Meet our patients: Nicaragua

Jimena, 11 months old, received her new smile during Operation Smile Nicaragua's first medical mission of 2021. 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.

Marling arrived at Operation Smile Nicaragua’s first local medical mission of 2021 with her 11-month-old daughter, Jimena.

As Jimena went through the screening process, Marling was cautious but tried to remain hopeful.

This wasn’t the first Operation Smile mission Jimena and Marling had attended.

Even from the beginning, the journey toward a new smile for Jimena was long and often filled with heartache and disappointment.

None of Marling’s prenatal check-ups indicated that she should be concerned with the development of her baby.

It wasn’t until Jimena was born that everything changed for Marling.

“When my little girl was born, the doctors told me she had cleft lip,” said Marling, thinking back on the day. “This was unexpected. But they said there was a foundation that provided free surgeries for children with this type of condition.”

Marling’s doctors were talking about Operation Smile Nicaragua.

Two months after Jimena was born, Marling travelled to Operation Smile Nicaragua’s care centre. But at that time, the COVID-19 pandemic had already hit the country hard.

“I got to the centre, and I was told it was closed,” Marling said. “I only wanted information about my daughter’s condition.”

Despite the centre’s temporary closure, the local volunteer team knew there were patients like Jimena who still needed care.

The courageous volunteers and staff created opportunities to ensure that they could still reach patients and families even though they were physically apart.

“They offered me the option of virtual consults,” Marling said.

The medical volunteer team followed up with Jimena and her family digitally until the day when it was deemed safe to resume in-person consultations.

“I felt welcomed when I visited the centre,” Marling said. “The doctors gave great service and gave my daughter a small disk that helped her for feeding.”

With this additional care, Jimena’s health continued to improve while her mother’s hope grew stronger.

Following strict health guidelines and safety protocols, Operation Smile Nicaragua announced that it would host a small-scale local mission in October 2020.

After learning that Jimena was a candidate for receiving surgery during that mission, Marling didn’t hesitate to make the journey.

However, an unforeseen health issue arose on the day of Jimena’s surgery that prevented the volunteer medical team from going through with the operation.

But even after Jimena’s surgery was cancelled, Marling didn’t lose hope that her daughter’s smile would one day be healed.

In December 2020, it appeared that Jimena’s second chance was within her grasp.

But surgery evaded Jimena once again.

After contracting a fever, she and Marling were informed by medical volunteers that undergoing surgery was too unsafe. Jimena’s family returned home disappointed but more determined than ever.

Jimena is ready to enter the operating room during Operation Smile Nicaragua's local 2021 medical mission in Managua. Operation Smile photo.

With her mother’s support and perseverance, Jimena arrived at Operation Smile Nicaragua’s first local mission of 2021.

After a comprehensive health evaluation, nothing stood in the way of Jimena and her brighter future.

She became one of 10 patients to undergo their long-awaited surgeries during the February mission.

“I feel happy because my daughter received her first surgery,” Marling said. “I thank those involved that made my daughter’s smile possible.”

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.

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.

“Some Day” Finally Arrives for Seth

Seth, before surgery. Photo: Margherita Mirabella.

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.

In Ghana, a country known for having deeply rooted and widespread social stigma surrounding cleft conditions, many people like Seth endure lives filled with pain.

Constantly living in isolation and being fearful of harassment from members of their communities, some people affected by cleft grow up feeling hopeless and unworthy of love or happiness.

Lacking awareness of the cause of cleft conditions, people in Seth’s community often insulted him. In school, he struggled to make friends and would often choose to skip break time with hopes of avoiding the harmful treatment from some of his classmates.

Throughout his childhood, Seth frequently asked his mother, “Why am I like this?”

Born with a cleft lip in rural Ghana, neither Seth nor his mother knew that there were organisations like Operation Smile devoted to helping people like Seth.

The years following his childhood were full of dark times for Seth.

Believing that being alone was his only escape from the insults and abuse, Seth isolated himself, which deepened his self-doubt and unhappiness.

