Sometimes It’s Hard

Kigali, RwandaSmile Train Program Manager, East Africa, Dr. Esther Nyambura Njoroge sent us this very touching account of a mother and her a newborn daughter who came in for free cleft surgery.

This week am in Rwanda for a Smile Train outreach. Smile Train is a charity organization dedicated to offering Free reconstruction surgery for cleft lip and palate babies. We are going to change peoples lives here, one smile at a time.

So this morning I [walk] into the hospital, all ready to be my usual charming self, and I go about reviewing the patients who have shown up today. Looking into their hopeful faces, one cant help but feel emotional-even the very cold-hearted. Patient one to ten are fantastic-right age, no obvious infections, ready for surgery after some lab tests. Then I reach patient 11 and my heart lurches. I will call her Tammy*. She is a beautiful little girl and am sure she will be a show stopper some day. She is very tiny and has an NG tube-this is a tube that is passed from the nose to the stomach for delivery of food or milk when someone is not able to feed for one reason or another. I remember how delicate a procedure it used to be to fix those back in ward 3D (Kenyatta National Hospital). Basically the tube ensures that food reaches its destination.

The mother is beside herself, a very sad look on her face. I inquire about the baby and learn that she is only 28 days old, and the tube was fixed at the hospital she was born at. The mother bursts into tears and mine follow. I step back and look away-surely a patient should not see me cry! Since I started working with cleft babies I find my tear threshold has shifted significantly, I guess it comes with the job description. When I regain my composure I ask her why she is crying and she retorts in a torrent of Kinyarwanda that I surely cannot understand. The nurse with me translates — her husband left her the day Tammy was born and has not returned since. She is all on her own with her two children and she pleads that we help her baby, if only so that the bread winner of her home can return. He blames her for the deformity, saying her body was impure and thus the resulting baby. His family shunned her and she had to move back with her mother, a great disgrace in her community.

Tears sting my eyes again but I resist. I think of my own daughter and am broken. Am broken because Tammy is too young for surgery yet. We cannot operate on her now due to safety issues. But, there is a lot we can do for this mother, we can give her hope and this is part of my job. So I patiently talk to her and the nurse translates in the language Tammy’s mother understands best. Together we counsel her on feeding the baby, and the reasons why we should wait until Tammy is three months old. Slowly, as we repeat the information over and over, her face brightens and I notice a change in the look in her eye, she is hopeful. Tammy will have her surgery in two months time, and that look will definitely change to joy. I know it.

At times like this, it’s really hard…but we march on changing the world one smile at a time.

*Tammy is not her real name.

Changing Families’ Lives In Colombia

Smile Train patient Lina and her sister after Lina's free cleft surgery

Cali, ColombiaSmile Train staff member Maryan Newbury recently visited our partner Gracia a Dios Un Niño Sonrie Foundation. While examining best practices for cleft surgery and administration to help with implementation at Smile Train’s other partners, she had the opportunity to visit patients and their families with surgeon Dr. Mauricio Moreno. Upon her return from Colombia, she shared her experience.

Accompanied by the community police, we made our way through one barrio after another, up the side of the mountain. When the police van could no longer climb the steep hill, we went by foot. Shopkeepers, children returning from their morning school session and passersby all tried to point us in the right direction, toward the home of 15-year-old Smile Train patient Lina Rivera and her family. Luckily, we met her younger brother along the way.

The Rivera family lives below a makeshift billiard hall, in a three-room cellar apartment. Electrical wiring hangs in clumps from the ceiling and one wall has mostly crumbled away, exposing the home to the elements. Nevertheless, the children’s mother beamed as she offered us a lunch of arepas and juice, expressing her deep gratitude to Dr. Moreno for the surgery that transformed her daughter’s smile.

I had brought Smile Train teddy bears to give to patients I met during my journey. All of the kids I met had grabbed them and smiled, even if they were still a bit sleepy when waking up from cleft surgery. This time, however, when I took a bear out of my bag and handed it to Lina, she simply turned and walked into the other room. Following her, I watched as Lina handed the bear to her little sister. The smallest member of the family hugged the bear tight, covered it with kisses, and gently put it on the bed. As Lina watched her sister whispering to the bear and tucking it in for a nap, I could see from the quiet satisfaction on her face that anything she receives she will surely share with her little sister.

We know that cleft surgery saves children’s lives, but it also improves the quality of life for their families and communities. When a child’s smile is transformed, she will have more to share with her family and her community throughout her life. By providing free cleft surgery, we didn’t just help Lina, we helped her whole family.

— Maryan Newbury

Words of Thanks from Chhengy’s Father

Smile Train patient Chhengly Hor before and after free cleft surgery

Phnom Penh, Cambodia — Chhengy Hor was born with a cleft lip and palate in April of 2011. She was lucky to be born into a loving family that was determined to take care of her no matter what. In a few months, Chhengy had her lip repaired at Smile Train partner hospital Monorom Clinic led by Dr. Nous Sarom. Our great partner team repaired her cleft palate when she was 10 months old. Her family has stayed in touch with Smile Train and her father Khykeng sent this note to the head of our programs in Cambodia:

Chhengy now is 19 months old, she has grown up healthy and strong. Now she is 11kg in weight.
She had her first plate surgery on February 17, 2012 in Phnom Penh. She
expect to go through the second palate surgery early next year. She eats well, she can eat porridge, rice, and more things like other kids. We still continue feed her formula milk with special nipples. Just early this month, she able to walk more confident with her walking. She learn to walk with support a few months ago. She has grown about 10 teeth.
I am pleased to share a photo of her. The photo was shot when she turn one year old.
Many thanks to you and Smile Train for support and thank you very much Dr. Sarom for your effort and care.
We are wishing you all the best.
Khykeng and family”

On behalf of Chhengy, our other patients, all of their families, and everyone here at Smile Train, thank you for helping us change the world, one smile at a time.