Going the extra Miles for Smiles: Madagascar nutrition programme

Held by his mother, Patricia, 14-month-old Icardi sips formula from a bottle. Photo: Henitsoa Rafalia.

Our promise of improving health and dignity during the COVID-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

Vololona leads a team of volunteers through a crowded neighbourhood, passing worn houses before stopping to knock on a metal door.

After a moment’s pause, Patricia appears holding her son, Icardi, who’s feeding from a bottle.

With relief in her voice, she says to the volunteers, “We’re so glad to see you. This is one of the last bottles we can prepare with the baby’s formula left.”

Amid the lockdowns and restrictions, Patricia and Vololona, Icardi’s grandmother, have tried to support their family.

Vololona sells small supplies to schools and churches while Patricia makes deliveries of steels rods in the community.

But with orders not coming in, and schools and churches closed, they’ve struggled to make ends meet.

“Baby formula is expensive, but we’ve somehow always managed to buy it, since Icardi needs it to grow,” Vololona explains. “But since the lockdown, we’ve not been able to put money aside to buy formula.”

Photo: Henitsoa Rafalia.

Throughout the COVID-19 pandemic, this has become the reality for many patients and their families around the world as they attempt to provide for their loved ones amid country-wide lockdowns and restrictions.

With the inception of the Extra S’Miles nutrition programme, our local teams in Madagascar are quite literally going the extra mile for families with hopes of minimising the hardships caused by the pandemic.

“Shortly after the state of health emergency was declared and lockdown measures were put in place, our patients became extremely vulnerable,” said Dr. Howard Niarison, Extra S’Miles Programme Coordinator. “We had to take action, even if that meant braving the virus and the miles that separate them from us.”

Photo: Henitsoa Rafalia.

The programme not only helps patients continue their nutrition treatment prescribed by medical volunteers prior to the pandemic, but also assist families living in regions where lockdown measures have made it nearly impossible to meet basic nutritional needs.

Malnutrition remains one of the most significant obstacles to receiving care due to an increased risk of complications during surgery. Without timely medical intervention, patients like Icardi can face major health issues as they are more vulnerable to illness, malnutrition and even death.

The Extra S’Miles team spanned nearly two thousand miles, travelling across the country of Madagascar to deliver nutritional packs to patients living in the regions hit hardest by the virus.

Within the packs provided to families are necessary supplies and hygiene products including food, soap, washable masks, hand sanitiser, ready-to-use therapeutic food (RUTF) and more.

Member of the Operation Smile Madagascar's Extra S'Miles nutrition programme team giving ready-to-use therapeutic food (RUTF) to a patient. Photo: Henitsoa Rafalia.

In addition to the nutritional packs, the Extra S’Miles programme enabled the team to check-in on the health of patients, reassure families that Operation Smile remained devoted to their well-being despite the cancellations of medical missions and provide counsel advice on how to remain healthy until the resumption of care.

Photo: Henitsoa Rafalia.

“It’s during difficult times that you know who your real friends are,” said José Augustin, patient coordinator for Operation Smile in Madagascar. “This health crisis is certainly a difficult time for our patients. Because we care for them, we’ll reach out to them since they can’t come to us.”

More than 530 families received the Extra S’Miles nutritional packs thanks to the dedicated team members who refused to let the pandemic prevent them from seeing smiles on the faces of patients in need.

Operation Smile Madagascar patient Coordinator Jose Augustin shares a smile with a patient. Photo: Henitsoa Rafalia.

With tears in her eyes, Patricia happily accepts the nutritional pack and the six cans of baby formula the Extra S’Miles team offers her.

Raising Icardi has been a long and difficult journey for Patricia and Vololona.

Despite their unconditional love for both Icardi and his older sister, they’ve faced seemingly insurmountable barriers in their attempts to care for a child living with a cleft condition.

Icardi’s father left shortly after his premature birth, unable to handle the stress of a baby born with cleft lip.

Smile Photo: Henitsoa Rafalia.

Many families like Icardi’s joined Operation Smile Madagascar’s nutrition programme with the hope of a new beginning.

The programme provides patients and families with educational support, ongoing health assessments and RUTF, a nutritive peanut paste that helps malnourished children gain enough weight to become healthy enough for safe surgery.

“Icardi is a survivor,” Vololona said. “That’s in part thanks to all the counsel and help we’ve received from Operation Smile. With this health crisis, Operation Smile has not forgotten him, nor us. We’re extremely grateful.”

Today, the Operation Smile Madagascar team remains steadfast in their commitment to the health and wellbeing of patients.

Through their continuous efforts to provide nutritional support, 62 patients were enrolled in the organisation’s nutrition programme as of October 2020. Of that total, 47 children reached an optimal weight with 13 more making significant progress along their journey to becoming healthy enough to receive safe surgery.

Help us to continue keeping our promise to patients like Icardi amid the COVID-19 pandemic. Your support today means we can help patients through these uncertain times and provide them with the care and surgery they deserve when it’s safe to resume our work.

Celebrating National Mentoring Month: Our Volunteers Create Lasting Impacts

Volunteer surgeons Drs. Wafaa Mradmi of Morocco, left, Rocio Trujillo of Ecuador, Souad Terrab of Morocco and Saloua Ettalbi of Morocco during our all-female medical mission in Oujda, Morocco. Photo: Jasmin Shah.

Our promise of improving health and dignity during the COVID-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

While the world faces new challenges, it’s vital that Operation Smile and our community of volunteers continue looking ahead and remain focused on working toward a brighter future for the patients and families we serve. 

Throughout January, we’re celebrating National Mentoring Month and recognising the medical and non-medical volunteers who enhance our world and strengthen our ability to reach more patients through mentoring the leaders of tomorrow.

During our cleft surgeon training programme in Madagascar, observers Drs. Briand Michel Rakotomanga, left, and Ravaka Ny Aina Rakotorahalahy, third from the left, watch as Dr. Lora Mae de Guzman of the Philippines operates. Photo: Rohanna Mertens.

Operation Smile changes the lives of children around the world with safe, effective and timely surgery thanks to the help of medical volunteers, partnerships, donors and devoted student volunteers.

It’s through training and mentorship programmes that our volunteer instructors have an opportunity to become mentors themselves, passing on their knowledge, passion and expertise they’ve gained as volunteers to students who will lead future generations for years to come.

Celebrating these stories presents an opportunity to spread positive messages, enact change in the countries where we work and encourage more people to join in our efforts to provide safe surgery and exceptional medical care.