Seth shared that the worst part of living with an unrepaired cleft condition was looking into a mirror because he said it reminded him that he was “not complete.”

To him, this meant he’d never have a fulfilling life.

Seth spent years battling depression, often asking God to forgive him for whatever it was that he believed he’d done wrong and to heal his smile.

There were even instances throughout his life that Seth considered suicide. But in those moments, he reminded himself of his mum, who continually reassured him that they’d one day meet someone who will help him.

Seth waited 34 years for that day to arrive.

The course of Seth’s life changed in March of 2015 when he saw a flyer for Operation Smile Ghana.

Patient coordinator Clement Ofosuhemeng carries Operation Smile Ghana posters as he travels throughout remote villages recruiting patients and raising awareness for the organisation. Photo: Zute Lightfoot.

Marvelling at the before and after pictures of others born with cleft conditions like him, he realised that a solution was possible, and it gave him a renewed hope that his “someday” may come soon.

There was an upcoming medical mission in Cape Coast. It was a long 10-hour journey from his home, but everything he experienced leading up to that moment made him determined to go.

After hours of travelling, he finally reached what he hoped was the beginning of his new life.

But there were hundreds of potential patients living with cleft conditions who attended the mission, all seeking life-changing surgery.

During a 2018 medical mission in Ghana, families of patients gather at the patient shelter on the second day of surgery. Photo: Zute Lightfoot.

Unfortunately, due to the high demand for cleft care in Ghana, Seth was not placed on the surgical schedule at that time. There were too many patients in need.

Seth was devastated, but he refused to give up.

While he knew it wasn’t his turn yet, Seth also knew he was getting closer to his day and said that he believed God would find him another opportunity to get the surgery he deserved.

A few months later, Seth received a phone call from Operation Smile Ghana telling him about another mission in Ho.

The mission site was a little more than two hours from his home. So, once again, he bravely travelled away from his community, hopeful of finally receiving his transformative surgery that he’d waited on for 34 years.

Once Operation Smile medical volunteers deemed him healthy enough for surgery following his comprehensive health evaluation, Seth nervously waited to hear his name announced.

That day, when Seth was told he’d be receiving his new smile, he felt in his heart that the hardships he endured were coming to an end. Finally, Seth could be truly happy.

“I’m not worried because I know everything will be okay,” Seth said. “I will be able to go everywhere with confidence.”

Seth smiles wide alongside his friend. Photo: Margherita Mirabella.

After returning home, Seth felt inspired by Operation Smile’s work in Ghana and wanted to be a part of it.

He hopes to become an advocate for the organisation and share his experience with others to help recruit more patients in need.

With his new smile, Seth gained confidence to chase after his dream.

“Before my surgery I never wanted to talk to people, now I am happy to talk to everyone,” he said. “I’m now in school to learn how to become a pastor. Before my surgery, I would never ever have considered becoming a pastor.”

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.

Seth, after surgery. Photo: Margherita Mirabella.

From loneliness to acceptance

Justin, 53 years old. Photo: Rohanna Mertens

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 he returned home, Justin was met with kindness and acceptance from members of his community for the first time in his life.

This was a sharp contrast to how many people in his village treated him before he received surgery from Operation Smile Madagascar to repair his cleft lip.

At 53 years old, Justin had spent his life feeling abandoned and alone because of his appearance.

His only son didn’t want to be seen with his father, and his wife left him due to the stigma associated with his unrepaired cleft lip.

The years of being called names like “sima,” a derogatory term meaning cleft lip, had caused Justin to become shy.

Then one day, Justin saw a poster for Operation Smile Madagascar in his village hall with pictures of patients before and after surgery.

That was the first time Justin had seen another person who looked like him, and the first time he saw someone whose cleft lip had been repaired.

While the thought of having his smile repaired was exciting, Justin also knew he would have to take a chance and travel somewhere far from his home.

But after speaking with a local health worker, Justin mustered up the courage to attend an upcoming Operation Smile medical mission.

He made the long 24-hour journey with his niece, Rasoa, and a large group of other families from the Ifanadiana area. None of them knew for certain if they would receive surgery once arriving in Antsirabe, but they felt hopeful for the possibility of a new beginning.

