Drawing Smiles

Anas with an Operation Smile medical volunteer. Photo courtesy of Anas.

Anas grew up believing that the scar on his lip was the result of a fall he’d had as a child – after 14 years, he learned the truth.

When their son was born with a unilateral cleft lip, Anas’ parents were scared and shocked. Neither had ever seen anyone with a cleft before.

Hoping to repair their son’s cleft condition, Anas’ parents took him to a clinic (unaffiliated with Operation Smile) where he received his first operation at 2 months old.

Sadly, the results of the surgery didn’t heal properly, and Anas was left with bad scars and unevenness in his lips.

Fearing that Anas would think his cleft condition was a consequence of God punishing him, Anas’ parents told him that his scars were the result of him falling from the stairs as a child.

So as he grew up, Anas never knew that there were more people just like him, living every day with an untreated cleft condition.

Anas’ parents loved their son. And in their minds, protecting Anas meant sheltering him from the truth.

But even in their efforts to help Anas live the best life possible, his parents couldn’t stop him from enduring years of harmful bullying.

When children at school noticed his scars, Anas would say that he’d cut himself shaving in an attempt to lessen the pain he felt. And when the hurtful comments and ridicule continued, Anas’ response to the cruel treatment would be to make a joke, hoping that laughing with his peers would make the bullying stop.

No matter how hurtful the abuse became, Anas persevered and refused to let it faze him or prevent him from living the life that he wanted.

Anas later admitted that the bullying he endured helped build his character and mould him into the person he is today – someone with the strength and desire to help others.

Anas with long-time Operation Smile Morocco volunteer paediatrician Dr. Najib Jilali in 2013. Photo courtesy of Anas.

It wasn’t until Anas was 14 years old that he learned that his father had been secretly researching medical options.

During his pursuit of finding a solution for his son, Anas’ father discovered Operation Smile Morocco and learned about the safe, life-changing surgeries it provides patients living with cleft conditions.

After hearing about the organisation’s upcoming medical mission, Anas’ father decided that it was finally time to tell his son the truth.

It was in that moment that Anas first learned about his cleft condition.

While travelling to the medical mission with his father, Anas didn’t know what to expect. He understood that the damage from his previous surgery could be repaired at the mission. But what Anas didn’t anticipate was the scene he would witness once he got there.

Hundreds of people just like him had travelled from across the country, carrying with them the hope of receiving surgery from Operation Smile Morocco.

At the mission, Anas felt an immediate connection with many of the patients. But it saddened him to see them hiding their faces and looking down in embarrassment because of their cleft lips.

Determined to make an impact, Anas formed a community by bringing together both Operation Smile Morocco patients and volunteers.

After passing his comprehensive health evaluation and receiving surgery to repair his cleft lip, Anas became inspired to achieve even more for the organisation.

Anas today. Photo: Ambra Marengo.
Anas today. Photo: Ambra Marengo.

Since his final surgery in 2013, Anas has earned a degree in psychology and volunteered with many organisations, working especially with orphans and children with autism.

Today, he interns at a hospital in addition to working toward becoming a credentialed child life specialist for Operation Smile Morocco.

Putting his psychology studies into practice, Anas touches the lives of patients and their families by helping calm worried parents after their child enters the operating room.

He tells them, “Look at me. I was your son!”

Once they see that Anas’ surgery was successful, anxious parents often immediately relax and try to learn more about his own journey to healing.

Anas says that being on both sides of the mission experience makes him feel like the bridge between the volunteers and patients.

After receiving surgery from Operation Smile Morocco, Anas gained so much more than a new smile.

“Here in Morocco, Operation Smile has a real community who gives a real hope to others. It gives the gift of a new beginning. We all share our humanity, languages, experiences with one another and become like a family.

“For patients, it’s a new beginning. We are giving them confidence and new hope. It is a priceless gift. This is really life changing; it has been for me, and it is for all of Operation Smile’s patients. It’s amazing to have such an organisation in my country. I am happy that, for my part, with the power of words, I can also draw smiles.”

Anas poses for a photo with a young patient during an Operation Smile Morocco mission. Photo courtesy of Anas.

Meet Our Patients: Madaba, Jordan

Meet Rana

Photo: Rae Ceretto.
Photo: Rae Ceretto.

More than six years ago, Leena and her husband travelled for four days to Jordan, leaving her home and family behind in Syria for a chance at a better life.

Leena said that she had no choice but to abandon everything in order to survive the violence and conflict in her own backyard.

“My home was destroyed because of the war. I had nothing left,” she said.

After four days of travel, she reached a United Nations refugee camp and was provided a one-room tent for shelter.

Today, that tent is home to her three young daughters, her husband, his second wife and their five children. All 11 of them live together.

For the last six years, Leena and her children have lived like this. Her eldest daughter, Rana, is 4 years old, so the tent is the only home that her daughters have ever known.

“I cannot afford to rent a house. I work on a farm with my husband in the fields. I work all day long, and I only earn five dinar a day,” Leena said. “I miss my daughters greatly. I don’t get to spend time with them. This makes my life very hard.”

The family often faces many hardships.

“Every time it rains, the tent falls down, everything is washed away,” she said.

For Leena, living in the tent makes raising her daughters difficult and accomplishing daily tasks a challenge. Sadly, when Rana was 1 year old, life became even harder after a tragic cooking accident.

Rana was playing close by as her mother was cooking potatoes with hot oil for dinner. When Leena turned to check on her, her daughter was no longer in sight.

In a panic, Leena turned back around, but it was too late. In a matter of seconds, her daughter had fallen into the hot oil and burned her arm.

“When I picked her up and I saw that her flesh had melted off of her arm, I was so in shock,” Leena said. “I blamed myself. Other people also blamed me and often asked, ‘why did you let this happen to her?’

“I wish I had two tents, one for cooking and one for living. I can’t help but think this would have never happened if I was back home in Syria.”

Today, 4-year-old Rana still hasn’t received the reconstructive plastic surgery that she needs. She’s grown up covering her arm with long sleeves and hiding her hand behind her back to keep it from being seen.

Other children, including her own brothers and sisters, often tease her because she is different, because of her scars. She hasn’t been able to make many friends.

“She is such a shy girl. In the summer, she wants to wear T-shirts and dresses like the other children, but she is scared,” Leena said. “She always asks me to cover her arm. I want her to get surgery so she can wear a dress, be confident and be happy. All I want is for Rana to be happy.”

Leena knew that she would never be able to afford surgery for Rana, but she did not give up hope. She had faith that it would all work out.

Then one day, she read online about Operation Smile Jordan and learned how it provides free surgery for children in need of reconstructive surgery for cleft conditions and burn-related injuries.

After connecting with the medical team, Leena was told to come to Operation Smile’s screening site in Madaba.

Her hope of getting Rana the care she needed continued to grow.

In Jordan, Operation Smile has expanded the surgical programmes it provides in order to address the needs of the local community. Many individuals in this area suffer from cooking-, accident- and conflict-related burns just like Rana.

