Welcome Home Zachary: An Adoption Story

Zach dolphin

Allison, mother of Zachary, a Smile Train cleft patient, tells us in her own words how much his surgery has impacted both of their lives.

This month, Zachary is turning FIVE! As it was certainly a miracle for him to make it to five days, much less five weeks, this is a momentous occasion.

Zachary is from the foothills of the Amhara highlands and was born in Addis Ababa, Ethiopia. As with so many children born with clefts around the world, his family’s reaction was to consider him as part of a curse, particularly as his was a severe, bilateral cleft lip and palate. Between such cultural views, a lack of medical care, and wide-scale poverty in Ethiopia, it is estimated that over 90% of babies with cleft lip and palate in that country do not survive.

Luckily, after a rough first week of life, some neighbors told Zachary’s birth mother about a non-profit hospital across the city that could help kids like him. Soon after, he was enrolled with Smile Train. The hospital cleft program set him up with squeeze-bottles for feeding, and with a formula program, so he could catch up on some much-needed nutrition. These measures saved his life.

While every effort is made to keep cleft children with their families, in Zachary’s case that was not an option. I had been living in Addis Ababa for several years, and was teaching at the American school there, when I first heard about Zachary. His doctors knew that I had completed a local adoption the previous year, and I was asked to share some information on the process.  Long story short, after all other doors closed, I happily agreed to adopt him. I brought him home just after his first lip repair surgery, and stayed with him in the Ethiopian hospital for his next two surgeries, as well.Tekola 13_5_10 #2

Now, Zachary is a happy, healthy, creative, energetic, and curious five-year-old. He and his older brother are the best of friends, and together we have all had some great adventures. He loves to hike, swim, sing, and entertain those around him…..he definitely makes full use of his great smile!

We have spent the past two years on the Caribbean island of Sint Maarten, where I am attending medical school. I am looking forward to being able to help kids like Zachary in the future.

As we celebrate Zachary this month, truly a “one in a million” kind of kid, we are grateful for Smile Train and all of those who have made his health and surgeries possible. As we say in Ethiopia, “Betam Amesegenalehu!”

From the hospital where Zachary received his Smile Train surgery;

“CURE International’s partnership with Smile Train has allowed CURE hospitals to have an even greater impact on children in the countries we serve. In Ethiopia alone, we have performed over 1,100 cleft surgeries, restoring the smiles of children and families that were once considered outcasts in their own families and communities. Stories of restoration and healing, like Zachary’s, drive home the need to make our organizations’ mutual focus on surgery a global health priority.”


Gamby Hospital Cleft Week April 24-30, 2013

Smile Train Patient Tesfaye Manaye before her free cleft surgery

Smile Train Patient Tesfaye Manaye before her free cleft surgery

Bahar Dar, EthiopiaSmile Train’s Program Manager of East Africa, Dr. Esther Njoroge, reports from the field.

Meeting with Smile Train cleft patients and their parents

Meeting with cleft patients and their parents

I always enjoy visiting Ethiopia and for selfish reasons, it’s the only time I can claim to be eight years younger and technically I would not be lying. The reason is they follow the Orthodox calendar, and therefore today is 17/8/2005, brilliant, no?

Today, I got to spend my time not boasting of my young age, but with a special group of people, cleft lip and palate patients from the Amhara region and beyond. It was the second day of a cleft week at Gamby Hospital, Bahar Dar. A week when the hospital dedicates its operating rooms for cleft surgery. The week is preceded by a month of intense awareness creation and mobilization. By today morning, 40 patients (and their parents or guardians) had gathered at the hospital, and we expect more as the week wears on. When the surgeons and I walked in, we were greeted by a multitude of eager, hopeful faces. They had traveled long distances; some had walked for two days to get to the point of public transport.

Smile Train patients and families await free cleft surgery

Smile Train patients and families

And so I spent the day talking to them and listening to their varied stories as well as sharing in their hopes and dreams. The best part about a day like today, is knowing deep down that we have changed people’s lives, possibly altered their destiny.


Meet Adenew, a shy 15 year old boy who is in 7th grade. He comes from Eastern Belessa, some 240km or so from Bahar Dar. He enjoys playing football and volleyball with his friends, and he dreams of being a private investor one day. A good choice of career, I tell him, private business is booming in Ethiopia right now and possibly in the foreseeable future. I ask him why he wants his cleft repaired, why he has travelled so far. “Though am not stigmatized because of my cleft, I feel bad living with a cleft, and I want to be like normal people” he replies and goes back to staring at the same spot on the floor. This is a survival mechanism for him, I realize, for as long as he is looking at that spot, one cannot immediately tell he has a cleft! Adenew finally gets his turn at the close of the day, and the smile on his face and eyes after I showed him his ‘after surgery’ photo spoke volumes!