Patients from across Madagascar arrive for screening during a medical mission in Antsirabe. Photo: Rohanna Mertens.

Arriving at the mission site, Justin was shocked after witnessing the scene before him: There were hundreds of people who looked like him.

Rasoa carefully documented Justin’s entire cleft care process.

Taking photos every step of the way, Rasoa, without even realising it, was creating a record of events that would one day have the potential to change the lives of more people like her uncle.

After undergoing his comprehensive health evaluation, Operation Smile medical volunteers deemed that Justin was healthy enough to receive surgery.

He shared with volunteers that he wasn’t nervous going into the operating room. He simply felt anticipation to see the change in his appearance after the procedure.

Rasoa was thrilled to call her mother, Justin’s sister, and tell her the surgery was a success.

When Justin saw his new smile for the first time, he was delighted with the result.

“Thank you for caring for me,” he said to the Operation Smile team.

After surgery, Justin smiles wide beside his niece, Rasoa, who remained by his side throughout his journey. Photo: Rohanna Mertens.

Returning home, he no longer felt the need to cover his mouth when talking to people or hide from interactions with others.

Even those who’d abandoned him in the past were willing to reconcile and join him in celebration of his life-changing surgery.

His once estranged 26-year-old son reunited with him.

Even his ex-wife, who left him because of his cleft condition, wanted to reconcile and try again at their marriage, but he declined. Justin said that he would rather start a relationship with someone new.

Today, Justin hopes to help more people like him.

With the photos Rasoa took during the medical mission, he can do just that.

“We want to help Operation Smile Madagascar find more patients,” Rasoa said. “We have photos, so we can explain what happens at the mission.”

Justin now happily lives his life as a subsistence farmer and refuses to let his cleft condition define him any longer.

Help us keep our promise to patients living in India 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.

Justin, after surgery. Photo: Rohanna Mertens.

Roman waited 19 years for his new life to start

Photo: Rohanna Mertens.

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 his story begins the same as many people born with cleft conditions, Roman was met with many hardships along his journey toward life-changing safe surgery.

The oldest of the five children in his family, Roman grew up never knowing that cleft surgery was possible.

However, even if Roman had known a solution was available, his family had no way of affording the cost of surgery as subsistence farmers, who cultivate only enough food and livestock to meet their own needs.

So, for 19 years, Roman lived with the burden of his unrepaired cleft lip.

He endured torment throughout his life because of his cleft condition, often being called names like “sima,” a derogatory term for cleft lip.

Growing up, he told people in his community that God had given him his lip, but that didn’t stop the hurtful bullying he experienced.

But everything changed for Roman when a local health worker came to his community and told him about an upcoming Operation Smile Madagascar medical mission in Antsirabe.

In the months after learning about his chance to receive surgery, Roman courageously made the bus trip to Antsirabe: It was farther than he had ever travelled away from his home.

Patients arriving at Operation Smile Madagascar's 2016 medical mission to Antsirabe. Photo: Zute Lightfoot.

Roman journeyed three and a half hours to reach our local team in Ifanadiana. They then transported him and other families the six hours to Antsirabe.

In some of the most remote areas of the world, many people like Roman lack access to critically needed resources and timely surgical care.

Operation Smile and its global community of volunteers strive to help patients and families overcome those barriers by bringing safe surgeries and comprehensive healthcare to where it’s needed most.

Upon his arrival to where Operation Smile provides accommodations for patients and their families, Roman was very surprised to see so many others who looked like him.

After passing his comprehensive health evaluation, Roman was deemed healthy enough to receive safe surgery.

On the day of his surgery, Roman admitted that he was scared but excited for his brighter future and ready to see his new smile.

And after receiving a surgery that lasted only around an hour, Roman’s life has permanently changed.

Photo: Rohanna Mertens.

After Roman made the long journey home to his excited community and family, many were surprised that his lip was completely repaired.

Today, Roman lives a happier life and is less shy.