The goal of burn-related reconstructive surgery is to improve the cosmetic appearance of scars and increase the function and range of motion that may have been limited due to the damaged skin.

Around the world, Operation Smile strives to use the expertise of its volunteer medical teams in treating cleft to create solutions that deliver safe surgery where it’s needed most.

As of March 2019, the United Nations reports that 670,238 individuals have registered as refugees from Syria. Leena and her family are just a few of the Syrian refugees who are currently seeking asylum in Jordan. Many of them do not have access to surgical care.

In the countries where its medical teams work, Operation Smile is able to customise the safe surgical care it provides based on the local need.

In addition to providing cleft care, Operation Smile Jordan provides surgical burn care to children who need it.

As long as there are children like Rana in need, Operation Smile will continue working to make sure safe and essential surgical care is available because the organisation believes that access to surgery is a basic human right.

“I speak to my family in Syria almost daily, I miss them. They’re doing fine, and it’s more safe now, but I cannot go back because I left the country,” Leena said. “It is my only hope that I will see my family again. To go back home in Syria and to give my daughters a normal life.”

Meet Mirna

Mirna with her father, Zeyad. Photo: Laura Gonzalez.

Regardless of where 6-month-old Mirna needed to be during Operation Smile Jordan’s mission, her father, Zeyad, was always close by.

Zeyad and his wife, Tasneem, arrived at the screening site with hopes that their baby girl would receive safe surgery and be given the chance to live the life they knew she deserved.

Throughout the family’s time at the mission, Zeyad couldn’t contain his love for his daughter and was often seen bouncing Mirna on his knee and giving her many kisses.

Before the day of her five-month ultrasound, Tasneem had never known that a child could be born with a cleft condition. But after the doctor told her about her daughter’s cleft lip, she began to worry about Mirna’s future and how her cleft condition might cause her to face additional health issues throughout her life.

“When I learned how she would be born, I was in shock,” Tasneem said.

She returned home to her husband later that day in a panic but couldn’t find the words to tell Zeyad what the doctor had said.

“All she could do was pace around the house touching her lip,” Zeyad recalled.

Unlike his wife, Zeyad was not concerned when he finally heard the news about his daughter.

He immediately got to work on talking to different doctors and researching online information to learn more about cleft conditions and what potential treatments existed.

The doctor who delivered Mirna informed them that surgery would cost more than $10,000 – a cost that they would never have been able to afford.

When asked how they learned about Operation Smile, Tasneem replied with one word: “Facebook.”

After reaching out online to Operation Smile, Tasneem and Zeyad were given the information they needed by the local team to take the one-hour taxi ride to reach the screening site.

Unfortunately, after receiving her comprehensive health evaluation, Mirna revealed to be too underweight to receive safe surgery.

When Zeyad heard the news, his confident and happy demeanour changed to genuine concern, and he started fumbling with his daughter’s medical papers.

Tasneem told the medical team that the thing she was looking forward to for Mirna most of all was, “that she would be normal, that she would be beautiful.”

Members of the local medical team reassured the anxious parents that all hope was not lost. They explained that Mirna could still receive surgery once she gained a little weight.

A reason why Operation Smile returns to countries like Jordan is because patients like Mirna are still waiting for their chance at a brighter future.

Meet Amar

Photo: Rae Ceretto.
Photo: Rae Ceretto.

A seemingly normal day quickly turned into one that Amar would be forced to remember for the rest of her life.

When Amar was 6 years old, she was playing in the garden with her friends in their village just outside of Damascus, the capital of Syria.

Suddenly, the entire street where she grew up was destroyed by fire and shrapnel when a car that was parked near the garden exploded.

Amar was hit by the blast and severely burned by the fire. Now, she lives with a scar covering the right side of her face – a scar that serves as a reminder of the life she left behind in Syria.

“I had no time to think and process what happened, I just reacted,” Amar’s father, Mhammad, said. “I needed to get my family away from the danger. There was no time to waste if we wanted to survive the war.”

Two months later, they relocated to Jordan.

Today, Amar is 12 years old and lives with her family in the capital Amman. Since the explosion, she has received burn care from another medical organisation that successfully made the scar on her face slightly smaller. Her father hopes that one day the scar will go away completely.

“I hope the scar will grow smaller and smaller so she can forget what happened to her,” Mhammad said.

Amar is teased heavily by other children in her school because of the burn on her face.

“I don’t remember the explosion, but I’m always teased, and it bothers me a lot. I’m trying my best to cope with it,” Amar said.

Despite the teasing, Amar excels in school. She is in sixth grade, and her favourite subjects are English, Arabic and science. Her voice is soft and kind, and she beautifully blended English and Arabic as she shared her story.

“After school, I want to be a lawyer because I want to help children who went through the same things that I did. I sympathise with them so much,” she said.

Amar is incredibly inspiring. Her positivity and compassion for others shines through her beautiful brown eyes and her warm smile. She enjoys her life outside of school by running and drawing things like animals, people and nature.

“I want to continue my studies and build a new future for myself here. I want to leave what happened to me behind,” Amar said.

Meet Nebras

Photo: Rae Ceretto.
Photo: Rae Ceretto.

Nebras’ mother, Hanaan, remembers the accident.

“I was doing chores around the house. I put water on to boil in a kettle, and I forgot that I left it on,” Hanaan said. “Nebras was playing and accidentally pulled the kettle down, spilling the water.”

The scolding hot water left her with significant scarring on her face, chest, entire right arm and hand. Nebras was 1 year old when the incident happened, and the severity of the burns have required Nebras to receive emergency medical care and expensive, ongoing treatments ever since.

Today, Nebras is 15 years old.

She has received treatment from Operation Smile three times in the past. And during a recent medical mission in Madaba, Jordan, Nebras came again in search of additional care.

“I don’t remember any pain from my injury or any of my previous surgeries because I was so young. But I’m nervous to see the doctor today,” Nebras said. “I know I’ve seen lots of doctors before. I don’t know why I feel this way. It’s just something inside of me.”

Nebras travelled to the mission site seeking a treatment to help ease the pain in her hand caused by the burn.

“It hurts me when I write too much,” she said.

Writing is important to Nebras. She’s an extremely intelligent girl and a model high school student whose favourite subjects are science and maths. When she grows up, she wants to be a doctor.

“It’s a dream of mine. I like working to achieve challenging things,” she said.

Even though she enjoys school, Nebras still faces hurtful treatment from a few of her classmates. She says that they are rude to her because of the way she looks.

They know that she was burned many years ago, but they still ask, “Why does your face look like that?” with hopes that she will react.

“I try not to react, but it depends on my mood. If I’m happy, I explain the accident to them. If I’m sad, I ignore them, but it affects me a lot more.”

Thanks to Nebras’ caring friends, her attempts to disregard the bullies painful comments are made a little easier. She says that she feels lucky to have an amazing group of friends who support her.

“I have many friends. We’re very close to each other, we do everything together. They’re like my soul sisters,” she said.

Hanaan was asked why she chose Operation Smile to care for her daughter’s burns. Her answer was beautiful.

