Celebrating the Year of Health and Care Workers

Operation Smile Nicaragua's local medical volunteers perform surgery on a patient at the care centre in Managua. The safe resumption of in-person care offers a glimpse into how medical programmes will be conducted in the COVID-19 era, informing the organisation on how to approach treating patients as conditions improve from country to country. Operation Smile photo.

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.

Throughout 2020, our world fought against an obstacle that threatened the lives and safety of people worldwide.

Throughout these times of uncertainty and fear, one factor has remained constant: the diligence of healthcare professionals on the front lines of a crisis that challenged health systems around the world.

In recognition of their dedication to providing care amid the COVID-19 pandemic, the World Health Organization (WHO) designated 2021 as the International Year of Health and Care Workers.

As a global organisation comprised of more than 6,000 medical volunteers, we’re honoured to recognise them and their talents as instrumental to the success of delivering high-quality surgical and comprehensive care to people in need.

For nearly four decades, Operation Smile has relied on the unwavering devotion of healthcare professionals including surgeons, nurses, anaesthesiologists, speech therapists, dentists and more to carry on our life-changing work.

Volunteer operating room nurse Redeat Wondemu during screening at a 2017 medical mission in Puebla, Mexico. For Red, being a part of Operation Smile goes beyond surgery. It’s a resolution for children born with cleft in low-resource countries to live happy and dignified lives. Photo: Jasmin Shah.

“The most rewarding part is that at the end of the day, I can go to sleep knowing I was able to help someone,” said volunteer nurse Redeat Wondemu. “For Operation Smile, it’s not just about making them comfortable. You’re completely changing their life, the way they grow up, and the way they’re accepted in their community.

“Whatever the role is, we do it with our whole heart. And I think that’s beautiful.”

Since March 2020, we’ve depended on them more than ever before.

Without the commitment of volunteers like Redeat to improve the health and dignity of children born with cleft conditions, we wouldn’t be where we are today.

Through these efforts, we’re proud to join the WHO in celebrating the world’s hardworking and passionate medical professionals.

Just as frontline doctors, nurses, technicians and other professionals continue to care for those in their communities, we will continue to reach and care for our patients despite the challenges presented by COVID-19.

In February 2021, Operation Smile Nicaragua carried out its first first local mission of the year, which delivered surgery to 10 patients who've been waiting for their new smiles. Operation Smile photo.

We’re continuing to work with local health leaders around the world to resume care safely at our centres and through medical missions.

After the successful completion of several missions conducted by teams of local medical volunteers in 2020, we’ve outlined a schedule of medical programmes planned to take place through June 2021.

Dr. Ruben Ayala, Operation Smile's chief medical officer, monitors a patient during a 2014 medical mission in Hanoi, Vietnam. Photo: Zute Lightfoot.

“We have watched dismayed, how the number of children needing treatment has increased during the pandemic,” said Dr. Ruben Ayala, Operation Smile’s chief medical officer. “Understanding the enormity of the challenge, we have pulled together our knowledge, people and resources. Our leaders around the world have laid out country-specific plans for adapting, evolving and creating environments where care can still be delivered safely.

“Cautiously, but optimistically, we carry on the work where possible, sending a clear message to our patients that, in spite of the pandemic, we have not abandoned them, and we never will.”

Regardless of how the pandemic slowed our care delivery on missions, our local teams continue to serve a role in the fight against the pandemic, displaying their commitment to changing the lives of patients in their home countries who still need them.

Marijose Kapunan and her husband, Rodney, have volunteered on more than 25 Operation Smile medical missions and are just two of thousands of our volunteers who are serving their communities during the pandemic. Photo courtesy of Rodney Kapunan.

Marijose Kapunan and her husband, Rodney, have volunteered on more than 25 Operation Smile medical missions and are just two of thousands of our volunteers who are serving their communities during the pandemic.

“We nurses are in the front, centre and back in the fight against this global pandemic,” said Marijose, an Operation Smile volunteer nurse and frontline healthcare worker in Jacksonville, Florida. “Nurses are valuable assets in formulating plans and processes to better manage the disease and prevent future outbreaks.”

Although medical missions were temporarily suspended in 2020, Operation Smile staff and volunteers around the world refused to stand aside in the face of adversity, devoting time and energy to providing care in any way they could.