With a new smile and a newfound confidence, Roman has experienced many aspects of life that he had never imagined, including getting a girlfriend.

His life has changed in many ways in the short time since his surgery, and he is looking forward to living a life of dignity, without fear of being teased or laughed at by members of his community.

While most of Operation Smile’s patients are children, there are many like Roman who are unable to receive safe surgical care until later in life.

Through nearly four decades of experience treating cleft, Operation Smile knows that cleft surgery offers optimism and hope – at any age.

“Thank you for taking care of me,” Roman expressed.

Help us to continue keeping our promise to patients like Roman 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.

Roman, after surgery. Photo: Rohanna Mertens.

After 35 years, Tereza is finally free

Tereza, 35 years old. Photo: Margherita Mirabella.

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.

After surgery, Tereza embraces her newfound happiness, but the pain of living 35 years with an unrepaired cleft condition isn’t something she’ll forget.  

As a child, Tereza faced torment because of how she looked. As she grew to adulthood, the bullying only intensified.

Some people from her community told her that she was only “half a person” and that she had nothing to contribute to village life.

Despite her dream of one day being accepted by those around her, the harassment caused Tereza to abandon her schooling and forced her to become completely ostracised from her village.

Although there were three people also born with cleft conditions in her community, Tereza’s decision to distance herself from her village also meant separating herself from the only three people who could understand the pain she was facing.

During a seemingly normal day, one of the people living with a cleft lip left to attend an Operation Smile medical mission in 2014.

Without enough money to afford the bus fare that would take her to Lilongwe, Tereza was forced to watch as the bus drove away.

But upon seeing them return with a new smile, Tereza was motivated. And she refused to let anything get in her way of attending the next mission.

Her opportunity came after she contacted Operation Smile Malawi, which arranged free transportation to the upcoming mission, eliminating the obstacle that stood in her way a year before.

Her perseverance paid off, and Tereza was taking the first step in her journey toward ending the painful harassment that had become all too familiar.

Although there were others in her community living with cleft conditions, Tereza believed that they were the only ones.

But after arriving at the mission site, Tereza was shocked to see so many others who looked like her.

For the first time in her life, Tereza felt like she was no longer alone.

Potential patients gather during a 2015 Operation Smile medical mission in Lilongwe, Malawi. This was the day Tereza learned that she was placed on the surgical schedule to receive her free cleft surgery. Photo: Margherita Mirabella.

It’s estimated that, worldwide, a child is born every three minutes with a cleft, which is about one in every 500 to 750 births.

We’re working to discover the causes of cleft through research and putting our evidence into action to prevent cleft conditions before they develop in the womb.

Tereza was amazed by the compassionate volunteers who were donating their time and expertise to patients and their families affected by cleft conditions – a sharp contrast to how she was treated in her community.

Globally, Operation Smile has improved the health and dignity of more than 300,000 patients living with cleft conditions, helping them to breathe, eat, speak and live a better quality of life with greater confidence.

In Malawi, our team is working to address the backlog of people like Tereza who have been unable to access the surgery they need.

For the first time in 35 years, Tereza was among people who would accept her for who she was, and she didn’t have to worry about what they’d say when they saw her cleft lip.

She found peace in the hectic environment of health assessments and pre-surgical appointments and was comforted by the fact that she was surrounded by kind people who understood what she was going through.

Tereza was overcome with happiness and relief when medical volunteers placed her on the schedule to receive her free surgery.

“When I have my surgery, it will be like I’m born again,” Tereza said. “I will be a new person.”

Tereza, after surgery. Photo: Margherita Mirabella.

While looking at her photo taken before surgery, Tereza admitted that she wasn’t happy. Living with an unrepaired cleft had taken a toll on her self-esteem and confidence.

Now, her life is very different.

“I am living a free life,” Tereza happily explained.

Since her successful surgery, Tereza has returned home and become part of her community again.

She loves engaging with others because she no longer fears being ridiculed.

Tereza feels excited to have had the opportunity to receive her life-changing surgery and plans to educate her community about cleft and Operation Smile’s life-changing work with hopes of preventing anyone else from experiencing the pain and loneliness she endured.

