Every child has a story. Most have come from the highlands of Peru or the Sierra, days away by bus. The front cover of every story reveals a tender little face, marred by an abnormality that would, if not corrected, dictate the rest of his/her life.
Through the generosity of those who donate to Rotaplast, doctors, nurses and non-medical alike, these abnormalities are being corrected. Children are given a chance to grow beyond the stigma which their abnormality carries.
Over all, this Rotaplast mission performed approximately 90 procedures on nearly 70 patients. Most, like Gina, are too young to understand the necessity of treatment.
But each time she smiles her mother will always remember Rotaplast and the gift given by the generosity of strangers.
Of course the cleft lip repair can make a dramatic difference in a child's life. In an hour and a half, the skilled hands of a plastic surgeon, with the help of the Rotaplast team, can change a little girl or boy's destiny from being shunned by family and society alike, to a normal-looking, smiling, laughing, playful child who is ready to take on the normal challenges of everyday life.
There are results everyone can see. We can witness the transformation, and the inevitable "oohs and ahhs" in the recovery room remind everyone why we travel thousands of miles to do this rewarding work.
However, the cleft lip repair is only part of the work we do during a Rotaplast trip. In addition to the "glamorous" restoration of the cleft lip, the plastic surgeons spend a great deal of time with our hands deep in a place barely visible to even our scrub nurse in the operating room. Our big fingers and hands work in a cavity barely a few inches in diameter, like a craftsman assembling a ship in a bottle. A cleft palate is a split or separation in the "roof of the mouth" which is also the floor of the nose. The cleft can involve the bony "hard palate" which also serves as a foundation for the teeth, and/or the soft palate, located way in the back of the throat, which also is connected to the uvula, the small fleshy "little tongue" that hangs in the back of the throat, the small piece of flesh subject to some folklore and mystery.
The child with an un-repaired cleft palate can suffer from a variety of maladies, from the aforementioned dental misalignment, poor nasal-oral hygiene, frequent ear infections that can lead to hearing loss, and most importantly and dramatically, poor speech that in some cases can be almost to impossible to comprehend. These children can be reluctant to raise their hands in school, refuse to converse, and be mistakenly considered to be unintelligent because of their reluctance. They can be subject to intense ridicule and bullying because of their reluctance of speech itself, which can lead to isolation, typically expected for the patien with an un-repaired cleft lip.
It is for these reasons why the plastic surgeon will lean and bend into this small cavity in the back of a baby's mouth, for hours at a time, tolerating suboptimal lighting, room temperatures, and noisy suction machines, performing a relatively misunderstood and unglamorous operation to rearrange the tissues responsible for speech. It may be a Z-plasty (furlow) repair, a pushback method, an intra-velor veloplasty, or even an operation on the back of the throat itself, called a pharyngoplasty. These back and neck stretching operations are all designed with the same outcome in mind; to restore a child’s ability to speak.
It is a gift that cannot be pictured on a poster or in an ad and shown at fundraisers. It doesn’t easily lend itself to a "before and after photo" during a report to supporters, it is not described by a catchy phrase like "saving smiles," and at times these palate operations take a backseat to the cleft lip repairs. However, it is a gift that can make it possible for a child to speak clearly to his parents about his wants, answer a question in school with confidence, or one day give a speech that can move the audience, or actually one day in the future reveal what is truly in her heart - it is the gift of speech.
I planned to write about a typical surgical day of a Rotaplast mission. The truth is, there is no typical day. Each day presents different challenges, new patients, and changing surgery schedules. Everything is not exactly on time or at the ready; and we adapt. Everyone on the team has a job to do. Each morning when we step on the bus at 7 am we know the key to a successful day will be to be flexible.
At the hospital, pediatricians do rounds, surgeons check on their patients, and the ward coordinators account for each patient and ensure they have their medical chart ready to go. The head nurse reviews and revises the schedule while the anesthesiologists and nurses prepare the ORs for the first surgeries of the day. Each day we utilize three operating rooms from the time we arrive until approximately 6pm or 7pm. The recovery team remains at the hospital until the last patient of the day has moved to the ward floor.
Throughout the day there is a buzz of activity as children are brought into the OR, transported to recovery room after surgery, and finally the moms, dads, or in many cases grandmothers are brought in to comfort their child.
Today, our 6th day of surgery we had another in-take. Reison is a sweet 5-month-old child with a bilateral cleft lip. He and his family live in southern Peru. He is here because his grandfather saw TV coverage of the Rotaplast mission to Peru. Reison will have surgery tomorrow; our last surgical day of the mission.
By the fifth day of surgery we’ve evaluated 112 patients; 78 at the opening clinic and 34 as walk-ins during surgery days. One of those walk-ins on day four of surgery was Luhana. Luhana is plagued by the same type of cleft abnormality as her mother was born with. Her Mom’s cleft was corrected when she was 6 years old. Luhana is 3 years old. She came to Rotaplast because her grandfather watched our press conference on TV when Rotaplast first arrived in Lima. Though Luhana lives in Lumbayeque province, she and her parents traveled the 15 hours to get here. Luhana will have her operation today.
