A Smile Years in the Making

Xi’an, China – For some people four years is a short period of time. For a surgeon four years is not time enough to achieve his degree. For Smile Train it is just a third of the time since it began providing cleft surgeries in China. However, for a child with a cleft, four years can change his fate. Four years helped Hua Tai’an and his family get through sadness and helplessness to happiness and hope.

Hua Tai’an was born in July 2006 with both a cleft lip and a cleft palate in Xianyang City, China. Not long after his birth, Hua’s father began to seek treatment for his son. The family used all their savings to pay for Hua’s cleft lip surgery, which still left Hua’s nose slightly misshapen. They had no money left to afford surgery to repair his palate. Luckily, not long after, Hua’s father learned of free cleft surgeries being provided at Smile Train’s earliest partner hospital in his province—Stomatological Hospital of Xi’an Jiaotong University.

The hospital’s staff was struck by the appearance of father and son when they arrived at the hospital. The child was beautiful, while the father was old, with long and shaggy hair. He seemed to be very poor. Despite making the journey with his son to the hospital, Hua’s father was still skeptical that surgery could be free in such a large hospital in a big city like Xi’an, especially because the first surgery had cost his life savings. The doctors told the father that, “Smile Train pays for you so that you can enjoy the free surgery.” The father was still rather in doubt about this, but allowed the surgery to be done.

On July 8, 2008, Hua Tai’an, who was now two years old, received a successful surgery to repair his cleft palate.

Hua Tai'an at two years old.

Hua Tai’an at two years old.

As time passed after the surgery the father found that his child was still unable to play with other children because Hua was unable to speak clearly. He was very concerned for his son. In 2010 the hospital invited the boy and his father to a speech language camp for cleft palate patients.

At the camp Hua and his father took part in the activities with the other patients and their families. Despite being with other cleft patients like him, Hua was too shy to look up or speak. His father said the poor appearance of his son’s nose was to blame. The team at the hospital recommended a second surgery to revise the cleft lip repair and help with Hua’s speech. Hua’s father was even more worried than during his first visit to the hospital. His concern was again about the surgery’s cost. The doctor’s explained to him that he need not worry because Smile Train would once more fund the treatment as well as transportation fee to and from the hospital for both him and Hua.

After many months spent debating another surgery, Hua’s father permitted surgical treatment for his son. On February 10, 2012, Hua was operated by the same surgeon who originally treated his cleft palate. The surgery was a great success and Hua was discharged from the hospital on schedule.

During one of Hua’s follow-up visits in November 2012, doctors thought that another child had entered their office due to his beautiful smile. Hua had made wonderful progress. He spoke confidently to all the staff and proudly shared his academic achievements.

Hua Tai’an, in primary school at grade one. He now has made great academic achievements and good friends.

Hua Tai’an, in primary school at grade one. He now has made great academic achievements and good friends.

Even the father’s smile had noticeably grown. He said his son had been much more cheerful, as if Hua was a different person. The difficulties of the past four years had disappeared. The father proudly displayed all the materials associated with his son’s years of treatment. Doctors were inspired when they noticed “pass cards” of the speech treatment camp that the father had cherished, but was so common to them. Hua’s father finally found that his son could be as outstanding as other children, if not more.

The team at Stomatological Hospital of Xi’an Jiaotong University was grateful and happy as well. Throughout the past four years the father had worn the same clothes every time he visited the hospital and under such difficult economic conditions the hospital staff was unsure how long the family’s persistence in treating their son could last.

It took the hospital staff a bit of time to consider what was the key to Hua’s and their success. They wrote to Smile Train this conclusion:

“Without the support of such a strong foundation, Smile Train, we couldn’t have persisted on for four years with a single patient. The poor families couldn’t have afforded the expensive surgeries many times. Without Smile Train, the team approach to cleft care wouldn’t have such development or scale as today. Without the thirteen years of Smile Train in China, how could we have seen the smiles of children with cleft lip and cleft palate?”

Smile Train’s Newest Partner From Bolivia

Tiwanaku Project Pamela Wren, Smile Train’s Latin America Director, welcomes Dr. Raul Caceres (left) and his staff to Smile Train.

New York, NY — Although Dr. Raul Caceres, a plastic surgeon and director of Smile Train’s newest partner, the Tiwanaku Project in Bolivia, has a surgical practice in New York City’s luxurious Upper East Side, he still devotes much of his time and talent to his hometown.

Born in Oruro, Bolivia, Dr. Caceres knows much about the hardships members of the community, located in the Bolivian Altiplano, 12,000 feet above sea level, encounter each day. The region is home to both magnificent scenery and some of Bolivia’s poorest citizens.

“Since I was born there I know what the conditions of the people are,” Dr. Caceres said. “They have one room that is the living room, dining room, everything, and the bathrooms, of course, are on the outside.” Residents also do not have electricity, so candles and bonfires must be used for light and warmth.

As Dr. Caceres’ career started blossoming during his work at top institutions like John Hopkins in Baltimore, among many others, he started thinking of ways he could give back to Oruro. It was not until a church trip to his hometown six years ago that he knew in which way he would do so.

During the trip the group visited the hospital in Oruro which was over a hundred years old and dilapidated. One participant noticed nurses washing their latex gloves to be used for the next day. “He just couldn’t believe it. He thought this is like going back in time, like a hundred years.” That same individual challenged Dr. Caceres to use his expertise as a plastic surgeon to help the hospital.

From the beginning Dr. Caceres had the full support of his church and six years later his vision, the Tiwanaku Project was complete. During that time a new hospital was built in the middle of the complex where the old one stood and is similar to any hospital found in the United States. “It looks like it is a castle in the middle of this one hundred year-old spread out hospital with some rooms falling down,” boasts Dr. Caceres. In Dr. Caceres’ “castle” the second floor is dedicated to clefts. (The first floor houses the Tiwanaku Project’s burn center.)

Another similarity between the Tiwanaku Project and the care in the U.S. is that each cleft patient is provided with continuous, comprehensive care all year round. “We have this opportunity that we have the infrastructure and we’ll have doctors train there in this kind of work [cleft care] so care will be given in a continuous kind of way.” Dr. Caceres also adds that many other specialists important for cleft care, including ENT doctors, audiologists, and dieticians, will also be available to patients.

Dr. Caceres has spared no detail to ensure that patients and their families are provided with the best care. The Tiwanaku Project now provides parents traveling great distances to the hospital, who previously slept on the floor and ate the leftovers of their children, a bed to sleep on and a dining room to eat provided meals.

“It is a unique place,” a prideful Dr. Caceres says with a smile.
Smile Train is also proud to have the Tiwanaku Project and Dr. Caceres on board to help Bolivian cleft patients in need. Below is a message from Dr. Caceres to the Smile Train donors.