Team photo on the second day of screening for Operation Smile's Women in Medicine: Inspiring a Generation medical mission at Hospital Al Farabi in Oujda, Morocco. Photo: Jasmin Shah.

Many of our female volunteers serve in pivotal roles, delivering high-quality surgical and multi-disciplinary care to patients affected by cleft. Last year, they were celebrated during our first international medical mission comprised entirely of women: Women in Medicine: Inspiring a Generation.

The mission brought together dentists, surgeons, nurses, biomedical technicians and others to share knowledge and inspire one another.

Members of the team engaged in training and mentorship activities, including an innovative cleft surgery simulation workshop for plastic surgery residents. The education components of the mission provided enrichment opportunities for female physicians that might not otherwise be available to them.

These simulations not only enhanced skills and empowered the medical professionals involved, but they also acted as another step toward these women one day becoming credentialed volunteer surgeons for Operation Smile.

“On average, an Operation Smile medical mission team is comprised of 60 percent female volunteers,” said Kathy Magee, Operation Smile Co-Founder and President. “We already know that our work simply wouldn’t be possible without their talent, generosity and compassion.”

Participating in the Serving Smile programme, Operation Smile student volunteers deliver meals to Sentara Leigh Hospital in Norfolk, Virginia. Operation Smile photo.

When COVID-19 introduced us to a new normal, our student programmes manager in Virginia Beach, Virginia, Pete Hansen, launched the Serving Smiles pilot programme, which underscored the power of rallying young people to support a cause.

His student volunteers partnered with local restaurants to bring meals to healthcare professionals caring for patients in local hospitals.

This inspired student volunteers to serve their communities by bringing much-needed business to family-owned eateries in addition to fuelling healthcare professionals battling COVID-19 on the frontlines.

“Even in the worst of times, Operation Smile finds ways to give back and support communities globally and locally,” said actress Kate Walsh. “I’m proud of the organisation and its newly launched Serving Smiles programme, which involves donating thousands of meals to hospitals. This effort feeds the soul and spirit of our healthcare workers on the frontlines of the COVID-19 fight. It’s a kind gesture that shows gratitude and appreciation for those putting their life on the line to protect ours.”

Members of the cook stove team speak to Holly Zoeller over Skype during their training at Operation Smile Global Headquarters in January 2020. Photo: Bethany Bogacki.

Our student programmes provide young volunteers with the opportunity to spread awareness, raise funds and educate others on medical missions.

These students often come back as mentors who are inspired to spearhead ideas such as the Cook Stove Project.

Our partners in research found a potential relationship between maternal smoke inhalation from an open-flame cook stove top and an increased risk of a child being born with a cleft condition.

A group of student volunteers took the initiative to the next level by raising money that will fund new cooking stoves for low- and middle-income countries like Chiapas, Mexico.

One of the volunteers, Holly Zoeller, began her journey with Operation Smile in high school when she travelled to Madagascar to educate young patients on the fundamentals of healthcare.

As a James Graham Brown Fellow at the University of Louisville, Holly used her grant money to continue her work with Operation Smile to provide children with safe surgery and medical care.

She pitched her cook stove idea to our student programmes team and soon found herself partnering with InfraRural, an organisation that specialises in building and installing wood-burning stoves.

Holly and her team’s efforts show the impact inspiration can have on communities around the world.

Volunteer clinical coordinator Doreenlove Serwaa of Ghana shares a special moment with a patient after surgery during Operation Smile's first local mission to Koforidua. Ghana. Photo: Zute Lightfoot.

As a Ghanaian nurse, Doreenlove Serwah relies on the courage and collaboration of her team to ensure the safety and care of every patient she meets.

In 2016, she joined our team and volunteered as a recovery room nurse devoted to providing care and support to patients and their families after surgery.

Doreenlove quickly transitioned from student to teacher when she became an instructor for American Heart Association basic and paediatric advanced life support courses.

Even then, Doreenlove felt motivated to do more.

Ready to harness her skills as an educator and a nurse, Doreenlove sought out the position of clinical coordinator.

“The clinical coordinator role is integral and paramount in the planning and execution of a mission,” she said. “Through that, I’ve discovered capabilities I didn’t know I had.”

Doreenlove went on to mobilise teams of volunteers coming from all around the world.

“Volunteering with Operation Smile paved the way for me to explore and use my leadership qualities,” Doreenlove said. “I’ve become a better nurse and a mentor to many.”

Our volunteers may offer different skillsets and come from different backgrounds, but they all share the same motivation to give back to their communities and inspire the next generation through compassion and education.

We nurture leadership and encourage the celebration of all volunteers during National Mentoring Month and throughout the year. We hope these powerful stories will inspire and empower the next generation of advocacy-minded leaders to enact positive changes on a global scale.

Help us to continue keeping our promise amid the COVID-19 pandemic. Your support today means we can help patients through these uncertain times and provide them with the care and surgery they deserve when it’s safe to resume our work.

Volunteer dentist Dr. Hanan Elayyan smiles wide at 1-year-old Bissan for their surgery during Operation Smile's medical mission to Amman, Jordan. Photo: Jasmin Shah.

Women in Medicine: Mentoring the Next Generation

Our promise of improving health and dignity during the COVID-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

Standing alongside the women who mentored and inspired them, our instructors became mentors themselves, passing on their knowledge, passion and expertise as volunteers to their students who will lead future generations for years to come.

The female volunteers who serve pivotal roles in delivering high-quality surgical and multi-disciplinary care to patients affected by cleft were celebrated during our first international medical mission comprised entirely of women: Women in Medicine: Inspiring a Generation.

“On average, an Operation Smile medical mission team is comprised of 60 percent female volunteers,” said Kathy Magee, Operation Smile Co-Founder and President. “We already know that our work simply wouldn’t be possible without their talent, generosity and compassion.”

Two-year-old Radouane smiles wide as he waits with his mother to receive his comprehensive health evaluation during screening day. Photo: Jasmin Shah.

In Oujda, Morocco, the female-led team of more than 50 medical volunteers from 25 countries joined forces to efficiently and collaboratively provide 286 patients with comprehensive health evaluations.

Of that total, nearly 130 children like Radouane received life-changing surgeries and brighter futures.

Nearly three years ago, Radouane’s mum, Safia, gave birth alone at home. But even after seeing his cleft lip, the love she had for him never faltered.

“I was not afraid. I’d seen kids like that before, and I knew that this was the gods’ fate. I’m grateful for what the gods gave me,” she said. “He’s my son. I love him, no matter what.”