Photo: Margherita Mirabella.

From patient to patient advocate

Weston Bello, an Operation Smile student volunteer from Malawi, right, poses with former patient John, who became a patient advocate after receiving surgery at the 2017 medical mission in Zomba, Malawi. Operation Smile photo.

Editor’s note: This story was written by Weston Bello, a student at the University of Malawi, Chancellor College, where he studies philosophy and psychology. As an Operation Smile student volunteer for two years, he’s taken part in two medical missions.

There is a part in the depths of our hearts that drives us to think of other people and seek to help in any way that we can. After John got his surgery from Operation Smile at the 2017 medical mission in Zomba, Malawi, that side of him came to life.

I met John before he got his surgery while he was staying at the patient village that Operation Smile provides at no cost. From what I noticed, he was very troubled by his situation. As he told me his story and the atrocities he had faced because of his cleft, I felt a deep need to help him in any way that I could.

From then onward, we became friends.

John first heard about Operation Smile from a volunteer who came to visit him at his workplace in 2017. When he learned about this opportunity to receive a surgery to care for his cleft lip, he was afraid that perhaps something would go wrong during the surgery. But thanks to the support and encouragement of the volunteers, John rallied the courage and went to the mission site in Zomba.

There, he received the gift of a transformed smile – and soon he would find a way to give back.

“After noticing how other people were suffering from cleft lip and cleft palate, I couldn’t just stand there and watch. I wanted them to get the same help that I got.”

– John, Operation Smile patient advocate in Malawi

At age 52 and close to retirement, John lives with his wife. His sister, who accompanied him to the Zomba mission, lives nearby and would check on him from time to time. A few weeks after the surgery, I visited John at his house to check on him, too.

I believe the day I visited him was the day that he became a volunteer for Operation Smile.

Before I left his house that day, he took me to visit a family that had a relative with cleft lip. I sat there listening to John talk to the family about Operation Smile and how it had changed his life, and I was very impressed.

From then onward, John went out and started looking for other people born with cleft lip and cleft palate so that they could receive the same gift that he did.

At the 2018 medical mission to Blantyre, John returned not as a patient, but as a volunteer. He helped out with patient coordination at the patient village.

Today, he continues to find other people born with cleft lip and cleft palate and shows them pictures of him before surgery. When people see the pictures, then see his new smile, they become motivated to receive care from Operation Smile.

He said that his life changed after getting his surgery; he is a happy person now. Once he retires, John said that he will continue reaching out to people and hopes that many people will also get free and safe surgeries and be happy as well.

“After noticing how other people were suffering from cleft lip and cleft palate, I couldn’t just stand there and watch,” John said. “I wanted them to get the same help that I got.”

Pre-surgical dental care saved Janat’s life

Janat, 1-month-old. 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.

When Janat entered the world in her small Moroccan village, no one could’ve predicted the physical and emotional challenges that laid ahead for her and her family.

Remembering back to the day when she saw her daughter’s smile for the first time, Fatima recalled the shock and fear that filled her heart.

But as she held her newborn baby in her arms, Fatima knew that there wasn’t anything in this world she wouldn’t do to protect and care for Janat.

However, due to factors outside of her control, keeping that promise became increasingly more difficult as Janat’s health rapidly began to decline.

For children born with cleft conditions, especially a cleft palate like Janat’s, they often encounter major hurdles with feeding and struggle to receive proper nourishment during the most critical time in a baby’s development.

Janat and Fatima confronted these obstacles every day.

“I was afraid that I was going to lose her,” Fatima said. “She was suffocating and the milk would come out of her nose. She can’t finish a bottle.”

Fearing for her daughter’s health, Fatima helplessly watched as Janat steadily became smaller and sicker during her first weeks of life.

“I knew that surgery was possible,” she said. “But I was scared and didn’t know where to go or who to ask.”

This is the case for many families of children born with cleft conditions.

Despite the consistent failed attempts at feeding Janat and the fear of watching her become more malnourished each day, Fatima persevered, determined to keep the promise she made.

