A True Journey of Smiles

Bosawas Jungle, Nicaragua—It’s not every day a man is willing to travel almost 175 hours, by air, land, and water, to make sure a patient receives cleft care, but that is exactly what Smile Train friend, Martin, did.

While on a short-term assignment in the Bosawas Jungle in Nicaragua, Martin Rojas met a nine-month-old with a cleft lip and palate, Queben Spelman. Because the little boy was from so deep inside the jungle, there was no knowledge of cleft, let alone treatment. Even if there had been, Queben’s mother, Bertalina, could not afford the surgery. There was no hope for Queben, until Martin came along.

After meeting Queben, Martin vowed to return to collect the infant and his mother so that Queben’s cleft could be repaired and five months later Martin fulfilled his promise.

“Having traveled all over the world and seeing dying children due to malnutrition, especially exacerbated by a cleft lip and palate and the subsistence, survival of the fittest, jungle living in which Queben lived, my biggest concern was that he would not be alive when I returned,” Martin said.

Martin’s journey started in Dallas, Texas. From there he landed in Managua, Nicaragua, drove about 12 hours (400 km) past where the road ended until driving became impossible. Then, Martin made a 23-hour journey via dugout canoe through three different rivers, spanning 200 km, to reach Queben and his mother in the heart of the jungle.

There was little rest upon arrival as Martin wanted to get Queben to the hospital as soon as possible as the little boy was suffering from malnutrition, due to his cleft, and was very ill.

“At 10 pounds and 12 ounces fully clothed and 24.4 inches long at 15 months old and not able to stand on his own. He was in awful shape, but alive!” Martin said.

With Queben and Bertalina this time in tow, Martin made his way out of the jungle and to the nearest Smile Train hospital in Leon, Nicaragua, which was just as grueling a journey.

Once at the hospital Queben was treated for malnutrition. He was there for about a month and half before he was healthy enough for surgery. During this time Bertalina proved herself to be a brave woman having never been out of the jungle or around any electrical appliances, cars, or elevators. The Smile Train team had to show Bertalina what a light switch was used for and how to use a faucet for she had never had electricity or running water.

After proper nourishment, Queben was able to receive his cleft lip and palate surgery. Once Queben recovered from surgery, Martin returned from Texas to bring the family back to their village in the jungle. Although a huge sacrifice, Martin was repaid by the happiness of Bertalina.

“Words can not express the immeasurable joy and peace written on the mother’s face. Her smile could not be contained for the joy in her heart at seeing her sickly son, on the verge of death, being brought back to life and given a second chance,” Martin wrote after returning from Nicaragua.


A Long Awaited Smile

Blog post 7.10.2014

Multan, Pakistan—Imagine providing for a family of three living on under seven dollars a day. Unfortunately, this is reality for young Muhammad Zaeem and his family. Muhammad is an only child living with his mother and father in a ‘kachi abadi’ in Pakistan. A ‘kachi abadi’ is an urban settlement in which impoverished people come together to create a makeshift community in order to support each other. Many of the people in these communities cannot read and do not have an adequate supply of resources.

Where Muhammad lives, superstition prevails over science. It is believed that children with a cleft lip are the result of carelessness on the mother’s behalf who, during pregnancy, cut something with a sharp edged knife during an eclipse. While a solution to Muhammad’s cleft was uncertain, his father became hopeful when he saw a Smile Train advertisement on the Bakhtawar Amin Hospital’s billboard.

Muhammad’s parents brought him to see Dr. Amir Hanif at the Bakhtawar Amin Hospital in September 2013. On his first visit Muhammad’s weight and hemoglobin levels were too low to undergo surgery. Dr. Hanif decided to wait four months so Muhammad could become stronger and properly nourished. Muhammad and his parents returned to the hospital in February 2014 and left three days later with Muhammad’s new smile.

The team from the Bakhtawar Amin Hospital visited Muhammad and his family two months later to find great news. Muhammad was living a normal, happy life and was accepted within his community. The family was cheerful and looking forward to the future.

Thankyou Smile Train

Cleft Surgery’s Role in Nutrition

Three-month-old Alham (left) shortly before her Smile Train surgery and five-month-old Alham two months after. Alham's story highlights the need for cleft surgery in order to obtain proper nutrition.

Three-month-old Alham (left) shortly before her Smile Train surgery and five-month-old Alham two months after. Alham’s story highlights the need for cleft surgery in order to obtain proper nutrition.

Tanga, TanzaniaIn honor of National Nutrition Month, Smile Train shares a story from Tanzania highlighting the role that timely cleft surgery plays in preventing malnutrition.

When Ahlam was born in rural Tanzania with a cleft lip and palate, her mother Salha, like so many mothers of Smile Train patients, did not know about the common birth defect. Salha’s first two children had been born without incident and perfectly healthy.

Salha and her five-month-old daughter Ahlam pose three months after Ahlam's cleft surgery. Ahlam's health and appearance have vastly improved thanks to her cleft surgery that has allowed her to eat properly.

Salha and her five-month-old daughter Ahlam pose three months after Ahlam’s cleft surgery. Ahlam’s health and appearance have vastly improved thanks to her cleft surgery that has allowed her to eat properly.

Luckily, shortly after Ahlam’s birth, the family was told about Smile Train and that the organization provided free care for thousands of children like Ahlam. The newborn girl would have to wait until she was three months old for surgery though.

During that time life for Salha was difficult. She had no problem feeding her other children, but Ahlam was different because of her cleft. Milk came out of Ahlam’s mouth and nose because she could not suck like a normal infant. With a large gap in her lip and at the roof of her mouth, feeding Ahlam was almost impossible.

Although surgery was a short time away, Salha worried her daughter would not make it. She was not steadily gaining weight and was becoming sick. Despite this, Ahlam’s surgery day came and weighed just enough to go through with surgery.Now at five months old, only two months after her cleft lip surgery, Ahlam’s appearance and health bear no resemblance to the baby girl who entered the hospital for cleft surgery. Not only does she have a new smile, but she has the chubby cheeks of other children her age. The difference is remarkable.

In four months Ahlam will undergo another surgery to correct her cleft palate, which should help her nutrition further as food can still escape through the roof of her mouth. Salha is also looking forward to her daughter’s next surgery and feels this will improve her health even more.

Salha is very grateful for the Smile Train surgery and is happy that her child will have a normal and healthy life.


To help mothers like Salha, Smile Train developed the following resource video demonstrating the best feeding methods for a child with cleft.