While once bullied for having an unrepaired cleft condition, Radouane now has a renewed chance at a dignified and healthy life thanks to the dedicated women who volunteered their time and skill to the mission.

But changing lives through surgery wasn’t the only accomplishment the all-female medical team achieved during this mission.

“Biomed techs, nurses, surgeons, dentists all come together and, with their different skills, teach everybody something new,” said volunteer dentist Dr. Carmen Kamas-Weiting from the U.S.

Volunteer cleft surgeon Dr. Wafaa Mradmi (right) instructs a fellow surgeon during the cleft lip and cleft palate surgical training workshop Photo: Jasmin Shah.

The team engaged in training and mentorship activities, including an innovative cleft surgery simulation workshop for plastic surgery residents.

The training and education components of the mission provided enrichment opportunities for female physicians that might not otherwise be available to them.

Cleft surgeons Drs. Wafaa Mradmi of Morocco, fellow mentor Irene Tangco of the Philippines and Saloua Ettalbi of Morocco led the surgical simulations. Thanks to their expertise, medical students as well as certified plastic surgeons learned techniques unique to performing surgery on people with cleft, resulting in improved surgical outcomes for patients.

These simulations not only enhanced skills and empowered the medical professionals involved, but they also acted as another step toward these women one day becoming a credentialed volunteer surgeons for Operation Smile.

“I think, as a surgeon who has technical skills, we are really blessed,” Wafaa said. “We have this unique chance to help people, to pass on our skills to the new generations for them to be able to give this cure and this care to those kids. I had this chance with Irene many years ago, and I’m still learning from her.”

Janat, 1-month-old. Photo: Jasmin Shah.

Dental training workshops also took place at the Operation Smile Morocco year-round care centre in Oujda, which allowed the dental students involved to enhance their knowledge of the intricacies that go into delivering high-quality pre- and post-surgical dental care to patients living with cleft.

When 1-month-old Janat arrived with her parents, Carmen alerted her fellow dental volunteers after realising that Janat was severely malnourished due to her cleft lip and palate.

Volunteer dentist and leader of the workshops Dr. Teresita Pannaci of Venezuela sprang into action and transported Janat and her family to the centre to be fitted for a feeding plate.

A few of the dental students were given the real-life opportunity to apply what they learned from the workshops during Janat’s two visits to the centre.

It was there that Teresita demonstrated how feeding plates are measured and moulded and why the plates can be life-saving for patients with severe cleft palates like Janat.

“For me, being an instructor or teacher in this is extremely important because … we need a generation to inherit this and inspire generations,” Teresita said. “It’s what we’re doing here. When I see this new generation that we’re beginning to train, they’re working, they understand what their role is, they are committed to the lives of patients.”

The soft mold of Janat's cleft palate, which later became her feeding plate that would allow her to drink milk with ease. Photo: Jasmin Shah.

Since being born, Janat had lost nearly half of her birth weight by the time she arrived to the mission. Her undernourishment was due to the challenges her mother, Fatima, faced when attempting to feed her.

Janat’s cleft palate would cause her to choke with milk coming out of her nose. Not knowing who to talk to or what to do, Fatima felt helpless and feared for her daughter’s life as she saw Janat’s health start to decline.

“I was afraid that I was going to lose her,” Fatima said.

Thanks to the feeding plate that Janat and one other child received at the centre from Teresita, Carmen and the dental team, eating, breathing and drinking became easier for her.

Fatima shared that Janat would only drink an average of 3 ounces of milk throughout a day. After testing out her new feeding plate, Janat drank 2.5 ounces in 10 minutes. According to Fatima, it was the first time she’d ever seen her baby drink without suffocating.

Volunteer dentist Dr. Teresita Pannaci, left, looks on as Janat's mom, Fatima, feeds her daughter for the first time with the addition of the feeding plate. Photo: Jasmin Shah.

“It was lovely to see our volunteers coming from the 25 countries, from five continents,” said Operation Smile Morocco Co-Founder Fouzia Mahmoudi. “Sharing their know-how with our residents and our surgeons, sharing it with the same love, with the same dedication, from the bottom of their heart. We are just a university without walls.”

Team photo on the second day of screening for Operation Smile's Women in Medicine: Inspiring a Generation medical mission at Hospital Al Farabi in Oujda, Morocco. Photo: Jasmin Shah.

For people interested in joining the medical field, hoping to one day impact the lives of patients like Radouane and Janat, volunteer post-anaesthesia care unit nurse Florence Mangula has a message.

“I would tell them, “Take up your position, do it with all your heart, so that you’re able to help the less fortunate people in the community. Do it with the passion to see somebody smile, the passion to see a family united, the passion to remove the stigma from the family and make a child smile.”

Help us keep our promise to more patients amid the COVID-19 pandemic. Your support today means we can continue to help them through these uncertain times and provide them with the surgery they deserve when it’s safe to resume our work around the world.

Post-anaesthesia care unit nurse Florence Mangula of Kenya checks in on a patient and their mother after surgery in the recovery room. Photo Jasmin Shah.

Voices From the Front Line: Q&A with Nurses Rodney and Marijose Kapunan

Volunteer nurses and frontline healthcare workers Marijose and Rodney Kapunan. Photo courtesy of Rodney Kapunan.

Our promise of improving health and dignity during the COVID-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

Learning that a family member received surgery from Operation Smile initially inspired Marijose and Rodney Kapunan to become volunteers, but it’s their selfless desire that motivates them to risk everything today in an effort to support patients through these challenging times.

“Growing up poor in the slums of Manila, I always dreamed of getting out of poverty and being able to practice in a caring and well-respected profession, travel the world and give back to my country and community,” Rodney said. “I’m not rich financially, but I feel abundant that I’m able to share my blessings.”

Bonded as nurses, parents and devoted volunteers, the duo feels united as they serve a role in confronting the devastating impacts of the COVID-19 pandemic together.

Having delivered care to children on more than 25 Operation Smile medical missions combined, Marijose and Rodney are now applying that commitment, skill and unwavering compassion to touch the lives of patients affected by the coronavirus.

“We nurses are in the front, centre and back in the fight against this global pandemic,” Marijose said. “Nurses are valuable assets in formulating plans and processes to better manage the disease and prevent future outbreaks.”

We recently sat down with Marijose and Rodney to hear more about what precautions they’re taking to protect the ones they love as well as where their eagerness stems from when they speak about one day getting back into the field for Operation Smile.

Photo courtesy of Rodney Kapunan.
Photo courtesy of Rodney Kapunan.

Q: What inspired you to become a nurse?