Smile Train Patient Adenew before and after his free cleft lip surgery

Tesfaye Manaye after her free cleft surgery

Tesfaye Manaye after her free cleft surgery 🙂

Tesfaye Manay

The young lady at the beginning of this blog is Tesfaye Manaye, who is my daughter’s age, three going on sixteen. She is the most adorable kid you can imagine and she had the cutest shoes. A last born in a family of three, she is the only one with a cleft in her entire family. Her mother traveled more than 280km, to give her a chance at a life without ridicule. Am sure that’s just what they received today, and after Tesfaye wakes up, the swelling goes down and the healing takes place, the smile on her beautiful face will be precious to see.

Siraw Mengest

And the triple bounty went to Mr. Siraw Mengest from Lalibela. At 59 years of age, he has lived with a cleft lip all his life. And what is worse, his two grandchildren, Mamite, 10 and Tekeba, 12 were born with a cleft as well. Today, a journey of two days on foot and 200km by bus coupled with all his hope and faith will bear fruit. Their clefts will be repaired, their lives changed forever, just by a smile.

Siraw Mengest  and his grandchildren before Smile Train surgery

Thank you Smile Train, on behalf of all these people for providing the fuel that keeps this train moving.

Three Days Later, Atiku’s Father Can’t Help But Smile

Atiku's father has a new smile too after his daughter's free cleft lip surgery from Smile Train

Addis Ababa, Ethiopia — Atiku, a five-year-old girl from Ethiopia has lived with her cleft, and the suffering it caused, all of her short life. Her mother abandoned the family because of her cleft. Born 600km from Addis Ababa (Ethiopia’s most populous city and capital), Atiku and her father traveled for two days to reach Smile Train partner hospital, Addis Hiwot Hospital. Her father, who has five other children, could not hide his joy as he held her after surgery. After her free cleft surgery, Atiku was changed for life and her father knew it, saying, “Atiku will one day be a teacher to change the community.”

His laugh was hearty as he recited how it has been difficult for him living with Atiku because of her cleft lip. It had been “hell on earth” he said, but now his wife might return after Atikus’ operation.

Better Late Than Never!

Contrary to popular belief, Smile Train helps cleft patients of all ages. We are often asked by partners if we have an age limit for surgery, and the answer is no: we will help any person with a cleft, regardless of their age or their ability to pay. In parts of the world where clefts are often left untreated, we often hear about elderly cleft patients. What could be more bittersweet than the story of 75 year-old man receiving cleft lip surgery? The joy of finally getting treatment mingles with the anguish of 75 tough years with a facial deformity and a new awareness of the simplicity of the surgery.

Here are the stories of some older Smile Train patients from Ethio-Tebib Hospital in Ethiopia:

Haji, 75, has five children and his second also has a cleft lip. He said he stayed all these years suffering from the stigma of his cleft condition because of lack of access and financial support to the treatment. Today he has been operated on and he is happy and grateful.

Abdu, 58, said he got cleft lip because his mother laughed at a cleft lip person while she was pregnant. He also said that the wife of his own uncle laughed at him seeing that he had cleft lip and herself gave birth to a cleft child who died at the age of two years.

His cleft was repaired, and he was also given counseling and advice on cleft lip condition so that he can also pass this information to his family and to the community.

Nuri, 50, is a old poor farmer and had cleft lip in addition to a dental condition. He got dental care and advice and his cleft was repaired and he said now he will return back to his family and community being a happy man.

A Smile in Ethiopia – Kayo

From partner surgeon, Dr. Erik Erichsen from Aira Hospital, Ethiopia

Stigmatization by a family or community because of cleft lip and palate is a common occurrence in many countries. Ethiopia is no different, and it is a huge advantage for a patient to undergo surgery at an early age. But with 78% of Ethiopians living on less than $2 a day, access to basic medical care is difficult for many patients and their families.

Two-month-old Kayo was born with a cleft lip and palate, causing his mother to neglect him. However, Kayo recently underwent cleft lip repair, performed by Smile Train partner Dr. Erik Erichsen at Aira Hospital in Addis Ababa, Ethiopia. Thanks to Dr. Erichsen, Kayo’s appearance has now changed dramatically. Kayo will return in ten months to have his cleft palate repaired.