Then one day, Fatima’s hopes were realised.

Volunteer dentist Dr. Teresita Pannaci of Venezuela, left, observes as Janat is fed by her mom while testing out her new feeding plate. Photo: Jasmin Shah.

After seeing an Operation Smile Morocco commercial, Fatima learned that the organisation not only provides free surgical care, but that there was an upcoming medical mission taking place in a little over a week in Oujda, a neighbouring city.

Overjoyed to learn there were skilled people devoted to caring for children with cleft conditions, Fatima and her husband prepared to make the journey, hoping that it wasn’t too late for 1-month-old Janat, who’d already lost nearly half of her birth weight.

Alongside hundreds of families seeking out care from Operation Smile Morocco’s highly trained medical professionals, Janat and her parents arrived in Oujda for screening day fully prepared to do whatever they could to save her life.

It was a long and gruelling day for the family as volunteer paediatricians, anaesthesiologists, nurses and other specialties assessed Janat’s health throughout the screening process.

It quickly became clear to the volunteer team that Janat wouldn’t pass her comprehensive health evaluation.

Having been unable to eat properly for the first month of her life, Janat had become severely malnourished and wasn’t healthy enough for safe surgery.

Just as Fatima started to think that they’d return home without a solution, the team of volunteer dentists on-site sprang into action.

Joining forces with Operation Smile Morocco staff, Drs. Carmen Kamas-Weiting of the U.S. and Teresita Pannaci of Venezuela stepped in, quickly transporting Janat and her family to the local care centre.

“I was so happy,” Fatima said while surrounded by the dental team preparing to fit Janat with a feeding plate. “I’m happy that, finally, she will receive help.”

With a cleft palate – a gap in the roof the mouth – patients struggle to eat or drink because milk oftentimes spills out of their nose or causes them to choke, making it almost impossible to obtain the necessary amount of nutrition needed to thrive and gain weight.

Having a cleft palate also makes patients vulnerable to illness, as they are more susceptible to infection, disease and even death.

To protect patients like Janat from the dangers of malnourishment – dangers that can prevent them from receiving the timely cleft surgery they need – dentists like Teresita and Carmen rely on pre-surgical dental care like feeding plates.

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.

The plates serve as the first step toward surgery, leading patients away from starvation and guiding them toward a healthier life – toward surgery.

“A baby with a cleft palate can’t eat,” Teresita said. “That’s why it’s so important to rehabilitate the function of breathing, sucking and swallowing food so that the child is eating in the home environment. This is the real reason why treatment must be done from birth.”

Patiently waiting for the dentists to create the plate, Fatima shared with the team that Janat could only manage to consume around three ounces of milk throughout an entire day. This amount is dangerously lower than the recommended two to three ounces of milk newborns are expected to consume every few hours.

With the feeding plate, the process of eating for Janat was transformed.

After testing out her new plate for the first time, Janat drank two and a half ounces of milk in less than eight minutes.

“I started to feel calm; [the plate] was working,” Teresita said. “I looked at her mother, and that’s when I saw she had tears in her eyes. When I asked, ‘Why are you crying? What kind of tears are these?’ She said, ‘They are tears of happiness,’ because she knew that her daughter was safe.”

Fatima, filled with relief, revealed that it was the first time she’d ever seen Janat drink without suffocating.

“I was so happy. I was so relieved,” she said. “I’m very grateful for what you’ve done for my daughter. I’ve never seen kind hearts like yours before.”

Fatima and Janat returned to the care centre once more during the mission before heading home. Adapting well to her new feeding plate, Janat slept comfortably in her mother’s arms with a belly full of milk for the second day in a row.

For the first time, Fatima watches as Janat drinks milk with ease thanks to her daughter's new feeding plate. Photo: Jasmin Shah.

Drinking a few ounces of milk may seem insignificant, but the plate also enables patients to reach even larger milestones: improving nutrition, achieving and maintaining weight for surgery, breathing easier for a better quality of life, lessening the severity of the cleft palate as well as improving jaw and nose development.