We were forced to reevaluate our normal practices of delivering care in order to push forward and seek out new and innovative opportunities to reach the patients who need us.

A patient from Nicaragua receives a virtual follow-up speech therapy care consultation from Operation Smile volunteer speech therapist. Operation Smile photo.

Our organization began utilising technology to provide patients with virtual speech therapy and psychosocial consultations, essential aspects of a patient’s comprehensive cleft care.

It also provided virtual education and training opportunities for health workers in low- and middle-income countries so they could better fight the virus.

Volunteers and staff working in care centres throughout Latin America created an opportunity to come together and provide much-needed virtual care, ensuring that we kept our promise of caring for patients and their families amid lockdowns and country restrictions.

The lengths that our volunteers will go to serve patients underscores the calibre of people donating their skills and expertise to Operation Smile.

Longtime Operation Smile volunteer speech pathologist Milagros Rojas of Peru during a 2019 medical mission in Lima. She brings years of experience to our local Latin America teams. Photo: Margherita Mirabella.

“I want to give thanks to those who made this opportunity possible,” said volunteer speech pathologist Milagros Rojas. “COVID was not a limitation, because anything is possible when things are done with humanity and infinite love.”

Today, Operation Smile volunteers continue to risk their own safety to serve their communities as the pandemic persists.

We’re extremely proud to work with passionate, talented health and care workers who care deeply about the patients and families they serve, whether it’s halfway around the world or right there in their home communities.

Volunteer plastic surgeon Dr. David Orr, left, performs surgery as students observe during a 2014 surgical training rotation in Jimma, Ethiopia. Photo: Jorgen Hildebrandt.

We know that professionals in hospitals, care centres and clinics around the world will continue putting the health and safety of their patients first.

There couldn’t be a more fitting time to declare 2021 as the Year of Health and Care Workers.

“Operation Smile changed my life,” said volunteer Jackeline Nuñez del Prado. “I thank God for giving me the opportunity to be part of the foundation that I love with my life. I’ll always be grateful for being part of the magic of creating smiles in the lives of patients and in my life as well.”

Join us as we celebrate 2021 as the Year of Health and Care Workers. The compassion and commitment of our volunteers are what enable us to continue keeping our promise to patients amid the COVID-19 pandemic. Your support today means we can help children living with cleft conditions through these uncertain times and provide them with the care and surgery they deserve when it’s safe to resume our work.

Volunteer nurse Jackeline Nunez del Prado of Bolivia screening a patient during a March 2020 medical mission in Oujda, Morocco. Photo: Jasmin Shah.

Speech therapy programme “HablemOS” helps thousands across Latin America

Operation Smile Nicaragua's care centre in Managua was the first centre to reopen its doors to patients amid the pandemic and began providing a mix of in-person and virtual consultations. Photo: Operation Smile Nicaragua.

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.

Despite the unprecedented challenges the COVID-19 pandemic brought to our medical programmes and care delivery, we’ve refused to stand aside in the face of this adversity.  

Volunteers and staff working in care centres throughout Latin America found an opportunity to come together to make sure that we kept our promise of caring for patients and their families amid lockdowns and country restrictions.

For patients born with cleft lip and cleft palate, speech therapy before and after surgery is an essential component of comprehensive cleft care.

Most of this ongoing work was done in person with patients at centers, but with the impact of the pandemic hitting countries worldwide, providing this care suddenly became impossible.

Operation Smile Regional Director Lizet Campos. Photo: Jasmin Shah.

Working closely with her fellow regional directors, Operation Smile Regional Director Lizet Campos created the concept of the programme called “HablemOS,” a play on words meaning “let’s talk” in Spanish with the capitalised “OS” at the end of the word symbolising Operation Smile.

Cleft conditions can make eating extremely difficult, so speech therapists oftentimes conduct consultations soon after a child is born, providing families with advice on how to properly feed their child.

Hundreds of patients have received speech consultations at care centres in Managua, Nicaragua; Asunción, Paraguay; Bogota, Colombia; and Caracas, Venezuela. Photo: Rohanna Mertens.