Rodney: “I get a lot of accomplishment and pleasure in helping people and the community in any way I can. It gives me an opportunity to positively impact patients by providing comfort to people throughout their most vulnerable moments, being an advocate, confident and a trusted adviser. I also like talking to people, making genuine connections and being able to inspire and motivate my patient to be able to overcome their illness and be a productive member of society. Lastly, I always wanted to be in a profession that is well respected, trusting and where I can exercise compassion on a daily basis. I can easily do that in this profession.”

Q: With both of you working on the frontlines in your hospitals, what precautions do you take to ensure the safety of patients, your children and other members of your family?

Marijose: “When Rodney or myself comes home from work, we strip off our clothes in the laundry room, separate our laundry from our children’s and shower before we even see our kids.”

Rodney: “I work in the emergency room, which is still receiving a lot of patients. The ER has to be restructured because of the coronavirus. So, aside from working, we’re also formulating ways to make our patients safe and us as well. Entering this profession, I always knew that there was going to be a risk. We have to be more vigilant. It’s scary. We’re trying to not only find ways to be safe in the hospital, but at home as well so that we will not spread it to our kids. I don’t blame people for being scared. We try to be a good resource for friends and family.”

Q: What is the environment like in your hospital? What limitations have you and your other medical professional faced?

Rodney: “We are still on lockdown, visitors are still restricted, we are still screening, checking temperatures and masking everyone who comes inside our facility. We’re required to wear level one masks all the time and complete personal protective equipment (PPE) and an N95 mask if patients check in with flu-like symptoms. Especially now, all the hospitals are on heightened alert for a possible outbreak.”

Marijose: “The most obvious limitation we had during this pandemic was a lack of preparedness on this kind of situation. Guidelines were changing almost every day and morale and confidence of the employees were low because they were scared of the disease and scared of losing their jobs. We also had problems with PPE distribution and inventory because we’re masking everyone that steps in the hospital. I just hope that after this pandemic, processes will be established to better prepare ourselves if anything like this happens again.”

Q: What have you learned or experienced from being a volunteer with Operation Smile that’s helped prepare you for responding to COVID-19?

Marijose: “Before the start of every mission, safety is emphasised. Safety of volunteers, patients and their families take priority. Once safety is established, take a deep breath, and gather as much information as possible and collaborate with team leaders for the course of action. Lastly, trust the plan and processes in place and evaluate the appropriateness of the plan.”

Q: In the light of this pandemic, why do you feel it’s so important to recognise nurses and the role they serve in the medical field?

Marijose: “As the largest sector of healthcare workers in every country, we nurses are in the front, centre and back in the fight against this global pandemic. Nurses are on the frontline triaging patients and sorting out possible patients with the virus and quickly moving them to be quarantined and protecting other patients who may not have the disease. Nurses are also in the middle of the action, taking care of patients in the intensive care unit, assisting in medical and surgical procedures, making certain medical supplies and PPE are maintained and protected.

“Enforcing sanitation and hand-washing, answering calls from the public and giving up-to-date information regarding the disease. And increasingly, nurses are valuable assets in formulating plans and processes to better manage the disease and prevent future outbreaks. Nurses are such a valuable part of the medical team and thus deserving of all recognition for what they do.”

Q: It’s a very stressful time in our world right now. How are you and your family doing personally with the impact this virus has placed on you? What emotions are you feeling as you continue to face this crisis head on?

Rodney: “Right now, we are staying positive and optimistic. We keep our faith to God and always pray for protection and strength. We as a family are staying humble and grateful, that despite my wife and I are both working in the hospital, we are both in good health and have not brought the virus home.”

Marijose: “We are staying vigilant with our hand-washing and infection control plans for home. We are also adjusting to home schooling our kids, doing more indoors activities, like sewing masks and learning a new language to occupy our time. We’re also educating our family that this virus is with us now and that social distancing and wearing masks is the new world once society starts opening up.”

Q: What motivates you to continue volunteering for Operation Smile even after the pandemic ends?  

Marijose: “I believe in this organisation. There is always hope. I’m encouraged and touched by the outcomes because I work in the operating room for Operation Smile missions and I see the before and after.”

Rodney: “It’s always a blessing to be a part of it. It’s hard work, we leave our family behind, but I always tell my wife, ‘We always go back thinking that we receive more than we actually give.’ I still find joy and accomplishment in what I do, I feel that I still have a lot of love and care to give to my patients. I still enjoy detective work, seeing a wide variety of patients, having more autonomy in their care, learning new life-saving techniques and most importantly, I still love making a difference in a single person’s life and my community.”

Photo courtesy of Rodney Kapunan.
Photo courtesy of Rodney Kapunan.

Complete Care from Start to Finish: Q&A with Anaesthesiologist Nur Lubis

Volunteer anaesthesiologist Dr. Nur Lubis of the UK during the Women in Medicine: Inspiring a Generation Operation Smile medical mission in Oujda, Morocco. Photo: Jasmin Shah.

Our promise of improving health and dignity during the COVID-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

From screening to the operating room to the post-operative ward, anaesthesiologists like Nur Lubis ensure the safety and health of every patient at all phases of care.  

Born in Malaysia and now working in the U.K., Nur has attended eight medical missions including Operation Smile’s first mission comprised of all female volunteers: Women in Medicine: Inspiring a Generation.

“It’s really inspiring,” Nur said. “Working with a big group of women and learning about each other’s roles. I’m hoping that being on this all-women’s mission will enable me to empower my trainees, especially the female ones.”

For Nur, it’s the skill-sharing and collaboration between a diverse team of people who want to achieve a mutual goal that reinforce her love and devotion of a career in medicine.

“I’m always learning something new,” she said. “That’s something that I can bring back to my work in the U.K. That makes me feel really proud to be a part of the team.”

We recently caught up with Nur to learn more about participating in our women’s mission in Morocco as well as hear about special moments she’s shared with patients and their families.

Photo: Jasmin Shah.

Q: What inspires you in your profession as an anesthesiologist?

A: “Ever since I was a resident, I’ve always wanted to volunteer with Operation Smile. I actually went as a resident to a mission in the Philippines in 2012, while I was still training in anaesthesia. I had a brilliant mentor and was encouraged to continue being a volunteer once I qualified as a consultant. Ever since then, I’ve done a mission a year or two missions a year. I hope to continue being a volunteer with Operation Smile.”

Q: What keeps you coming back?

A: “What keeps me coming back is the energy and the enthusiasm of working together with different professions, also with different colleagues from all over the world. I’m always learning something new in each mission. That’s something that I can bring back to my work in the UK. Often, there’s better ways of doing things that we haven’t thought of, and working in this kind of environment is such a brilliant way to meet different colleagues and share different ideas.”