I give thanks to God for giving you and your team of surgeons these wonderful hands. I will eternally be grateful for your surgical intervention for my daughter Lissette and for giving her the most beautiful smile I have ever seen.
Appreciatively, please accept this little gift,
The gift Hadie enclosed was seven 1 sol coins each with a different symbol on the back; much like the USA issued state quarters.
We've completed three days of surgeries and changed the course 25 young lives. While the majority of Rotaplast patients are children, we do see the occasional young adult who's life would be positively impacted by a surgery that could not be possible without Rotaplast.
Grecia was abandoned by her mother at the age of 2 ½ months. If a child is born with a cleft facial abnormality, they may be socially stigmatized, their family punished or they may simply lack the same attention and care as other children as a result. The child may be kept in the shadows of society; locked away from view and hidden by his or her family. In Grecia's case, she was left to her husband’s sister, Nellie. Nellie took the baby and loved her. Grecia grew into a young woman of 21 and dealt with a lifetime of eating difficulties. The food she put in her mouth would fall out of her nose due to the gaping hole. Her young life was spent being teased and tormented by others who saw this. Yet she persevered and entered nursing school until someone told her that she could not become a nurse with food falling out of her face. She left nursing school embarrassed and humiliated. She made a wish to get her cleft palate repaired by her 22nd birthday.
Soon after that wish, a neighbor saw an advertisement for Rotaplast on TV the day after our team landed in Lima. Nellie and Grecia packed their bags and were on a bus to Lima that very night from the north coast of Peru.
Lissette was born with a cleft lip. Although her mother, Haide could not afford surgery for her baby, she was not going to give up nor trust just any foundation to operate on her child. A former student of social work, Haide researched the foundations that offered free surgery. She chose Rotaplast because of our reputation and results. Rotaplast has been coming to Peru for five consecutive years. Lissette will receive a surgery that will take approximately 1 and 1/2 hours and will change her life forever.
Leonel Atpoma Chumbe was born 4 months ago with a right unilateral cleft lip. His mother, Doris, 20, heard a radio advertisement promoting this Rotaplast mission to Lima. Although they live in a mountain province called Huancayo, they traveled the 8 hours in hopes Rotaplast could help Leonel. We will. One and one half hours of surgery will change Leonel's life forever.
Andre, 5 months old, lives with his parents and seven siblings in Chucampa province, 12 hours away from Lima. They were unable to get to Lima for opening clinic. We evaluated Andre on the first day of surgery. He is in need of a right cleft lip repair. Andre was scheduled for surgery for the next day.
Eydam is a beautiful boy of 4 years old. He looks like a normal little guy but inside his month Eydam needs a repair to his soft palate so he may eat normally. Eydam will receive surgery; one and one half hours later, his life will be changed forever.
Our team returned to the hospital Wednesday, January 11 to conduct opening clinic. A crowd of families gathered by the clinic door, waiting for the chance to have their child seen by Rotaplast.
I recognized the family of Luis-Augusto who were at the press conference. Luis is a happy 6-month-old baby with a bright smile. Unfortunately his smile is obstructed by a cleft lip. Luis-Augusto comes from Cajamarca, Peru approximate 8 hours away by bus. His soft-spoken father said they heard an advertisement about Rotaplast coming to Lima on the radio and hoped that Rotaplast could help their son. While in Lima, the family will stay at a local hostel provided by Club Rotario El Rimac.
At clinic, children are evaluated by our team surgeons, anesthesiologists, and pediatricians. Team nurses record vitals. An evaluation is then made on whether the child is a candidate for surgery. Overall, we evaluated nearly 90 children. As usual on a Rotaplast mission, new families will seek our help throughout the week to come.
Twenty-seven medical and non-medical volunteers touched down in Lima, Peru Monday, January 9th at 10:50pm to begin a two week Rotaplast medical mission that will change the lives of children and families forever.
Over the next couple of weeks, our team will be faced with logistical challenges, schedule shifts, and at times, uncertainty. The key to a cohesive team is to remain flexible, accommodating, and focused; eyes on the prizes, as they say. The prize here being the lives of the children we will come to know and love.
By 3:00am our team, along with help from our host Rotarians, Club Rotario El Rimac, managed to get all our boxes through customs and arrived safely, albeit a little tired, to Hotel Exclusive San Agustin.
A tour of the Hospital National Arzobispo Loayza by Dra. Margarita Marchino, our host plastic surgeon, and Dra. Margot Escobedo, a dentist and our local Rotarian Coordinator, was the order of the day during day two. Upon arriving at the hospital we were greeted with the opportunity to participate in a press conference through PeruTV News channel 7.