Speech therapists also provide patients with palate-strengthening exercises before surgery that help improve the procedure’s outcome. As a child grows and begins to speak, their ongoing care helps patients be able to speak more clearly.

In collaboration with our medical oversight team, speech council, programme manager Mauricio Rojas of Mexico and programme coordinator Maria Cristina Galindez of Venezuela, Lizet and her team implemented HablemOS in mid-August of this year.

With the support of Operation Smile Sweden and generosity of the Swedish Postcode Lottery, Lizet and her team have a fully funded programme that they hope will show patients and their families that Operation Smile remains committed to them despite the current global challenges.

“So far, the programme is proving to be a resounding success,” Lizet said. “To date, our teams in Latin America have delivered speech consultations to more than 3,200 patients. There’s also an in-person component, as 629 of the consultations were given at our care centres in Managua, Nicaragua; Asunción, Paraguay; Bogota, Colombia; and Caracas, Venezuela, though this continues to be conducted on a much more limited basis than the virtual therapy sessions.”

Volunteers and staff feel inspired by the deepening of the organisation’s investment in speech therapy, which is critical to helping our patients live dignified and fulfilling lives.

Longtime Operation Smile volunteer speech pathologist Milagros Rojas of Peru during a 2019 medical mission in Lima. She brings years of experience to our local Latin America teams. Photo: Margherita Mirabella.

The HablemOS team is honoured to lead the way in developing a programme that has the potential to be replicated and implemented everywhere that Operation Smile works.

“Just imagine, in these sessions, through songs and stories, we can make our little ones exercise their speech abilities and keep them from finding it tedious,” said volunteer speech pathologist Milagros Rojas. “Instead, these sessions turn into play sessions.”

Knowing that many patients’ families had access to either internet-connected smartphones or computers, speech therapists were contacting families and resuming or beginning virtual consultations within weeks for hundreds of patients while the doors of the centres remained closed to the public.

If families lacked internet access, therapies were delivered over the telephone as well.

With a lack of certified speech therapists like Milena Cleves in Latin America, the HablemOS program provides opportunities to increase the number of qualified therapists in the region. Photo: Marc Ascher.

“There’s a lack of certified speech therapists throughout the Latin America region and in many other low- and middle-income countries,” Lizet said. “So we knew it would be critical to offer training and education opportunities to speech therapy providers so that more – and more qualified – therapists can deliver care to more patients.”

Working together with the Mexican speech and language therapy non-profit Hablarte E Integrate, the training and education portion of the programme has enrolled 61 speech therapists from 13 Latin American countries.

“Although we’re professionals, we can always grow in knowledge,” said Operation Smile Panama volunteer speech therapist Alina Navarro. “I’m delighted to be acquiring a new perspective. In terms of mentoring, it’s been useful to discuss the cases together with other professionals.”

The HablemOS programme team feels driven to keep delivering much-needed speech therapy care to patients as the world continues to cope with the effects of COVID-19.

“I want to give thanks to those who made this opportunity possible,” Milagros said. “COVID was not a limitation, because anything is possible when things are done with humanity and infinite love.”

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.

HablemOS team member and programme manager Mauricio Rojas, left, shares a special moment with Jonathan during a 2019 medical mission in Mexico. Photo: Rohanna Mertens.

Ensuring Healthier Lives Through Nutrition: Q&A with Charlotte Steppling

Operation Smile's nutrition programme manager Charlotte Steppling. Photo: Rohanna Mertens.

As our nutrition programme manager, Charlotte Steppling has seen first-hand how lacking proper knowledge and guidance on nutrition can have a devastating impact.  

Years ago, while aiding patient recruitment efforts for Operation Smile medical missions, Charlotte came to a startling realisation.

“We were turning away patients suffering from malnutrition,” she said. “I was waiting to see these kids show up at the next mission, but they just weren’t coming back. They were dying, and it broke my heart.”

Children born with cleft conditions often face major challenges with feeding and receiving proper nourishment during the critical months after they’re born. These factors can lead to malnutrition, delays in growth and development and sometimes even death.

“What if we had come in contact with them earlier or what if we had a strong programme through Operation Smile Madagascar a year prior?” Charlotte often asked herself.

Operation Smile knew that in order to uphold its promise of delivering high-quality, safe surgical care to as many patients as possible, nutrition needed to become a priority.