Q: How does it feel to be surrounded by so many leading women in their fields during the first-ever Operation Smile all-female medical mission?

A: “It’s really inspiring. Everyone’s making a huge difference in their little way. Everyone is able to work together in a very positive way. I think we’ve managed to work really, really well as a team. We’ve been very encouraging to each other, we’ve learned lots from each other as well. It’s been very empowering, looking at women in different areas within Operation Smile. They’re each amazing in their own way and in their profession. That’s been really wonderful to see.

“It’s a very highly skilled workforce because everyone is at the height of their career. The surgeons are fully trained and so are the anaesthesiologists. But at the same time, we’ve also got residents who are here with us. We hope to empower them as well and to be their mentors. The same with the biomed, which is usually a very technical specialty. There are usually men on the missions, and it’s great to see the two women biomeds who are brilliant at their jobs. It’s just been really amazing. There’s a lot of sharing of information, which is great and very clear communication. I think everyone’s very much rooting for each other.”

Q: Do you think the volunteers at this mission feel energetic and motivated because they’re all working toward one common goal?

A: “Yes, you can see that everybody is enthusiastic to be here. We’ve got the nurses, paediatricians, dentists that look at their teeth and the obturators. Then in the operating room, there’s anaesthesiologists, the surgeons, and the biomed tech, who makes sure all our equipment works well. Not to forget the medical records team, and they’re there to make sure that we are vigilant in recording all the information so that when they [the patients] come again for follow-up, everything’s very clear and safe.

“We’re all working together for the common goal of providing cleft lip and cleft palate surgery safely for the children here in Morocco. Our focus is to get the best care for those children and to make sure that they have a good experience, not a scary one.”

Q: The theme of this women’s mission is to “inspire a generation.” What does that mean to you?

A: “I’m hoping that being on this all-women’s mission will enable me to empower my trainees, especially the female ones, to volunteer with an organization like Operation Smile. There’s always been a lot of interest in wanting to get involved. I think it’s good being a mentor to these trainees and showing them the way to do it, that it’s possible to have a career and do voluntary work at the same time, especially if you’re a woman.

“I would say that a career in medicine is great, it’s really rewarding. It’s really hard work, but I love it. When you love your job, it’s not really a job, it’s fun.”

Q: What is it about Operation Smile missions, not just the women’s mission, that you look forward to or that really touch your heart when you’re delivering care?

A: “I think the most special moment of the mission is, two moments, really. One is when the mums or the parents give their child to you to be taken into the operating room. You can see that there are a lot of emotions there. To them, it’s a big responsibility to take the child and to keep that child safe during surgery. The other special moment, which is even better, is to hand that child back to the mum and for the mum or the parents to see that the child is okay.

“For me, it’s more the fact that the procedure is actually a very safe surgery and that can be done over a short time. It makes such a big difference to them. I think that’s what really strikes me. These kids often don’t have that option available to them if Operation Smile was not operating in their country. Giving them that opportunity and opening up the rest of their life, I think that’s something really special.”

Help us keep our promise to patients amid the COVID-19 pandemic. Your support today means we can continue to help them through these uncertain times and provide them with the surgery they deserve when it’s safe to resume our work around the world.

Photo: Jasmin Shah.

Reflection on Workplace – Lindsay

LINDSAY MISSION

NHS practitioner Lindsay explains what it’s like working on a COVID ward and how her experience on Operation Smile missions has helped her dealing with the pandemic.

Whilst attending our shift handover in the operating theatre department tearoom, I felt a strong sense of Déjà vu.

It reminded me so much of the morning meetings on an Operation Smile mission. The ‘buzz’, anticipation and the many questions being asked. Some familiar faces and lots of new ones.

As the virus became more prevalent in our workplace our shift patterns changed and our teams as well. We have been placed in teams of about 23 practitioners, Team A (that’s me!), B, C, D, E. Our shifts have also changed to 8-9 (13 hours) day and night. I recently was able to reduce my hours to part-time and so returning to these long difficult shifts is a challenge.

Just like an Operation Smile mission, when days can be long, we all keep each other going, support those who are tired or sad, play music (when appropriate) teach each other new skills, have breaks when possible and get through the shift with humour and kindness.

Safety is paramount, always. There are many human factors to consider so I am grateful for my H/F faculty training and Operation Smile for allowing me the opportunity to experience surgery in developing countries which has prepared me for this pandemic.

Instead of going into work feeling confident, I feel anxious, not knowing where I will be allocated. I am finding myself working with staff from other areas and I don’t know their strengths or weaknesses, just as they do not know mine.

We also are expected to cover shifts in ITU where full PPE is worn all day (12 hours). I am completely out of my comfort zone in this intensive environment. I admire the staff who work there. Wearing PPE for so many hours is very uncomfortable, hot and difficult to communicate.

Lindsay PPE

To identify ourselves we use stickers or tape to write our name/role on and attach them to our gowns or visors, a practise close to my heart.

I bought this excellent idea back to my workplace after my very first mission to Vietnam in 2014, back in my own department this was met with varying degrees of acceptance. However, with Covid-19 and wearing PPE this has become the norm. I hope it continues! Knowing someone’s name and role can be vital in an emergency situation.

Operation Smile has taught me to ‘make things work’. To be practical and use my common sense, get creative and to use all of the expertise in the team whilst at all times being aware of the situation and keeping our practise safe. I feel that these skills have been honed in on during this pandemic.

I am finding my position at work very tough, it’s an unprecedented time. I feel emotional and often sad, but I am coping.

On the 12th of April, John my partner and I were to be married and I should be in the Maldives on our honeymoon now! Instead I am preparing for a night shift in emergency theatre.

If I can help to fight this virus I will. As a nurse there is no question about that.

I am so looking forward to an Operation Smile mission, I cannot tell you how much I miss it and my ‘OP Smile’ family.

I send love and best wishes to you all and take comfort in your support.

Lindsay

A Frontline Hero: Remembering Nurse Carlos Armas

Volunteer nurse Carlos Armas screens a patient during a 2015 Operation Smile medical mission in the Dominican Republic. Photo: Marc Ascher.
Volunteer nurse Carlos Armas screens a patient during a 2015 Operation Smile medical mission in the Dominican Republic. Photo: Marc Ascher.

Serving as one of Operation Smile Peru’s most beloved and admired volunteer nurses, Carlos Armas leaves behind a powerful legacy etched in the hearts and minds of those who knew him.

