Journey of Smiles: Brazil

Four-year-old Bianca Lima before her Smile Train cleft surgery and three months after.

Four-year-old Bianca Lima before her Smile Train cleft surgery and three months after.

Salvador, BrazilSmile Train staff member Caity Roarke recently visited Hospital Santo Antonio a Smile Train partner hospital in Salvador, Brazil. While there Caity was able to meet Bianca and observed the quality cleft care provided to this young patient. She shares her experience below.

Bianca Lima received her first surgery to repair her cleft lip at Hospital Santo Antonio in Salvador, Brazil, on July 10, 2013. When I met her last month, she had just turned four and was back at the hospital for a series of aftercare visits. In one day and in one building, she was cared for by a social worker, a speech therapist, an orthodontist, her surgeon and a psychologist.

Every day Hospital Santo Antonio sees patients for everything from pre-screening for surgery, to speech therapy and orthodontics. The facilities at the hospital allow for continuous and accessible after care for past patients as well as those who received surgery at another hospital. Their main waiting area is a circular ‘one-stop-shop’ where patients can see as many as eight different practitioners all in one day. This is especially important to those patients, like Bianca, who have to travel miles and miles in order to see these doctors and get the appropriate care after their cleft surgery.

The last time Bianca was at the hospital she had come for her Smile Train surgery. Before the surgery she never spoke. On the day I met her, she met with a speech therapist to come up with a plan to expand her language. Bianca then met with a psychologist to help her become more comfortable engaging with others.

While she is still a bit shy about speaking, she instantly lit up around the other children in the waiting room and spent the entire afternoon playing games and interacting with everyone around her, laughing and smiling the whole time.Bianca is just one of the many examples of how essential aftercare can be and what a profound effect it can have on children’s lives beyond one surgery.

For Wayan’s Parents, Paradise is in their Child’s Smile

Wayan Arsa Diprasta, held by his mother, Ni Nyoman Sulatri, plays with an employee of the Smile Train partner hospital where his cleft was repaired, Yayasan Senyum Bali.

Wayan, held by his mother, Ni Nyoman Sulatri, plays with an employee of the Smile Train partner hospital where his cleft was repaired, Yayasan Senyum Bali.


Tabanan, Indonesia Smile Train staff member Emily Dakin recently visited Smile Train partner hospital Yayasan Senyum Bali in Indonesia. While examining best practices in administration at partner hospitals, she had the opportunity to visit patients and their families with staff members. Upon her return from Indonesia she shared her experience.

When you hear someone talk about Bali, thoughts of a tropical paradise with pristine beaches and the greenest landscapes imaginable come to mind. Every guidebook talks about how gracious, warm and religious the people are. You can’t help but think that anyone who lived in such a heavenly place would be anything but happy. And you can’t imagine that anywhere on the island doesn’t live up to this ideal.

Wayan's street is home to a community of 35 people who all share one, outdoor toliet.

Wayan’s street is home to a community of 35 people who all share one, outdoor toliet.

Over an hour away from luxury hotels and major tourist areas, I met one-year-old Wayan Arsa Diprasta and his family. After driving across narrow bridges, hairpin turns, and uneven roads, we finally reached his small compound within the town of Tabanan called Desa Marga Dajan Puri. In order to reach Desa I walked up a steep, dusty, dirt hill to reach a small road with about 10 modest homes built around a small shrine. Each house had just two rooms and very limited electricity. There was one outdoor toilet and faucet for the 35 residents of the compound. Their small space shared with the ducks, chickens, and emaciated dogs that freely wander around. This was not the tropical paradise that everyone envisions.

I was greeted by a small group of villagers, including Wayan’s parents, his father, Wayan Suarsa, a non-permanent day laborer, and, his mother, Ni Nyoman Sulatri, a housewife. We were immediately surprised by their happy and friendly disposition. It was such a sharp contrast to the surroundings. They insisted that we take the iced tea and boiled tubers (potato-like food) that they offered us as they told us the story of their son.

Wayan and his father, Wayan Suarsa

Wayan and his father, Wayan Suarsa.

They were surprised when Wayan was born with a cleft lip and palate as no one in their family had been born with the condition before. As paying for surgery was out of the question, the family was thrilled to learn about the free treatment that their son could get through Yayasan Senyum Bali. However, since the foundation was over an hour away, Wayan’s family had to borrow a motorcycle to get to the market in town. And from there, they had to take a van to the main terminal, and then three minibuses to get to the hospital in Denpasar. But they didn’t complain. They were so grateful that their son could receive treatment – that was all that mattered to them.

I’ve never seen a baby as happy as Wayan. He was thrilled to interact with so many people and wasn’t afraid to reach out to be held by us… or to grab our sunglasses! He couldn’t stop giggling despite the hot, dusty air. And I’ll never forget how gracious and welcoming his family was. It made me realize why the Balinese people are so spiritual and devoted. It’s not just because of their amazing island, it’s because they are grateful for every gift that they are given, no matter what other struggles they have to endure.

A cleft surgery does more than save a child’s life. A cleft surgery gives them the opportunity to smile no matter what difficulties they’ll have to face in their lives. Wayan and his family have witnessed a miracle and now all of them will be smiling and laughing no matter what life brings them.