Due to the compassionate individuals like Charlotte who’re devoted to helping bring nutritional support to the forefront, specialised programmes have been established in 24 countries including Madagascar, India, Ghana and Guatemala, where more patients’ lives are being saved through timely intervention and dietary education.

“We need to reach these patients as early as possible,” she said. “Whenever a patient is born with cleft, they should know that Operation Smile exists.”

We recently spoke with Charlotte to learn more about the future of Operation Smile nutrition programmes as well as why it’s crucial for children living with cleft to be well-nourished before they can receive surgery.

Charlotte speaks to participants in the feeding programme at the patient shelter during a 2018 Operation Smile medical mission in Antsirabe. Patients who aren't chosen for surgery because they're underweight or malnourished are invited to join the feeding programme. For three days, parents and children attend educational workshops about hygiene, health and nutrition. Photo: Rohanna Mertens.

Q: Charlotte, can you tell us a little bit more about how you found yourself in this role as Operation Smile’s nutrition programme manager?

A: “I arrived in Madagascar in 2013 to serve as a Peace Corps volunteer. In the village where I lived, I came across numerous children and adults living with untreated cleft lip and cleft palate. I realised there were numerous barriers to care including the lack of knowledge of and access to medical care. They were unaware of the opportunity to receive care and the potential to be evaluated by a medical team with the hopes of receiving free surgery. The idea was unfathomable to them: ‘Free surgery? Free care?’ As I explained to the potential patients, I spoke about Operation Smile and gained their trust, we travelled to the capital city, Antananarivo, and met the Operation Smile team.

“After three years of service with the Peace Corps and throughout three years spent recruiting more than 70 patients from a remote village in Madagascar, the local foundation offered me an opportunity to join their team. I was based in Antsirabe, a central highlands city and worked at the local hospital Operation Smile had partnered with.

“Here in Madagascar, there’s less than one physician – 0.18 actually – for every 1,000 people, which makes access to healthcare challenging. Nutritionists are a rarity. Antsirabe is located in a region that has a stunning rate of malnutrition at 65%, the highest rate in Madagascar. Interestingly, this region is also a prominent agriculture hub and the main producer of vegetables and cattle.

“It’s hard to make a child gain weight, and it’s really challenging when you are dealing with a ton of different variables. I believe increasing knowledge around nutrition, around the first 1,000 days of life, around healthy habits and adopting a hygienic environment, is essential.”

Children playing outside of the nutrition centre (unaffiliated with Operation Smile) Charlotte established to help patients and families overcome barriers to care. Photo: Zute Lightfoot.

“This motivation to make change, to make a difference in the lives of the most vulnerable, propelled me to open a non-profit to fundraise a nutrition centre in Antsirabe. We opened this nutrition centre (unaffiliated with Operation Smile) in 2017 and offered care to patients living with cleft conditions and those living without them. I could not stand to not make a difference. I could not sit back and not act.

“At Operation Smile in Madagascar, we decided to build a nutrition programme to cater to patients suffering from malnutrition. The programme paralleled the medical mission timeline, and we asked patients who were assessed as malnourished to stay at the patient village for a couple days.

“We built a programme based on education around breastfeeding, the promotion of healthy foods and nutrition, and the importance of water, sanitation and hygiene. We used in action activities to teach and empower families on how to adopt healthy behaviours that could make a lasting change in the lives of their children. We provided our patients and their families with donations of ready-to-use-therapeutic food (RUTF) and breast milk substitutes.

“Through follow ups, we noticed weight gain. Through interviews, we identified changes in the behaviour of caregivers. We were thrilled to see patients that were following the nutrition programmes were coming back for medical screening and cleared for surgery. I fully believe that, currently seeing the status of the world, we have the due diligence and the need to intervene on a nutritional level as an organisation.”

At the patient shelter, participants in the feeding program listen as Charlotte talks about the importance to food diversification, nutrition and breastfeeding techniques. Photo: Rohanna Mertens.

Q: Tell us why adequate nutrition is so critical for children who are born with cleft conditions?  

A: “To receive surgery, you need to be at a healthy nutritional status. At Operation Smile, we have very high standards around who is cleared for surgery. All of our patients are candidates but being cleared for surgery is a very different topic. You have a lot of parents who are feeding them whatever they can, whether that’s watered-down rice water, condensed milk mixed with water or some type of porridge or stew.