It is with great sadness that, on June 29, we learned Carlos lost his battle with COVID-19 after bravely fighting on the front lines of the pandemic. He was 63.

His commitment to patients was deeply ingrained in his spirit of wanting to care for people in need.

“Carlitos will always teach us about passion and selfless devotion to others in need.”

Silvana Espinoza, Volunteer Patient Imaging Technician for Operation Smile Peru

Despite knowing the risks, Carlos proudly led a team of selfless medical professionals and delivered much-needed care to people impacted by the coronavirus in his country.

“I still remember my last conversation with Carlitos,” said Anyela Quintanilla, Programs and Student Clubs Manager for Operation Smile Peru. “He said that they told him he could take leave because he was part of the high-risk group, but he refused to stay home. He decided to work at his hospital’s COVID area, passionately and lovingly caring for his patients.”

Motivated to help others at a young age, Carlos began his career as a nurse technician when he was 20 years old. But deep down, he always aspired to do more in his field.

Years later, after incredible determination and effort, Carlos graduated from Universidad Ricardo Palma at the age of 50 with a degree in nursing.

With pride, he would say, “I am Licentiate Carlos Armas,” a term meaning “graduate.”

Carlos with a patient during a 2018 medical mission in Lima, Peru. Photo: Margherita Mirabella.

After becoming a pre- and post-operative nurse for Operation Smile Peru in 2008, Carlos constantly demonstrated how much he loved being a volunteer and how helping people was his greatest passion.

When the pandemic first impacted his country and his people, Carlos was fiercely determined to care for patients – even if that meant sacrificing his own health and safety.

“I’m a nurse who has started from the bottom,” Carlos said to people who asked him why he accepted the position on the COVID-19 response team. “I’m not afraid.”

Carlos wasn’t the kind of person to stand by and watch as people suffered. His selflessness shined, not only with Operation Smile Peru, but wherever he felt that he could make a difference.

“This is a great loss to Operation Smile Peru’s family. You worked with us until the end. You could have stayed home. Yet you decided to stay and continue working. You wanted to be a part of this fight.”

– Maribel Obeso, Volunteer pre- and post-operative nurse for Operation Smile Peru

In addition to the COVID-19 pandemic, Carlos provided his services to care for families affected by the 1991 cholera outbreak and devastating earthquake that hit Pisco, Peru, in 2007.

Even in the face of adversity during his time on the front lines, Carlos refused to lose hope.

“Our patients are going back home walking now,” Carlos had shared with his team. “Things are getting better.”

On a medical mission in Lima, Peru, Carlos performs a comprehensive health evaluation on 3-month-old Gael during screening day. Photo: Margherita Mirabella.

People were drawn to Carlos’ optimism and kindness, not only on the front lines but during every Operation Smile medical mission.

“They say that friends are those who stick with you through the ups and downs. And under these circumstances, you’ve become part of our family. My dad will always be in our memories.”

– Karla Armas Moreno, Carlos Armas’ daughter

While Carlos is no longer with us to help create new smiles, his impact lives on through his friends, family and patients who were touched by his commitment and enthusiasm to do what was right.

Carlos and volunteer Nidia Ruiz during a 2015 Operation Smile medical mission in Puebla, Mexico. Photo: Marc Ascher.

The Power of Passion: Operation Smile Nurses Marlene Do and Karina Olivo

Operation Smile volunteer nurse Marlene Do of Canada poses with a patient during a medical mission. Photo courtesy of Marlene Do.
Operation Smile volunteer nurse Marlene Do of Canada poses with a patient during a medical mission. Photo courtesy of Marlene Do.

Our promise of improving health and dignity during the COVID-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

When it comes to caring for a child, there are many aspects of her work as a volunteer that Marlene Do enjoys.

According to Marlene, a devoted Operation Smile volunteer nurse from Canada, the children she meets on medical missions are what keep her coming back for more.

They remind her that, despite needing to be resilient during life’s most challenging times, there are opportunities to enjoy life and smile in the smaller moments.

The stickers and bubbles that she uses to play and bond with patients during screening aren’t just for them. They can be for her, too.

Photo courtesy of Marlene Do.

Donating her time and skills as a nurse on seven medical programmes, Marlene often witnesses just how much surgery can positively impact a child’s growth, development, speech and overall quality of life.

As a patient progresses, the organisation does as well.

Out of the 51 volunteer positions on an Operation Smile international medical mission, 19 positions are filled by nurses, representing 36 percent of all our medical volunteers.

Nurses like Marlene are the only medical volunteers who actively provide care for patients at every stage of the surgical cleft care process.

“Operation Smile [provides] their patient population with comprehensive cleft care,” Marlene said. “They are provided with access to so many specialists like child life specialists, speech language pathologists, dentists and orthodontists. [The organisation invests] in the future of the countries they work in by capacity building through teaching and mentorship.”

Operation Smile volunteer nurse Karina Olivo of Canada. Photo courtesy of Karina Olivo.
Operation Smile volunteer nurse Karina Olivo of Canada. Photo courtesy of Karina Olivo.

Regardless of their subspecialty, Operation Smile nurses like Marlene and Karina Olivo possess specific skillsets and knowledge that contribute to the promise of providing every patient with the exceptional care that they deserve.

“I became an Operation Smile volunteer 10 years ago, for the same reason I pursued nursing,” Karina said. “I wanted to help bring care to those who might otherwise never receive it due to lack of access. The collaboration, learning and flexibility that allow teams to work towards the same goal never ceases to amaze me.”

Early on in her career, during her first rotation in a children’s hospital, Karina recognised her desire to become an advocate for children and their families, allowing her the opportunity to become a paediatric nurse.

Karina then began testing out different areas of the nursing medical field — from a bedside nurse to education to management — that empowered and enriched her with every experience, as both a professional and a human being.

“Nurses are the glue that hold healthcare together,” Karina said. “For many people, [they are] the only healthcare professional they will have contact with.”

With 2020 being the International Year of the Nurse and Midwife, stories like Karina and Marlene’s are the ones we hope will inspire the next generation of nurses and celebrate the people who are instrumental in changing the lives of patients and their families around the world.

Help more nurses like Karina and Marlene continue to change the lives of patients living with cleft. Your support today means that we can keep our promise to our patients and provide them with the surgery and care they need when it’s safe to resume our work around the world.

Assuring the Highest Quality of Care

Volunteer nurse and clinical coordinator Mamta Shah with a patient during a 2017 Operation Smile medical mission. Photo: Anja Ligtenberg.