“I have trust in Operation Smile, that’s why I chose to come here. I want the best for my daughter. I know she will make an impact on society. I want her to be someone who empowers and inspires others, like a world leader or a president.”

From Hurt to Healing: Efren’s Emotional Change

Editor’s Note: The Philippines holds a special place in the history – and future – of our organisation. It was there that Dr. Bill Magee, a plastic surgeon, and his wife Kathy, a nurse and clinical social worker, became inspired to create Operation Smile after witnessing first-hand the dire need for life-changing cleft surgeries while working an independent volunteer medical mission in 1982. Unable to provide surgery for so many children due to lack of resources, the Magees promised to return. We’ve been going back ever since. As we work into our 35th year, we’re highlighting the birthplace of Operation Smile with this four-story series. This is the second story.

At 9 years old, Efren’s schoolmates were his worst enemies. He lashed out against his bullies, who constantly targeted him with insults because of his cleft lip and cleft palate. He came home in tears almost daily, his father, Efren Sr., recalled.

After receiving life-changing surgery from Operation Smile in the Philippines, Efren now carries himself with a sense of dignity and his outlook on life has been fundamentally changed – he’s happier, more confident and now looks forward to going to school.

“Those who have bullied him have now become his friends,” Efren Sr. said. “When he goes to school now, he is never in a fight. Now, the other children are happy for his sake.”

Photo: Jörgen Hildebrandt.

In the years leading up to Operation Smile’s intervention, Efren and his family lived with so much hurt in their hearts. When he was born, Efren’s mother, Juditte, was stricken with overwhelming sadness when she saw first saw her baby’s deformity. Juditte struggled to understand how her baby could be born this way. She thought it could be related to a fall she took when she was nine months pregnant with Efren, or it was a result of Efren sucking his thumb as he developed in the womb.

“We didn’t have any relatives with cleft, so we wondered why this happened to us,” Juditte said. “We felt so sad about his situation, and I have cried a lot.”

Scientists do not believe that either possibility Juditte pondered causes cleft conditions. In an effort to understand all known causes of cleft, both genetic and environmental, Operation Smile and its partners are leading the International Family Study, which seeks to translate medical research findings into preventative measures to help families like Efren’s in the future.

When Efren was 6 years old, the family was hopeful that he could receive surgery at a medical mission led by another non-profit organization. During screening, the medical staff discovered that Efren had an irregular heartbeat and believed that surgery would be too risky to perform.

Living in extreme poverty severely limited the family’s options for a future surgical solution. It would be three years before the Philippines-based non-profit Abounding In Love would connect Efren’s family with Operation Smile in June 2014. During that time, the family’s home was destroyed by Typhoon Yolanda in 2013. A tent provided by the United Nations Refugee Agency served as temporary housing for the family as they waited for their new home to be built.

With Abounding In Love covering their transportation costs, Juditte’s sister and Efren arrived at the Operation Smile medical mission site in Cebu for another chance to heal Efren’s smile. His parents had to stay home on Bantayan Island as Juditte had to care for their six other children and Efren Sr. could not afford to miss work.

A comprehensive health evaluation performed by Operation Smile medical volunteers found that the irregularity of his heartbeat was so minor that surgery posed no threat to Efren. Finally, he was cleared for surgery to repair his cleft lip.

After Efren’s successful procedure was complete, his aunt could breathe a sigh of relief. She looked forward to also relieving Efren’s parents’ anxiety by returning to Bantayan Island with Efren and his new smile.

Photo: Jörgen Hildebrandt.

“I am so happy now – I can’t express in words how happy I am. It hurt so much every time I saw him come back from school crying before,” said Efren Sr., whose son’s speech abilities dramatically improved in the months following his cleft lip surgery.

Without the help of Operation Smile, Efren’s parents would not have been able to afford surgery for their son. Efren’s father is a fisherman and struggles to make enough to feed his family of nine. The older children work with their father, instead of going to school, to help supplement the family income. However, Efren Sr. envisions a brighter future for his son.

“I am hoping Efren will continue school up to a high level and go to college – I would like him to become a teacher,” Efren Sr. said. “He has big dreams, but couldn’t do it without surgery – without Operation Smile.”

Photo: Jörgen Hildebrandt.

“A Pillar of my Life”

Ángel and his daughter, Karla, waited anxiously.

At an Operation Smile medical mission in Puebla, Mexico, screening day had already been long and exhausting before a medical volunteer would announce which patients had been put on the surgical schedule.

Questions were asked about Karla’s history with her cleft lip and palate, photos were taken for health records and medical volunteers conducted a comprehensive health evaluation to determine if she was healthy enough for safe surgery.

But for Karla and her father, their anticipation would soon become elation.

“When they called her name, I didn’t know whether to cry, laugh or sing,” Ángel said with tears in his eyes, as he reminisced on that special day.

Karla, age 2. Photo: Jasmin Shah.

More than two years before travelling to the mission, Ángel and his wife, Julieta, were thrilled to be three months into the pregnancy of Karla, their fifth child. But their excitement soon turned to heartbreak when an ultrasound showed that their baby would be born with a cleft condition.

“We felt badly,” Ángel said. “Pain, anger. That’s how I felt.”

But the pain he felt couldn’t compare to the love he felt for his daughter. Even when his neighbours blamed him for Karla’s condition, Ángel never stopped loving and fighting for her.

“My daughter Karla is a pillar of my life and the reason I value life,” he said.

Her cleft lip and palate caused eating to be difficult. For the first year of her life, Karla had to be fed with a syringe.

Ángel searched for a hospital or organisation that would provide affordable surgical care for his daughter, and for months, he was met with disappointment.

Feeling strained but determined, he continued his search until he found a local organisation that not only connected him with Operation Smile Mexico, but also provided him transportation to the medical mission.

After years of feeling helpless, hope finally returned to Ángel.

After the numerous obstacles Karla and her father faced together, Karla’s chance at a brighter future had arrived.

Karla enjoys singing and playing with local volunteers in the child life area. Through play, these young patients are able to remain calm and happy in this new, and often stressful, hospital environment. Photo: Jasmin Shah.
When it's Karla’s turn for surgery, her surgeon, Dr. Blas Dominguez of Mexico, and clinical coordinator Rosy Frias take Karla to the operating room. Photo: Jasmin Shah.

As he watched his daughter walk toward the operating room, Ángel became anxious but had faith in the Operation Smile medical team.

After his daughter’s cleft lip surgery, Ángel could not look away from his daughter’s new smile.

“The feelings I had when I saw her, with the surgery done, I cried inside. I was happy,”  he said. “I will make it my life’s mission to find and help families with clefts.”

Karla sees her new smile for the first time. Photo: Jasmin Shah.

And today, Ángel is doing just that.

At the most recent Oaxaca mission, he volunteered as a patient advocate, comforting nervous parents and letting them know what to expect just as someone did for his family two years before.

Double the Smiles

Manus, left, and Wanna hold their twin sons, Ou and Lak, centre, as they await their comprehensive health evaluations during an Operation Smile medical mission in Thailand. Photo: Peter Stuckings.

