

Q: Explain to us why it’s so important that children born with cleft conditions receive orthopaedic care?

A: “These kids need to use their obturators. But during the pandemic, those who were already receiving the treatment had to pause it. Those who were born during the pandemic and haven’t yet started the treatment have been losing a lot of weight because it’s difficult for the mums to learn how to feed them on their own. They get very frustrated when they can’t breastfeed their children, giving them formula instead. We must begin or continue the treatments so that we can make sure that the separated segments develop correctly and eventually allow the child to feed properly.

“It’s important that the babies who were already receiving treatment get to continue with the process because their mothers tried to make them use the insert for as long as possible until it didn’t fit anymore. We looked for alternatives. Resuming the treatment means straightening and correcting the position of the segments like we were trying to achieve earlier for some. And for others, it’s about achieving better diction, better pronunciation and learning to breathe through their nose, which is something that they must learn. That’s the important thing.”

Q: Lastly, is there anything you’d like to say to other doctors or members of your specialty about volunteering?

A: “The important thing about volunteering is that it must come from the heart. You can’t force someone to do it. I could tell someone, ‘Come on, help us,’ but if that person lacks the conviction and desire to do it, they won’t be a good volunteer.

“There are lots of people who volunteer and many others who wish to do so. Many professionals have the knowledge and time to dedicate to our young patients, in our case, with their cleft lip or cleft palate. I invite those doctors to volunteer. We would benefit greatly from their knowledge, and our patients would, too. I invite those doctors to come to us, to get more information about Operation Smile Guatemala. I invite them to come here to the hospital, where we can inform them better on how to use their knowledge to help others.”

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.

His dream is within reach

Cosmas, 21 years old. 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.

If any of Cosmas’ 12 brothers and sisters were in need of medical care growing up, the closest health clinic to their home was a 30-minutue walk. As for the closest hospital, that was a three-hour walk.

Not once during any of his regular check-ups to the clinic was Cosmas told that his cleft condition could be repaired with surgery.

Cosmas grew to accept that his cleft as God’s will but was still unhappy. He believed that he’d live with the burden of an unrepaired cleft lip forever. For 21 years, he did.

But on a day that Cosmas expected to be like any other, a friend in his community told him that he wouldn’t have to live the rest of his life with his cleft condition because Operation Smile Malawi had an upcoming medical mission.

Unfortunately, he learned about the upcoming mission too late. Even if he and his dad had the money to pay for travel, they never would’ve reached the mission site in time. But both men refused to give up.

Ganizan, Cosmas’ father, was a 70-year-old subsistence farmer. Cosmas earned a small salary as a farmer, but he also learned that neither he nor his father could pay for surgery through the local hospital.

Cosmas was hopeful that he would receive another opportunity to get safe surgery for free through Operation Smile Malawi.

When Cosmas was 21 years old, Ganizan was determined to find a way to get his son the surgery that he knew would change his life. Walking the three hours it took to reach the district hospital in Dedza, Ganizan sought out more information about the process of getting his son to the next Operation Smile Malawi mission.

He was told to arrive back at the district hospital in August where a bus provided by Operation Smile Malawi would be waiting to take them to Lilongwe at no cost.

After much waiting, the day finally arrived, and Cosmas and his father left their community to begin the long 7-hour trip to the mission site.

After passing his comprehensive health evaluation, Cosmas and his father learn that he's been placed on the surgical schedule during a 2015 Operation Smile Malawi medical mission in Lilongwe. Photo: Margherita Mirabella.

Following their journey, they arrived in Lilongwe, and Cosmas felt at peace seeing others like him. For the first time, he knew that he wasn’t the only one living with a cleft condition.

As many as nine in 10 people around the world can’t access basic, surgical care and can endure years of bullying, social isolation and severe health problems from an untreated cleft condition. For Cosmas, a lack of education and awareness about cleft conditions in his community proved to be a barrier that lasted two decades.

Although he was often teased, all Cosmas wanted growing up was to be treated like everyone else. He had friends and loved to watch soccer and his favourite player, Malawi’s own Fisher Kondowe.

On the verge of undergoing a surgery that he waited on for more than two decades, Cosmas was looking forward to enjoying the activities of his peers without being burdened by his cleft condition.

His experience at the Operation Smile medical mission was much different than life in his community. There was no worry about being harassed or teased. For once in his life, he was around people who accepted him.

“When I go home people will stop making fun of me,” Cosmas said.

He walked into the operating room with confidence, knowing that he’d come out with a completely new smile – he couldn’t wait for the opportunities his future would hold.

Cosmas, one year after his surgery. Photo: Margherita Mirabella.

Ganizan didn’t stop smiling when he saw his son for the first time after surgery.

He had spent 20 years watching his son struggle to come to terms with his cleft condition and now his life is renewed. Both Cosmas and his father gave a big thumbs up when asked if they were satisfied with the surgery.

When he saw his reflection for the first time, he could not believe the change he saw in the mirror.

Since returning home, Cosmas feels like he is now free.

Although he always had friends, he didn’t like to go out in public with them for fear of being teased. Now, he feels excited to go out with friends because nobody stares at him or calls him names.

Interacting with others is something that Cosmas now embraces. He is currently in his first year of high school, and his favourite subject is social studies with dreams of becoming a police officer.