Our promise of improving health and dignity during the COVID-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

When it comes to our work of delivering exceptional cleft care to people around the world, the safety of our patients has been, and will always be, our greatest priority.

As an organisation comprised of compassionate and selfless medical professionals who go above and beyond by donating their time, energy and expertise to our mission, it wasn’t a surprise when some of those volunteers expressed interest in doing more with their volunteerism.

As many volunteers voiced a desire to serve on more medical missions, Operation Smile’s medical quality team created an innovative solution: The team established a position that not only presents volunteers with more opportunities to learn and care for patients, but further strengthens and enhances our safety protocols.

Bryan Zimmerman, Operation Smile Assistant Vice President of Quality Assurance, said that the inspiration behind creating a volunteer quality assurance (QA) officer position was to continue improving upon two of the organisation’s top priorities, the safety of our patients and the quality of their surgical results. QA officers’ evaluations are designed to bolster the knowledge, practices and abilities of our medical volunteers around the world.

“The only way to effectively create a culture of safety and quality is by showing that you care,” Bryan said.

Operation Smile Assistant Vice President of Quality Assurance, Bryan Zimmerman, centre, speaks to a mother and patient during a 2019 medical mission in Antsirabe, Madagascar. Photo: Lorenzo Monacelli.

After creating the curriculum for the QA training programme, Bryan and his team received applications from more than 35 volunteers from countries including Italy, Mexico, the U.K., Australia, Norway, South Africa and the U.S.

Of that total, 11 volunteers participated in and passed the five-day tactical training and education course that took place at Operation Smile Headquarters in November and December of 2019.

Volunteer clinical coordinator Mamta Shah checks the vitals of a patient after surgery. Photo: Anja Lightenberg.
Volunteer clinical coordinator Mamta Shah checks the vitals of a patient after surgery. Photo: Anja Lightenberg.

“Simulation stations were set up that provided opportunities to touch and feel what different parts of the mission are like,” said Mamta Shah, a volunteer nurse, clinical coordinator and QA officer. “The final was a walk through, an actual chart audit and mission audit twice. This was an incredibly valuable experience for volunteers.”

Posing as staff and volunteers, actors intentionally made mistakes and missteps during the mission simulation that the QA officers would be tested to identify. They were assessed during each of the mission phases: screening, pre-operative, anaesthesia, surgery, recovery and post-operative.

For Rodney Kapunan, a volunteer pre- and post-operative nurse with years of mission experience, the QA training instilled in him a new appreciation and respect for all roles and specialties.

“Training was an eye-opener for every one of us, because even though we are seasoned volunteers with more than 10 missions and experienced in our fields, we are now tasked to oversee the processes of the whole mission,” Rodney said.

Photo courtesy of Rodney Kapunan.
Photo courtesy of Rodney Kapunan.

“Operation Smile is distinguished for being an association that follows the quality standards established,” said Rosa Sanchez, a volunteer nurse, clinical coordinator and quality assurance officer for Operation Smile Mexico. “We guarantee that patients receive good attention and give the family full security that their kids are in good hands.”

Slated to attend medical missions throughout 2020, the certified QA officers like Rodney and Rosa were ready to step into their new role and empower volunteer teams to continue delivering the highest quality of care possible.

But those plans were upended when the coronavirus pandemic began. Only two officers were able to attend their scheduled missions before Operation Smile’s decision to postpone all international travel.

As one of those two volunteers, Rodney witnessed the medical quality team’s vision come to life.

“There were a lot of great ideas that were brought forward by some volunteers during my last missions in Egypt,” Rodney said. “I reminded them that this organisation is always improving, and I love to hear their suggestions on process improvement and patient safety.”

Adapting to the pandemic, Bryan and his team now deliver online refresher courses that make sure the officers are prepared to reach their highest potential whenever it becomes safe to travel again.

But those courses weren’t the only component to transition online: Two additional QA officers received training and became credentialed through virtual training.

With a new dynamic, Bryan and his team worked diligently to create a virtual QA education course that aligned with the same goals and experiences as the in-person training.

The curriculum included informative presentations, questionnaires addressing specific concerns and a virtual fact-find of a local hospital.

Operating room nurse Amanda Stahlhut during a patient's operation. Photo courtesy of Amanda Stahlhut.

“An opportunity for me to contribute to those great efforts is an honour,” said Amanda Stahlhut, an operating room nurse who underwent the virtual training. “I pledge to not lose momentum or motivation with the current pandemic delays, knowing that this QA programme will transform how quality and safety is viewed and actioned.”

Even some volunteers like Rodney say that they are using their QA officer training to be better prepared for working on the frontline of the COVID-19 pandemic.

“Especially when I’m putting on my personal protective equipment, I always have someone double check if I missed anything,” Rodney said. “I also practice good habits in my practice to better protect myself, my co-workers, patients, guests and family from contracting the virus, thus cultivating a culture of safety.”

The 13 officers, diversified by country as well as specialty, represent a multitude of positions including a surgeon, paediatrician, bio medical technician, two anaesthesiologists and various nursing specialties.

And as committed advocates for safety and care, the QA officers also embody Operation Smile’s unwavering drive to improve and evolve in order to meet the needs of every patient.

“We all make mistakes. We can evaluate our mistakes and see how we can improve on them,” Mamta said. “Increased efficiency and safety leads to better team morale and preparedness, which then leads to improved patient outcomes, improved patient satisfaction and better quality of care.”

Photo: Rohanna Mertens.

Her Lasting Impact: Q&A with Salmah Kola

Speech language therapist Salmah Kola of South Africa, left, screens a young patient during an Operation Smile medical mission in Koforidua, Ghana. Photo: Zute Lightfoot.

The first time Salmah Kola was exposed to Operation Smile’s work, she didn’t foresee that one day she’d become a key member of the organisation.

She first learned about the organisation when the South African TV show “Free Spirit” showcased a medical mission in Madagascar. Looking back, Salmah remembered seeing the crowds of patients and families and being in awe of what was being accomplished across her beloved continent.

At the time, she was still a speech therapy student, but her now-late brother told Salmah that he could envision her doing similar work once she finished school.

And sure enough, after Salmah graduated, she was reintroduced to Operation Smile when a fellow colleague – an Operation Smile volunteer – returned from a medical mission in Rwanda. She shared stories with Salmah and talked about how it felt to be involved in something that was changing global healthcare.

“I signed up immediately! It was only after some time that I went on my first mission to the Democratic Republic of Congo, and I have not looked back since,” she said.

That decision changed the course of her life.