Thailand’s beauty is not only seen woven within its towering forests and cascading waterfalls, but also in the smiles of its people.  

In Thai culture, a smile can convey more than just happiness or pride. It can also express an apology or exhibit sorrow with the idea that obstacles in life are more easily overcome if confronted with a smile. Because of this belief, Thailand is aptly nicknamed “The Land of Smiles.”

And in rural north-eastern region of the country, Wanna and her husband, Manus, work hard to provide the best possible lives for each other and their three children.

Yet, the challenges the family faces every day couldn’t prepare them for the news that they received four months into Wanna’s second pregnancy with their twin sons, Lak and Ou.

An ultrasound revealed that Ou had a cleft lip and palate.

While Wanna was devastated by the news, Manus felt enormous guilt and believed that he was the sole cause of his son’s condition. He attributed it to bad karma because each time that he fished, he would tear the hook from the fish’s mouth, leaving an open gash in its lip.

His feeling of blame only intensified after the delivery of the other twin, Lak, who was born with a cleft lip and palate that wasn’t detected by the ultrasound.

Ou, left, and Lak. Photo: Peter Stuckings.

After the twins’ births, a doctor informed Wanna and Manus that surgery was possible – a huge relief because their cleft conditions caused Lak to struggle when drinking milk and Ou to choke when being fed.

While they were grateful that surgery was an option, the family couldn’t afford the cost.

While Wanna cares for the children at home, Manus farms rice and cassava on the nine acres of land that he leases. At the most, he makes a low and inconsistent income of around £1,200 a year. Half of this total is then paid to the land owner.

But the young parents were determined that both of their sons would receive surgery to fix their conditions and help them eat without difficulty. They also knew that their sons faced lives filled with ridicule and exclusion due to deep-rooted social stigma associated with cleft in their community.

Nothing would stop them from finding a solution and, thanks to Operation Smile Thailand, they did.

Soon after the twins were born, they learned about a medical mission taking place in nearby Ubon Ratchathani, Thailand, where a team of medical volunteers could perform surgery, free of charge.

Once Lak and Ou received comprehensive health evaluations, the 8-month-old boys were deemed healthy enough to receive surgery and placed on the mission schedule.

Wanna and Manus see their son Ou's smile for the first time after his cleft lip surgery. Their other twin son, Lak, also received cleft lip surgery during the same mission. Photo: Peter Stuckings.

Wanna was overjoyed with the results of her sons’ cleft lip surgeries. But she was still worried because both twins continued to struggle to eat and drink. The boys needed to grow bigger and stronger before they could receive cleft palate surgeries.

And one year later, Lak and Ou returned to a mission in Surin and got the operations that made eating and drinking effortless.

Ou, left, and Lak, one year after their cleft lip surgeries. Photo: Peter Stuckings.

Wanna diligently works with the twins to improve their speech by using the exercises from an Operation Smile Thailand speech training camp they attended two years after their palate surgeries.

As twins, Lak and Ou are very similar. They both love spicy food, mangos and riding bikes outside of their home. However, Lak, the elder of the two, has a hot temper and is closer to his mother, while Ou is very headstrong and always talks about how he is “dad’s son.”

Ou, left, and Lak, three years after their cleft lip surgeries. Photo: Peter Stuckings.

By providing access to free, safe surgical care, Operation Smile gave Lak and Ou more than just new smiles. It restored a vital aspect of their culture and ensured that the twins would grow up happier and healthier with the promise of brighter futures.

“I would like to thank Operation Smile who helped my sons get surgery,” Wanna said. “This project could help all Thai children with cleft have new smiles.”

Photo: Peter Stuckings.

The Tailor of Her Future

It’s been a jarring and crawling two-hour drive since the pavement of the nearest town gave way to a red clay road pocked with pools of muddy water that conceals vicious potholes and crevices.

The condition of the road stands in stark contrast to the lush natural beauty that surrounds it as you head deeper into jungle. Just as it narrows down to a car-wide path cut through the thick tropical underbrush, the road widens, and the vegetation clears.

A small green hut emerges a couple of hundred metres ahead.

Photo: Zute Lightfoot.

Now 18 years old, Faustina stands behind a manual sewing machine, focussing on a line of stitches that she’s running into a bolt of purple and white fabric. Under the shade of this green hut, under the watchful eye of Memunatu, the village’s head seamstress, Faustina and her classmates are studying to become masters of the craft.

The sounds of cheerful laughter and conversation fill the humid air, echoing into groves of green cocoa trees as the near-equatorial sun shines brilliantly.

Photo: Zute Lightfoot.

“To be honest, with my cleft, I could have never imagined this kind of a future for myself,” says Faustina with a cool confidence as 17 years of isolation and stigmatisation are sent into the past with a subtle giggle.

The change in Faustina’s demeanour is as dramatic as the physical transformation of her smile – both made possible by a surgery that lasted a little more than 45 minutes.

When we first met her at an Operation Smile Ghana medical mission, her eyes reflected a lifetime of pain and longing. She stuck close to her father, Mohammed, as she dreamed of what her life could be like after surgery.

Today, Faustina is the tailor of her future.

Faustina, her teacher, Memunatu, centre, and her fellow sewing apprentices. Photo: Zute Lightfoot.

“I wanted to be a hairdresser, but after the surgery, I gave it some thought and realised that I really wanted to be a seamstress,” Faustina says. “Learning to be a seamstress makes me happy, and I will be able to help my family by sewing for my siblings and my mother and father.”

Her teacher tells us more about how Faustina has transformed into the friendly, often outgoing, young woman that she is today.

“Before the surgery, she used to be a shy type, quiet type, that any time there is gathering you would definitely not find her among the people showing up,” Memunatu says. “After surgery, what I’ve seen is that she is now very friendly and she’s open. She has a lot of friends and you can see that now she feels free.”

Memunatu adds that Faustina been a quick study as a seamstress, and that she envisions a bright future for her in the craft.

Faustina says that she’s completely focussed on studying the craft of sewing and that her goals are both to get her own sewing machine and to master sewing so that she can open her own shop. She envisions a future where she meets a good man, gets married, starts a family and supports her parents as they grow older.

As we talk to Faustina, her selfless nature becomes more apparent. She tells us that the reason she pivoted from dreams of hairdressing to sewing was because sewing was something that she could do for the entire family, community and herself, whereas hairdressing limited her to a smaller group of people.

Faustina and her father, Mohammed. Photo: Zute Lightfoot.

“As a father, my wish is to see that my daughter achieves something in life, and it’s her greatest wish to learn something, and I realise that sewing is what she’s very passionate about,” Faustina’s father, Mohammed, says.

“I know that life has its trends. You pass through difficulties before you get to the promised land, before you make it. So for me, I see her life going through this process. Operation Smile gave her that surgery, and it’s making life easier for her to push for achieving her dreams.”

Mohammed says that every day when he prays, he prays for the continued success and deepening of the skills of everyone involved with Operation Smile.

Faustina and her stepmother harvest cocoa near their home. Photo: Zute Lightfoot.