“I am very happy and thankful to Operation Smile, and I hope they will keep helping others,” Cosmas said.

Help us to continue keeping our promise to patients like Cosmas 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.

Connection Through Storytelling: Q&A with Volunteer Alison Smyth

Alison during a post-op follow-up in 2013. She embraces Jheleen, right, and Andrea, left. Operation Smile photo.

While many people may not know Alison Smyth, her impact on Operation Smile’s mission can be felt in nearly every patient story seen on our social media and website.

Through her volunteer work as Operation Smile’s assistant production manager, Alison has attended a total of 109 international trips with Operation Smile: 74 medical missions, 32 follow-up trips and three film productions.

Her journey with Operation Smile began while she was living in Lima, Peru, in 1999, when Alison volunteered as a translator in support of a medical mission.

“Like so many Operation Smile volunteers, I was hooked from the very beginning,” Alison recalled.

Over the years, her position in the organisation has transitioned into an integral part of our storytelling.

Connecting with patients face to face to learn how surgery transformed their lives allows Alison to see first-hand the change Operation Smile brings to the lives of families around the world. While interviewing patients and families is one of her major responsibilities, the work she does has a much greater impact.

During a 2012 medical mission in the Philippines, Alison embraces the family of Jan, a young patient who received surgery. Photo: Marc Ascher.

Families welcome Alison into their homes and see her as a friend and someone who they can trust.

Visiting them can include 15-hour car trips, long walks through the countryside and trekking through rice paddies. But no matter how the long journey is, Alison shares that it’s worth every mile to see the joy on the faces of families whose lives we have touched.

“In my work, I have seen so many instances where a child, the siblings and family members are shunned, teased, and ostracised from the community,” Alison explained. “Mothers who, before surgery, do not take their child out into the community in order to avoid the questions, the blame, the teasing.

“After surgery, many mothers say the biggest change in their life is that they can go out with their child and their child is like all the other children.”

We’re grateful for Alison’s compassion and devotion because we’re witness to the stories she’s helped bring to life.

“Quite simply, I love my work,” Alison said. “And I’m fortunate that I’m able to volunteer full-time. What inspires me? Our families – telling their stories and raising awareness for Operation Smile.”

We sat down with Alison to learn more about her work with Operation Smile throughout the years as well as hear her favorite stories from her time in the field.

Seven-year-old Sarban with Alison as they walk hand in hand through his community during a 2012 home visit after his surgery. Photo: Jasmin Shah.

Q: What is your favorite aspect of your work with Operation Smile?

A: “Being out in the field and meeting and learning about the families’ lives, hopes and fears for their child. The time at the mission and going through surgery and recovery is filled with anxiety for the parents, and even though they are happy post-surgery, they still worry about how they will care for their child through the recovery process. Probably my most favorite aspect is when I return to the country six months to a year later and meet the families, babies, children, adults again and learn how the surgery has restored dignity to the family and learn of the hopes they now have for their child’s future.”

Q: You’ve been a volunteer with Operation Smile for more than 20 years. What inspires you to continue volunteering full time?

A: “Over the years, I have seen how our in-country foundations have, through their work and education, reduced the stigma of living with a cleft condition. To hear mothers say that they learned about Operation Smile at birth or, in some cases, during the pre-natal ultrasound is an enormous step forward. For a mother to know that there is a solution is life changing.

“Mothers that come to a centre with their baby say that the experience is very positive because, at the centre, they meet other mothers like them and are able to share experiences with them. A number say that the centre is like their second family. Knowing that in some small way I can be part of the team that is instrumental in making a difference is what motivates me to continue to travel many, many weeks a year (at least before COVID-19 and hopefully again in the not-too-distant future).”

One day after surgery, Alison holds 8-month-old Bismata at her home following a 2012 Operation Smile India medical mission. Photo: Jasmin Shah.

Q: Can you tell us something that people would be surprised to learn about the patients you’ve met during your travels?

A: “Not sure if this is surprising, but the trust the families put in the Operation Smile teams is humbling. They trust complete strangers with their child. The fact that they so rarely complain about the many hours they wait or the fact that they may not be scheduled for surgery this time.”

Q: Is there a patient or family story that stands out as most memorable in your time with Operation Smile? What was so powerful about that story?

A: “So many stories! The 56-year-old gentleman in Ghana who was 55 before he learned that surgery was possible. On learning that he was scheduled for surgery he called his wife to tell her to prepare two chickens and buy Fanta because they were going to hold a party when he got home. Two sisters in the Philippines: when I asked the mother what was the most special part of the girls’ surgery day – apart from the surgery itself – she answered hearing the girls say “Mama” properly for the first time. In so many cases the most powerful aspect is that a simple surgery can return dignity to a child, a patient, a family and in some cases a community.

“One of the most memorable answers I received was on asking 66-year-old Qi Xiu what she was looking forward to most after her surgery. Her response was, ‘I am looking forward to taking my grandchildren to school and no one will laugh at me.’

“When we met Qi Xiu a year later, she told us, ‘I love my smile, nobody laughs at me anymore.’”

Alison reconnects with 66-year-old Qi Xiu of China one year after receiving surgery during a 2016 medical mission. Photo: Zute Lightfoot.