Travelling to Ghana, Malawi, the Democratic Republic of Congo, Madagascar and Paraguay as a speech language therapist, Salmah has spent eight years helping transform the lives and futures of children.

Providing speech therapy care to people in Africa and South America is only the beginning for Salmah. With no plans of slowing down, she aims to attend missions all over the world.

“I have been on nine missions so far, and I strongly hope that my mission career continues indefinitely,” Salmah said.

We recently sat down with Salmah to learn more about her work as a speech language therapist and hear what has driven her to dedicate her life to Operation Smile for nearly a decade.

Salmah speaks with a patient's family member during a medical mission in Ho, Ghana. Photo: Margherita Mirabella.

Q: What is your motivation to give so much of your time and effort to Operation Smile?

A: “Collaboration, collaboration and more collaboration! I have never worked in a context where a group of strangers from all over the world can come together and make such a great impact in a short amount of time. The team element that is fostered in every mission is what makes missions so appealing to me. All team members are valued, and there is always room for sharing. Beyond that, there are always local volunteers who are involved, which makes the impact of the work we do more lasting. These factors, amongst others, result in comprehensive care, which is why I’m so committed to Operation Smile. Just the mere fact that speech therapists are included in missions means that each patient’s long-term success is a priority.”

Q: Can you describe the value that speech language therapists bring to Operation Smile’s patients?

A: “Speech therapists play a vital role in many areas within the mission context, namely feeding, speech development and correction, and language development across all ages. To elaborate on one area, feeding issues are common, particularly in a child’s first few months of life. This can be a very frightening and debilitating time for parents, and without the right information and support, it can have detrimental effects. Many of the patients we see on missions in Africa come from impoverished backgrounds, and special cleft bottles are not feasible due to the lack of running water, limited safe heating systems and poor literacy to aid them in using formula. In cases such as these, we offer feeding solutions that are better suited to the child’s needs and the context. Having in-country volunteers also means that these families receive follow-up care and very often return to missions stronger, healthier and ready for surgery.

“Furthermore, speech is another main area of concern. People with a cleft palate often present speech problems, making their speech difficult to understand and resulting in bullying or being shunned by the community. Although a cleft palate surgery fixes the palate, these patients often require follow-up speech therapy. This can be a long-term need, and all patients are encouraged to return to follow-up missions to assist with their speech. During missions, the family and caregivers are counselled on activities and exercises that can be used to correct speech. With the assistance of translators, letters to the school can also be written to advise and educate teachers on the speech problem and how it can be managed.

“Interestingly, in some of the countries where I have worked, speech therapy is an unheard of profession, so much so that translators use long-winded explanations to describe what we do since the vocabulary for the profession does not exist in the native language. This means that we play a vital role in advocating for the profession and have the opportunity to see patients who, had Operation Smile not been active in their country, may never have had the opportunity to receive our services. For the field of speech therapy, this is simply phenomenal!”

Q: How do you feel that your service to Operation Smile has made you a better professional?

A: “I have and will always maintain that although going on missions means that we give and share of ourselves and our expertise, we are also very much on the receiving end. I have become a better speech therapist by having had the opportunity to work with other speech therapists with more years of experience, more mission experience and different insights than what I have. Reflecting on all my mission experiences with my fellow speech therapists from Canada, the U.K., the U.S., Sweden and South Africa, I’m fortunate to say that I have truly fine-tuned my skills, shared my expertise and developed lifelong friendships. Beyond expanding my speech therapy skills, my organisational skills have improved. When screening 100-plus patients in a day and sifting through them to divide them into appropriate groups – for example, those needing feeding intervention and those needing speech therapy – the admin piles up fast. Thankfully, this is a skill that missions have helped me hone in on.

“The impact missions have had on me as a professional are great and valued, but these are not as important as the impact it has had on me as a human being. I have been humbled to be lucky enough to be a small part of this gigantic puzzle. I’m honoured to work with people from all over the world who entrust me with something as valuable as their loved one’s feeding and communication.”

Photo: Zute Lightfoot.

Q: Which patient or family story stands out as the most memorable in your time with Operation Smile? What was so powerful about that story?

A: “Since I have an added qualification in lactation consultancy and a keen interest in feeding intervention, my favourite patient stories are often the ones surrounding the young, malnourished babies. These families often need extensive counselling and support in order for them to support their baby’s growth. Something worth mentioning is that the mothers are often proactive in supporting each other through their difficulties. So often, mothers who arrive at the mission site with healthy and thriving babies are ready and willing to assist those who are struggling. You may see them sitting in on a feeding talk, offering a shoulder to cry on or assisting with physical care of a baby to allow a stressed mother time to relax and process. This is truly one of those moments that restore my faith in humanity. I also always tell the mothers that what we know is not as powerful as what we share.”

Q: Have you been involved in training and education for Operation Smile? What is the value of providing those educational opportunities for medical professionals?

A: “Collaboration is a recurring theme here, and a by-product of collaboration for me is capacity-building and upskilling. Every single mission that I have been on has included a training component. The training is as important as the surgeries that are performed. By equipping local volunteers with knowledge and skills, we ensure that the legacy of comprehensive care continues long after we have left.

“Training means that we value the work we do beyond our own needs and wants, meaning that sustainability is of greater importance. I would love to go on missions to the same site every year, but it’s more important for me to be able to share a skill and make sure that, in my absence, patients still receive the treatment they need. The reason initiatives like the speech and dental conference are so important is because they supply a platform for us to brainstorm ideas to make sustainability of speech therapy a reality. This is where we, as speech therapists, come together and really plan how we can make follow-up speech therapy a reality and, in so doing, effect greater change.”

Q: In November, you were a part of a global team of speech language pathologist leaders who gathered at Operation Smile Global Headquarters. Can you describe that experience and the importance of bringing that group together?

A: “November’s meeting was nothing short of insightful, educational and exhilarating. The speech and dental conference afforded us with the opportunity to meet and discuss pressing issues, which are sometimes difficult to address through email or telephone. We were able to share our experiences and expertise and make future plans to further our role and our impact on missions. Speech therapy needs after surgery can be extensive and long term, and ideas such as speech camps were discussed and explored. This is just one way that we are looking at ensuring that the patients we treat get the most holistic care. The exciting thing about volunteering with Operation Smile is that the services we offer are constantly being monitored and improved upon. Working with the population affected by cleft is about more than just the aesthetic change. It’s about the changes we can make to our patients’ quality of life in the long term.”

Salmah with a young patient and his father during a medical mission in Koforidua, Ghana. Photo: Zute Lightfoot.