Faustina’s home is located at the top of the tallest hill in the area. It’s surrounded by the cocoa trees that her family and other community members farm for the Ghana Cocoa Board, which buys the beans for commercial distribution. This is the community’s principal form of income. Subsistence crops are also grown, and livestock are raised to round out the lifestyle. The natural beauty surrounding the village is absolutely breathtaking.

Faustina and Mohammed lay out cocoa beans for drying. Photo: Zute Lightfoot.

Although Faustina’s community has rallied around her since her surgery, the spectre of the mistreatment that she endured for most of her life lies just under the surface.

As she sits proudly atop full bags of cocoa beans next to the village’s scale, we ask her a question that evoked deep emotions in everyone within earshot: “How have you been able to forgive and befriend the same people who once treated you so poorly?”

“I have forgiven them,” Faustina says. “But I’ve realised that they have this sort of guilt in them because of how they acted towards me before my surgery. And now that they have accepted me, deep in their minds, you realise that they have this sort of ill feeling of guilt in them. But for me, I don’t hold anything against them. I have accepted them as friends.”

Faustina poses with her family and members of her community. Photo: Zute Lightfoot.

She tells us that before surgery, when she dreamed, she would have her cleft lip and that those dreams would be sad. But after surgery, those dreams ceased and that she would be as she is today, singing in front of her church. Now that she can — and does — sing before the congregation, she says she feels like her dreams have come true.

“When I fetched water with a cup to drink, no one wanted to use the same cup as me. So life, as a whole, was not pleasant for me; I wasn’t a happy person,” Faustina says. “So, there was no way that it could cross my mind that the future would look bright.

“But now, looking at this change and the ability to mingle with people, to go everywhere that I want to go, everyone accepting me, I see a bright future. Now, when I take a cup and fetch water and drink, people use that same cup and drink.

“It means that I’m accepted by all.”

Photo: Zute Lightfoot.

Perseverance and Resilience: Lexxi’s Journey of Healing

In Colombia’s La Guajira Desert, striking natural beauty is balanced with harsh and unrelenting conditions.

The dry wind is abrasive, whipping dust and sand into the scorching heat. Yet, blue skies and radiant sunshine are abundant, and tall green cacti stand above the scrub thickets.

For millennia, the Wayuu people have called La Guajira home. But for Elba and Lexxi’s family, it’s become a difficult place for them to thrive.

Lexxi was born with a cleft lip and palate, the seventh of eight siblings and the family’s only child affected by a cleft condition.

Lexxi, age 8. Photo: Rohanna Mertens.

Her family lives in an impoverished, remote and dangerous area near the border with Venezuela that’s a four-hour bus ride away from Uribia, Colombia, the nearest town. As Venezuela’s economic and civil institutions have descended into a dire humanitarian crisis, criminal activity in this region has been on the rise.

Elba, Lexxi’s mother, tells us that thieves stole both her motorbike, the family’s sole mode of transportation, and her small herd of goats.

After the birth of her eighth child, Elba and her children were abandoned by her husband.

Despite these incredible hardships, Elba perseveres. She makes a living by weaving mochilas, traditional Wayuu wool bags, and selling them in the market in Uribia.

Elba weaves a mochila, a traditional Wayuu wool bag, as Lexxi watches. Photo: Rohanna Mertens.

However, the craft generates a low income, preventing Elba from being able to afford surgery for her daughter. This factor and the remoteness of their village, which lacks running water and electricity, created nearly insurmountable barriers to Lexxi receiving surgical care.

Eight years earlier, when Lexxi was born, Elba was shocked and heartbroken to see her baby born with a cleft lip and palate.

“When I saw my daughter like that, I got scared,” Elba says. “I wondered, ‘What is going to happen with my daughter? Is she going to be like this when she grows up?’”

At the time of Lexxi’s birth, Elba wondered why her daughter was born with a cleft lip and palate, as did her neighbours. She wondered if she had eaten something wrong during the pregnancy. Others speculated that Elba had been scared by an animal before Lexxi was born.

Without having learned that the cause of an individual’s cleft condition cannot be specifically determined – it could be affected by genetics, environmental factors or a combination of both – Elba eventually accepted it as God’s will.

But overwhelming worry and doubt soon befell Elba; Lexxi’s cleft lip and palate prevented her from being able to breastfeed. Elba’s only option was to spoon feed Lexxi goat’s milk, and, fortunately, her daughter was able to feed this way.

Throughout her childhood, Lexxi was often sick and her cleft palate caused her difficulty with eating and breathing properly at times. Living hours away from basic health services, Elba did her best to care for Lexxi as she dealt with these bouts of illness.

Much like her mother, Lexxi is resilient. She loves to go to school and is a bright student, though some of her classmates bully her and call her names such as “no mouth.” She is quick to defend herself against her bullies, and her teacher and friends also stand up for her.

One of Lexxi's favourite activities is drawing the landscapes and animals of her home village in La Guajira Desert, Colombia. Photo: Rohanna Mertens.

Recently, Lexxi came down with an acute respiratory illness, and Elba knew that she had to rush her to the hospital for treatment. It was on this journey that Elba learned about Operation Smile Colombia and the annual medical mission it hosts in nearby Riohacha.

This was the first time that Elba heard that surgery could repair her daughter’s cleft condition. It was also the first time she felt a sense of hope for her daughter’s future.

With the help of a local public health coordinator, Elba and Lexxi made the long journey to a friend’s village just outside of Uribia, which is where we met them for the first time. This area is called Polvo, meaning “dust,” and it closely resembles their community.

Lexxi and Elba walk through their friend's community near Uribia, Colombia. Photo: Rohanna Mertens.

From here, it’s a short drive to Riohacha, where Operation Smile Colombia medical volunteers will be providing free cleft surgery and multidisciplinary treatment, including speech therapy and psychosocial care, next week. Every year, the organisation brings these services to the hardest-to-reach patients in rural and remote communities across the country.

When Elba and Lexxi arrive at the mission site, surrounded by dozens of other families and children affected by cleft conditions as well as compassionate volunteers, their dispositions transform from downcast and reserved to hopeful and energetic.

Lexxi receives a speech therapy consultation from Operation Smile Colombia volunteer Paola Andrea Eussen as part of her comprehensive health evaluation during the August 2018 medical mission in Riohacha, Colombia. Photo: Rohanna Mertens.

After receiving a comprehensive health evaluation, Lexxi was deemed healthy enough to receive surgery for her cleft lip.

“The idea is that Lexxi, who previously had problems because of her cleft, now with a new smile, a new face, will be accepted by other children,” says Dr. Sonia Montenegro, an Operation Smile Colombia volunteer anaesthesiologist. “She will be included; she can play with them and have a normal childhood.”

And after a surgery that took about an hour to complete, the course of Lexxi’s life changed forever.

“My heart was pounding so loud and I had to tell myself to calm down,” Elba says, visibly relieved and overjoyed after seeing her daughter’s new smile for the first time. “She looks so beautiful now, and I feel nothing but sheer happiness.