“Then you have babies who’re having challenges latching or mothers who are having challenges breastfeeding. That’s where Operation Smile is focusing on prioritising mother’s milk as the first intervention. Mother’s milk is free and full of nutrients, so if we can somehow get mother’s milk to the baby, then that is the best option.

“Then you have babies who are essentially dealing with malnutrition because, a lot of times, the parents aren’t aware of nutritional diversification and food diversification. So, we teach them about food that’s accessible, available and affordable to the patient’s family.

“We work with communities through our local teams to figure out what is available, then think about innovative ways to include high-protein density foods and provide a balanced diet so that patients are well-fed and well-nourished. The patients’ caregivers are also well-educated and feel empowered that they can provide for their children.”

Charlotte watches as 12-year-old Frederic sees his mother, Celestine, for the first time after surgery. Photo: Zute Lightfoot.

Q: Is there a moment or a specific patient who really illustrates why you’re passionate about this?

A: “There was a patient with a bilateral cleft lip and cleft palate. He was maybe 4 months old when he first came to our medical mission. I had met his mother, and she was doing everything she could for her little boy. She was having challenges breastfeeding him because she was no longer producing milk and during the early months didn’t have the opportunity to receive counselling on relactation techniques. The baby was very hungry.

“At that time, I had opened up the nutrition centre, and she was one of its first members. Her son was part of the programme, and he was receiving RUTF through Operation Smile and breast milk substitutes as well. His mum also received meals, because it was apparent that she was having difficulties feeding herself.

“Then one day, he wasn’t feeling good. We brought him to the hospital in Antsirabe, and he was put in the paediatric ward, monitored over two days. His system just let go, and he didn’t make it.

“I often keep him and his mum in my thoughts when I design programmes. What if we had come in contact with them earlier? What if we had a strong programme a year prior to him being born? He could have come into the programme, and we could have intervened earlier and made a difference in his life. I never want another mum to feel that way or deal with the death of a child due to malnutrition when that’s something we can help with.”

Q: What’s happening right now with regard to nutrition programming that you’re most excited about?

A: “It’s an exciting time for nutrition and Operation Smile’s comprehensive care programmes. Currently, our team is working on building a resource library for our programme countries to feel more supported when it comes to building and designing nutrition programmes. We’re also creating a curriculum for training, having a credentialing pathway for nutrition volunteers and building training sessions for community health workers and caregivers. Working closely with our local teams, we’re striving to ensure that the information is country- and culture-specific based on what food groups are available and what recommendations they would like to make about nutrition and feeding.

“We’re also finalising a comprehensive nutritional assessment that will assess the nutritional status of a patient suffering from malnutrition and building a platform to track their progress. This assessment will allow the nutritionist in country or nutrition volunteer to properly provide the necessary prescription of care for the patient.”

Photo: Zute Lightfoot.

Q: Could you tell us a little bit more about your vision for the future? What are the main challenges in light of the pandemic? What’s the potential that we can see through these programmes?

A: “With the current pandemic, we are looking into innovative ways to run our programmes virtually. In countries where our patients live in extremely remote locations with no access to electricity, we are finding solutions on how to reach patients as early as possible. In Madagascar, we use patient advocates. We train community members to deliver messages around nutrition and feeding, water, sanitation and hygiene to get as close as we can to the patient in a trusted manner.

“When I look at a long-term vision for nutrition programmes for Operation Smile, I believe nutrition interventions and activities are going to take a forefront for a lot of our countries. COVID-19 has had a significant impact on childhood malnutrition and nutrition-related mortality. It’s had a detrimental impact on the general population, but the effect it’s having on people affected by cleft, who already have challenges feeding, is even more substantial.

“We need to act now. This is our time as an organisation to step in and make a change in the lives of our patients, in some ways saving their lives, providing them hope, and supporting them in these extremely difficult times.”

Photo: Rohanna Mertens.

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

Marijose Kapunan and her husband, Rodney, have volunteered on more than 25 Operation Smile medical missions and are just two of thousands of our volunteers who are serving their communities during the pandemic. 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.