Chinese is an opaque language. Instead of an alphabet they have several thousand characters. Each character represents a different word. For example over an exit sign there are four characters, which mean safe exit, but individually the four characters have a different meaning. There is no chance that an English speaker can guess a printed word’s meaning. Our team is dependant on our translators in order to function. On a medical mission there is no room for error, so everyone has been vigilant to be sure they are understood. For everyday communication pointing, gesturing, and smiling has become an important part of our communication.
Today started cool and cloudy, with smog. Now we have sun and smog. Three operating rooms, and 17 surgeries on the docket, make for another long day. Our ward has 38 beds total for pre O.P. and post O.P. Today we hit max occupancy with 38 children plus all the family members so we are adding several cots. It will be a full house tonight.
I sat in while Marlene our team speech pathologist interviewed a 19 year old young man. He has soft palate issues that currently let most the air in his speech escape through his nose. The result is a soft nasal voice without definition between syllables. He works and lives at home with his parents. In China there are more boys than girls, so the girls can be choosy. I spoke with his parents after they ducked into our break room to dodge the media. They wanted to show their thanks by presenting us with a banner which thanked Rotaplast for helping their son. Since their son is a young adult they do not want him to be used by the media for publicity purposes. How refreshing! So I will just call him 163. He is a strapping young man, and stands well over six feet tall. I told his parents that I wished for a successful surgery and that he would find a pretty girl. At last word the surgery went well and he is in the ward now.
Back to work. By the second week even the non-medical volunteers know what a Dingman clamp or a fistula is. This afternoon Dr. Granger is going to be the surgeon for a little boy named Jia Hao. He has what is called a bilateral lip, meaning it is split in two places. A single tooth projects beyond the gap in his lips. Nan explained to his mother that the next time she saw her son he would look different, and sometimes a parent will get used to the appearance of their child with the cleft. The mother smiled and said she was looking forward to seeing him without the cleft.
One can only imagine the anxiety a mother has while she waits to see her infant after surgery. I was in the recovery room when Jia Hao was wheeled into recovery, and his mother came to see her son. Little Jia Hao had an extensive procedure to rejoin the huge gap in his lip. Mom was upset when she saw her child with all the swelling, and discoloration that accompanies this type of surgery. Mom is only 24 and this is her only child, so she may have had different expectations. Everyone tried to comfort her, but we needed to get our translator to tell her that the swelling would subside, the natural color would return.
Dr. Granger arrived at the team hotel at dawn, so we will run three OR’s today. The hospital is very large with the ward on the second floor, and the OR on the 5th floor, and Michelle’s orthodontic workroom on the 4th floor. A convoluted five minute walk will get you from the ward to the OR. More than a dozen members of the Chinese media arrived today to follow the story of 4 year old Lipling Wang. Lipling is an orphan who was abandoned at birth by her parents because of her cleft lip. She was adopted by the woman you see in the attached picture even though she had a daughter of her own and is 80 years old. Lipling lives in a small village in the mountains several hours from here. Lipling brought a bunch of yellow wildflowers that she had picked from her yard to present to her doctors. Lipling was a favorite of our team before she became famous in the local media with an open smile, and gregarious personality that transcends the language barrier. I spoke with Lipling’s grandmother, and I asked what she wanted for her adopted daughter when she grows up. Her response was, “to be a doctor!” Why not?
The weather has been very pleasant with blue skies and high temperatures in the 70’s. Our first day of surgery started early with two operating rooms as Dr. Granger is still in transit from the United States. Most of the cleft lip procedures are revisions as most of the children had prior surgery. Marlene, our team speech pathologist, examined a girl named Jinxlao who required palate surgery. Jinxlao’s open palate reduces her ability to speak. Her voice is very soft and when you can get her to talk she talks like a six year old. Your heart goes out to think she has not been able to express herself like other children her age. I spoke with her father with the help of a translator. Her father said she is not a good student, which is not a surprise considering her limited ability to talk. On a brighter note, our head nurse Sandra who has been on 10 missions reported that it was a good first day overall. The 10th and final surgery of the day left the ward by 6pm.
Today is pre clinic day, and the day we meet the children. The dedication and commitment of all the team members is obvious as everyone gets to work. It is amazing to see our team in action, with efficiency, and good humor the team reviewed 162 children before the day was over. Our team quickly bonded with the children, and the children responded with big grins, and friendly waves.
Following a team meeting and breakfast we boarded a bus for the short ride to Shijiazhuang First Hospital. Shijiazhuang First Hospital is a 1,100 bed facility. We experienced a warm welcome at a ceremony attended by the Rotaplast team and over 50 hospital staff members. This was followed by a tour of the ward and operating areas. Over 60 were present for a joint meeting of hospital and Rotaplast staff. Dr. Tomlinson, our Medical Director, discussed our procedures and emphasized the importance of communications. We were treated to a lunch by our hosts at the hospital.
I consider Day one as the day we meet the children, and day zero as the travel day. For those team members that started in Philadelphia, it was a 43 hour day. Our full team assembled in San Francisco for the flight to Beijing by way of Hong Kong. All the team members had plenty of time to bond with each other at the airport between flights. We cleared customs in Beijing and boarded our bus for the four hour ride to Shijiazhuang. We had a pleasant surprise when we found that the seats actually reclined far enough to sleep. We arrived in Shijiazhuang at the peak of rush hour and were accorded a police escort to clear traffic ahead of us. Upon arriving at our hotel we enjoyed hot showers and beds for the first time in two days.