“I am really thankful to everybody who helped us. I am satisfied, I am happy, this is all I feel right now.”

Lexxi gazes into a mirror at her new smile. Photo: Rohanna Mertens.

Before Lexxi and Elba returned home, Lexxi was scheduled to return to next year’s Riohacha medical mission to receive a cleft palate surgery that will help her speak more clearly, eat and breathe without difficultly, and prevent recurring illnesses and infections.

A year passes, and we meet Elba and Lexxi in Polvo once again. While Lexxi, now 9, is still very shy and sticks close to her mother, her surgery has healed beautifully. We soon learn about how cleft lip surgery has brought improved health and happiness to her life.

“She already speaks much better after her lip surgery, and she is so beautiful,” Elba says.

Lexxi, age 9. Photo: Rohanna Mertens.

Elba tells us that nobody bullies Lexxi anymore, and she wholeheartedly enjoys third grade. She is a great student and excels at maths; most recently, she learned how to divide. Her favourite things to do are studying, completing her homework and drawing pictures of animals and landscapes. Elba adds that she’s heard Lexxi talking to her siblings about her dreams for adulthood, telling them that she would love to become a secretary, nurse or doctor one day.

As soon as Lexxi arrives at the mission site, she is all smiles as she’s greeted by the volunteers and makes fast friends with children around the screening area, dancing and playing with bubbles.

She colours and draws as she awaits a speech therapy session from volunteer Angie Agudelo, who provided lessons for Elba to give to Lexxi when they return home.

Lexxi engages in a speech therapy session from Operation Smile Colombia volunteer Angie Agudelo. Photo: Rohanna Mertens.

Lexxi’s palate surgery was a success. She’ll have the option to return to Riohacha every three months to receive ongoing speech therapy and other treatments like psychosocial counselling from Operation Smile Colombia volunteers.

Though surgeries and cleft care can’t solve many of the problems that her family must face in their rugged corner of the country, Lexxi’s journey of healing is on a path toward a brighter future.

Photo: Rohanna Mertens.

Amid Crisis, Healing

As the tropical sun beats down and the arid wind blows, plastic bags and tumbleweeds roll across expansive and barren dust fields where La Guajira Desert meets the outskirts of Uribia, Colombia.

Across a dry ravine, a sun-parched clay road bends toward an array of small lots lined with fences made of cacti lashed together by metal wire. The pieces of plastic trash stuck to the thorns flap in the gusts. On the lots stand tiny shacks made of thin pieces of wood, cardboard, fabric, metal or fibreglass – anything that can create a barrier against these harsh elements.

This is the April Third refugee camp. This is where Marbelis, her family and many hundreds more displaced Venezuelans have fled the political and economic chaos that’s plunged their home country into crisis.

As of the publication of this story, more than 4.5 million Venezuelans have relocated with over 1 million seeking refuge in neighbouring Colombia.

Just down the road from Marbelis’ shelter, a group of young children buzz around a neon-painted playground and fill the air with laughter, a stark contrast to the austere surroundings.

Marbelis’ son, Pedro, is part of the fray. But unlike the friends that he’s made at April Third, the 7-year-old is living with an unrepaired cleft lip and cleft palate.

Pedro and his friends play at the April Third refugee camp in Uribia, Colombia. Photo: Rohanna Mertens.

It’s here that Marbelis has finally found hope for a brighter future for Pedro and her family.

“When we arrived here, I felt better,” Marbelis says. “It was a joy to come here, for me and for my children. The food is easy to get, and it’s not like that there.”

As Marbelis tells us about life in her native country, she fights to hold back tears.

As the conditions continued to deteriorate in Venezuela, so did the family’s ability to make ends meet. Often, Marbelis’ husband, Nelson, would work long hours on a farm and still couldn’t afford to feed their family of five at the end of the day. Rolling blackouts became increasingly frequent.

She also lost hope that Pedro would ever have the chance to receive surgery.

“When I was in Venezuela, I found out about a surgical mission (unrelated to Operation Smile) and enlisted, but nothing happened,” Marbelis says. “Some physicians came to our house advising that I would have a chance for him to get an operation. I enrolled in that, but again, nothing happened.

“I got tired of waiting.”

Seven-year-old Pedro and his mother, Marbelis. Photo: Rohanna Mertens.

In March 2018, the family decided to leave Venezuela for Colombia. Nelson, originally from Colombia, knew that a better life for his family lay on the other side of the border, including the opportunity for Pedro to receive cleft surgery.

“I felt sad, but we had to do it because of the situation in the country but also for the sake of my son,” Marbelis says. “We came in a pickup truck called Listineros. We left early and arrived at night.”

It would take several months before Pedro’s family settled in the April Third camp. However, it was only a matter of weeks after their arrival that the local healthcare community identified Pedro and his need for cleft care.

Marbelis learned about Operation Smile Colombia and the possibility of receiving free cleft surgery from the woman who managed a food hall in the camp.

Pedro draws at this family's home in the April Third refugee camp. Photo: Rohanna Mertens.

“She asked me for his documents, and I gave them to her right away,” Marbelis says. “I was glad and filled with enthusiasm. She was supporting me, and as she moved forward, so did I.”

Soon after her arrival, Marbelis began working as a cleaner for a man in Uribia. After he learned that Pedro was living with a cleft condition, he contacted Aristides Ortiz, a public health coordinator for Uribia’s health department.

Ortiz then connected with Operation Smile Colombia. They confirmed that Pedro was the same boy living in the April Third camp that they identified through the food hall manager’s outreach. Though they missed the 2018 Riohacha medical mission by two months, he was scheduled to attend the following mission in August 2019.

Ortiz tells us that many of the Venezuelan refugees living in several camps that have emerged around Uribia arrive in poor health. He says the two local hospitals only have the capacity to treat refugees in emergency situations, leaving conditions like cleft lip and cleft palate unaddressed.

Non-governmental organisations partner with the local health system to provide basic treatments, but the need here remains dire. For people living with untreated cleft conditions in marginalised communities like Pedro’s, the annual Riohacha mission is their only chance to receive free surgery.

Marbelis says that while Pedro was fortunate to avoid the severe health problems that can be caused by cleft conditions, he still carries the emotional burden of having been bullied by his former classmates in Venezuela. He also becomes frustrated when people misunderstand him when he speaks.

Pedro and Marbelis await Pedro's comprehensive health evaluation during the August 2019 Operation Smile Colombia medical mission to Riohacha, Colombia. Photo: Rohanna Mertens.

Accompanied by Ortiz, Marbelis and Pedro arrive to the Riohacha mission hopeful that Operation Smile Colombia medical volunteers will determine that Pedro is healthy enough to undergo surgery.

After receiving a comprehensive health evaluation, Pedro proves to be an ideal candidate for surgery and is placed on the schedule of Dr. Mauricio Herrera, Operation Smile Colombia’s medical director and volunteer cleft surgeon.

“I have waited for it to be done since he was born, but it never worked out,” Marbelis says. “At last, the time for his surgery has come, and I am very happy.”

Pedro has his vital signs checked by anaesthesiologist Dr. Carolina Zapata. Photo: Rohanna Mertens.

According to Martha Tristancho, Operation Smile Colombia’s executive director, it’s the organisation’s duty to serve families like Pedro’s.

“Every day we find more people who need us, and through our volunteers and the care they offer, we have the opportunity to give smiles,” Martha says. “That makes me believe more every day that we must continue to have a commitment; that we must increase our capacity to offer care to everyone who comes to us.”

Mauricio adds: “It’s really sad that, because of a situation they can’t control, there is a delay in their treatment. It’s really not fair; children should receive surgery at the right time, so they can live a normal childhood and not have to wait for the situation in the country to improve or the health system to change.”

Pedro and Marbelis await Pedro's surgery. Photo: Rohanna Mertens.
Anaesthesiologist Dr. Hernando De Vivero Gomez and Clinical Coordinator Silvia Natch take care of Pedro in the operating room just before his surgery. Photo: Rohanna Mertens.

When the time comes for his surgery, Pedro smiles as he holds hands with anaesthesiologist Dr. Hernando de Vivero as they walk to the operating room.

In a little more than an hour, Mauricio performs the surgery that Pedro deserved to have within the first few months of his life.

Operation Smile medical director and cleft surgeon Dr. Mauricio Herrera, centre, operates as surgical resident Dr. Andrea Tavera, anaesthesiologist Dr. Raquel Cohen and operating room nurse Geraldin Rodriguez assist during Pedro's surgery. Photo: Rohanna Mertens.

Soon after Pedro is omitted into the recovery room, Marbelis is overcome with emotion when she sees her son’s new smile for the first time.

“I almost ran in here, and when I saw him, I started to cry, because he looks so beautiful.”

But Marbelis knows that this is only the beginning of Pedro’s cleft care journey. Before he is released to return home, Pedro is scheduled to receive cleft palate surgery at next year’s Riohacha mission. While the future remains precarious for her family, Marbelis’ resolve for Pedro is absolute.

“We’re ready for his palate surgery now,” Marbelis says. “I will keep fighting until everything is done.”

Marbelis sees Pedro's new smile for the first time after his cleft lip surgery. Photo: Rohanna Mertens.

Care for Brighter Futures: Oscar’s Story

Anyone who sees this young man, bicycling down the streets of Bogotá, Colombia, and entering Universidad El Bosque with a book bag slung over his shoulder, would never imagine that doctors once told his family that he was destined for a life of misery.

Oscar was born with a cleft lip and palate, but he looks like any other student on campus. Wearing blue jeans and a green sweater with bold text reading “nothing is perfect” on the front, he greets his friends on the way to the gym. There, he’ll lift weights for about an hour before his English class begins.

In his sixth semester, he is practically fluent in English. He dreams of travelling and studying abroad – maybe in the U.S. He has big plans of a Ph.D. exam and possibly becoming a university professor – that is unless he’ll be working for Operation Smile – or a translator; he wants to learn French as well.

Photo: Rohanna Mertens.

The possibilities seem endless for Oscar – he has so many plans and so much hope for a bright future.

But it hasn’t always been this way.

His mother, Maria, was only 17 years old when Oscar was born. Her doctors never told her about Oscar’s condition, even after she received ultrasounds. The day he was born, the maternity ward doctors immediately took him away from her and started whispering to each other.

One doctor asked her, “What kind of life do you want to live?” He told her that he had something serious to tell her that she “just had to accept.” Her child was born with a cleft lip and a cleft palate.

“I started to cry and didn’t want to accept it. I prayed to God that this was just a nightmare and that I would wake up and it wouldn’t have happened,” says Maria, her eyes tearing up by the memory. “But the next day when I woke up again, the doctors were all there, the child’s aunts were there, crying. The father was also crying – everybody was crying – and honestly, at that moment, I didn’t want to accept him as my child.”

Photo: Rohanna Mertens.

Now, she sits with her handsome son in their living room, looking through photo albums. He has heard this story before, but it’s still painful, especially as he sees his mother become upset.

“My sister was 15 when he was born. But she was the only one who didn’t think this was so terrible. She thought the baby looked cute, so she convinced me to see him again, to have a look at him and cuddle with him. And we did,” Maria says. “And of course then, when I held him in my arms, everything was different. That was the day when, to me, he was born.”

Photo: Rohanna Mertens.

It has been a long journey for Maria and Oscar to receive the care that he needed.

He first received surgery at a state-owned hospital in the city, but they were not cleft specialists and the stitches broke open the next day. The following time he was on the list for surgery, he fell ill with the flu and the procedure had to be cancelled.

It was then that she first heard about Operation Smile and learned that the medical non-profit would soon be conducting a surgical mission. When they first entered the doors of the hospital where Operation Smile was working, everything changed.

Photo: Rohanna Mertens.

Operation Smile Colombia was founded in 1994 by Carlos Arturo Vargas. He and his wife lost a son, only 15 months old, in a car accident and wanted to do something to honour him – something that would benefit children in need.

“The need to help treat this pathology is enormous in this country,” Carlos says. “Before we started, there was practically nothing here, and it was tragic to see the lack of knowledge the parents had and how they only knew of the myths about cleft, how they hid their children from society.”

Starting by bringing in international teams of volunteer doctors and nurses for around 10 days to operate on about 100 children and then leaving, Carlos felt the need to build something lasting after a few years. Colombia’s lack of follow-up and ongoing cleft care was profound, so they started to work with local specialists to be able to offer the children orthodontic care, psychology, speech therapy and other treatments.

“We realised it wasn’t the surgical procedure that was the only solution. So we started to look for a way to treat both the child and the parents, who are so important to get a successful rehabilitation,” Carlos says. “We created rehabilitation centres where we could take care of pregnant mothers, using ultrasounds to detect (cleft conditions), and to prepare them for what would come, and then later with different courses such as the introduction course, where they meet other parents and children with cleft and can see that they are not alone.”

Photo: Rohanna Mertens.

Operation Smile Colombia operates two care centres in Bogotá and Duitama – year-round clinics that offer comprehensive, free cleft care to those who need it.

The foundation also offers cleft care services at several partner hospitals across the country, where they can connect with patients who live in remote areas. These locations not only offer surgeries, but also the same level of care as the care centres.

“So far, we have performed more than 23,000 surgical procedures here in Colombia, and we have around 1,500 patients coming to our care centres (and locations) for comprehensive care every year,” says Martha Tristancho, the executive director of Operation Smile Colombia. “We treat mostly people from the regions where we have our (locations), but through internet, we have grown a lot in numbers of patients coming from other regions, including very remote areas.”

She explains why she thinks the centres and locations are so successful: It’s the “magic” created by the commitment volunteers and staff show towards their patients and their families. By providing patients with the surgeries they need, as well as specialty care that enriches their lives and helps them become fully integrated in society, volunteers and staff make them feel like a part of the Operation Smile family.

Olga Sarmientos is a speech therapist at the centre in Bogotá who used to see Oscar when he was a patient there. She is proud of him and his achievements.

“To know that Oscar now is studying languages at the university, to see him so satisfied and happy with himself, makes me extremely happy. He is such a good example of the opportunities all our patients have if we can work with them,” Olga said. “We can support the family and show them that everything is possible and that the cleft, that once was a very traumatic experience, can become just a memory.”

It’s clear that Oscar’s and Operation Smile Colombia’s commitment to the development of his speech have shaped his ambitions.

In 2019, Oscar achieved one of his many dreams by graduating from Universidad El Bosque with a bachelor’s degree in bilingual education. He currently works at an English-language customer service call centre for a major United States-based retail company, where the culmination of his years of speech therapy is realised daily. Oscar aspires to one day move to the U.S. and teach English as a second language to children who are native Spanish speakers.

“Operation Smile has meant very much to me. They gave me the tools and motivation to improve my life, to live a life with higher quality,” Oscar says. “Without exaggerating, I have Operation Smile to thank for almost everything in my life. They were there by my side, all the time, through the treatment and into my social integration.”

Olga Sarmientos is a speech therapist at the centre in Bogotá who used to see Oscar when he was a patient there. “... to see him so satisfied and happy with himself, makes me extremely happy,” she said. Photo: Rohanna Mertens.
Olga Sarmientos is a speech therapist at the centre in Bogotá who used to see Oscar when he was a patient there. “... to see him so satisfied and happy with himself, makes me extremely happy,” she said. Photo: Rohanna Mertens.

“He is going to be a beautiful boy”

Photo: Rohanna Mertens.
Photo: Rohanna Mertens.

Greth Liseth was devastated when her son, Erick Manuel, was born.

She had never seen anything like a cleft lip or cleft palate before; and nobody could explain why her Manuelito – “Little Manuel” – was born that way. She couldn’t breastfeed him and she felt so helpless that she couldn’t feel love for her child.

Greth Liseth is a mother to five children whom she has been raising alone since her husband abandoned their family. The 35-year-old strives to care for her family, but life is hard in their home on a dusty, gravel road in a remote, impoverished area of Olancho, Honduras.

Photo: Rohanna Mertens.

Greth Liseth wakes up at 5 a.m. every morning to prepare breakfast for her children before they go to school. She then goes to work as a cook in a private home. Her oldest daughter, 14 years old, stays home to take care of Manuelito. Greth Liseth only earns 1,000 lempiras ($44) each month, which is never enough to buy groceries for her children. She must borrow money to survive.

When Manuelito was born, she felt overwhelmingly burdened, desperate and lonely. People turned to superstition and blamed Greth Liseth for Manuelito’s condition, saying she had watched too many lunar eclipses. One woman told her that her son was a monster and his deformities were her fault.

“But the doctors said I shouldn’t worry too much since they know a person that could help,” Greth Liseth said. “His name is Don Alex Guerrero and they gave me his number.”

Don Alex Guerrero with Greth Liseth and her family. Photo: Rohanna Mertens.
Don Alex Guerrero with Greth Liseth and her family. Photo: Rohanna Mertens.

Alex, or Don Alex as he is called by everyone he meets or helps (the use of the honorific Don conveys respect for that person), is a father to four children. His youngest son, César, was born with a cleft lip and cleft palate four years ago. He remembers how he and his wife experienced the most difficult time of their lives trying to find help for their son. No doctors had advice for them when César was born. Since his cleft kept him from feeding properly, he almost died of malnutrition. Fortunately, they learned about Operation Smile Honduras’ care centre in Tegucigalpa, where they finally received the free surgery that saved their son’s life.

They have since committed themselves to helping other families in their region. Greth Liseth’s family is one of them.

“Don Alex found me at the bus station when I had just left the hospital,” Greth Liseth said. “I didn’t know how to feed my son. Don Alex told me to stay there. He left and came back with formula, drove me home and taught me how to feed my son.”

Don Alex helped Greth Liseth learn how to feed her baby. Photo: Rohanna Mertens.

Don Alex also invited her to his house to meet César. That was the moment when Greth Liseth felt hope return to her life.

“I was so happy when I met his child because he looks normal, without any problems,” she said. “I know that with the will of God, my son is going to be beautiful and healthy.”

Greth Liseth arrived to the Operation Smile medical mission in Tegucigalpa’s Hospital San Felipe with the hope that her son would receive surgery. Don Alex brought her and 18 other children and their family members there. Before this trip, Don Alex escorted Greth Liseth four times to Operation Smile’s care centre, which is only steps away from Hospital San Felipe. The medical staff at the centre provided Greth Liseth with instructions and the formula that her son needed to gain enough weight for the surgery.

Don Alex poses with Greth Liseth, Manuelito and other patients he has brought to Tegucigalpa for cleft care. Photo: Rohanna Mertens.

Greth Liseth could have neither afforded the bus ride to the city, nor would she have dared to go there alone without the help of Don Alex. Without him, she would not have found Operation Smile Honduras and Manuelito would not have received one of the 150 surgeries performed on children like him during this 2016 medical mission.

Now, Greth Liseth feels confident about her son’s future.

Greth Liseth and other mothers of Operation Smile patients learn more about their children's upcoming cleft surgeries. Photo: Rohanna Mertens.

“He is going to be a beautiful boy,” she said.

“He already has many ‘girlfriends’ at the centre. The female staff love him and play with him every time I go there,” she said with a smile.

Months after surgery, Manuelito has a beautiful smile. Photo: Rohanna Mertens.

Beyond that, her feelings of loneliness and despair have disappeared.

“I want to thank Operation Smile, because if it wasn’t for them, my child wouldn’t be able to have surgery,” Greth Liseth said. “I know that everything is going to be fine if we have faith in God, and I want to thank the staff and Don Alex for all the support they have given me.”

Photo: Rohanna Mertens.

Editor’s Note: In the 20-year history of Operation Smile Honduras, our medical volunteers have delivered free cleft surgery to more than 4,500 patients. However for most of this time, all too many patients born with cleft conditions were not able to get surgery when they were babies, which is the ideal age range for the best results.  

In 2014, there were about 1,000 cleft cases remaining in the country and many of those potential patients were adults, teens and children. Together with Operation Smile Honduras, we made a commitment to find them and end their needless suffering by making sure they receive the safe and effective surgery they deserve. 

Supported by medical missions and the ongoing care provided at Operation Smile Honduras’ care centre, a strategy was put into motion to identify and recruit potential patients, many of them among the poorest and hardest-to-reach in the country.  

We’re proud to report that the effort was successful. 

Now, the remaining patients in Honduras who need surgery are nearly all babies and toddlers. For the first time in the country’s history, Operation Smile has made sure that cleft surgery in Honduras is truly SET: safe, effective and timely. 

On May 11, 2017, Operation Smile Co-Founder and CEO Dr. Bill Magee made the historic announcement alongside the President and First Lady of Honduras. 

Though we’ve reached this historic milestone, our work is far from done.  

In this series, we share the stories of how Operation Smile Honduras was able to find and provide surgery for the final patients of the country’s backlog of cleft cases.