While Janat didn’t receive surgery during the March Oujda mission, Fatima’s determination was stronger than ever before, and she planned to return to the centre on an ongoing basis to allow for volunteers to monitor Janat’s care and progress.

Janat’s journey so far has been filled with fear, uncertainty and seemingly impossible obstacles. But no matter what lies ahead, Fatima refuses to give up.

“Nothing is too hard when it comes to my daughter. I will do anything.”

Shortly after the conclusion of the March mission in Oujda, Operation Smile Morocco, like all of our teams around the world, made the decision to postpone future missions and care delivery at care centres. While the decision was made to ensure the safety of patients, families, volunteers and staff, the postponements left people like Janat and Fatima waiting.

Thankfully, through closely following all health ministry guidelines and protocols, including mask-wearing, social distancing, temperature screenings and more, the Moroccan team has successfully reopened its care centre doors, allowing for waiting patients like Janat to return and continue their ongoing care.

Today, Janat is 10 months old and her condition has dramatically improved.

Through her family’s commitment to improving her health and the success of her feeding plate, Janat’s weight has significantly increased and she continues to show incredible developmental progress. To this day, Fatima remains hopeful for Janat’s continued improvement.

“My daughter will be OK. I’m happy now,” she said. “Surgery will be life-changing. In the future, Janat will get an education.”

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

10-month-old Janat, today. With the help of her feeding plate, along with her family's dedication and love to care for her, Janat has become healthier and gained considerable weight. Photo courtesy of Janat's family.

When All Seems Lost, Hope Appears

Photo: Marc Ascher

Shocked and heartbroken when her baby Valeska was born with a cleft lip, Zorida received more discouraging news within the first moments of her daughter’s life.

No sooner than learning that surgery was possible to repair Valeska’s cleft lip, the young Nicaraguan mother was told by doctors that the procedure would be far too expensive for her and Valeska’s father to afford. The couple was informed that more affordable, possibly even free, surgical treatments could be found in Managua — a six-hour bus trip from their hometown.

Every six weeks after the birth of her bright-eyed daughter, Zorida travelled to Nicaragua’s capital only to return home dejected. Each time she sought help for her baby, she realised surgery cost much more than the family could afford. One round trip cost the family 1,800 córdobas (£45) — a massive drain on their average weekly income of 1,000 córdobas (£25) — making it so Valeska’s father couldn’t afford to accompany 17-year-old Zorida and his baby on their journeys.

“I was so sad,” Zorida said. “I felt that there was no solution for my baby.”

Back at home, Zorida experienced ridicule from neighbours who blamed her for her daughter’s condition. Drawing from deeply-rooted local superstition, they said that Valeska’s condition resulted from Zorida walking outside during an eclipse.

Photo: Marc Ascher

“People laugh at my baby,” Zorida said. “They taunt her and I hear others talking about her. They tell their children that she’s horrible and if they stare at her, they could look that way too.”

Zorida couldn’t help but to feel a sense of guilt that Valeska was born this way.

“I thought it was somehow my fault,” she said. “I thought that somehow this was God’s judgment on me.”

As hope and resources dwindled after 10 months of searching, a call from the local hospital provided relief for the young family. Operation Smile was conducting a medical mission in Estelí — three hours away — and that free surgery was possible for Valeska.

Again, Valeska’s father struggled to earn the money to pay for the bus fare. Like each of the previous trips to Managua, he was unable to embark on this life-changing trek.

Anaesthesia resident Anna Bengsston of Sweden comforts Valeska. Photo: Marc Ascher.

At the medical mission’s site, Hospital San Juan de Dios, Zorida waited nervously while holding Valeska. Naturally, she remembered her unsuccessful attempts to access safe surgical care for her daughter and the disappointment that inevitably followed. After a successful screening, Zorida beamed with pure elation when she learned Valeska was selected for surgery. Now, she could exhale knowing that the bus ride back home would be filled with joy instead of despair.

In a single surgical procedure, Operation Smile volunteers repaired Valeska’s cleft lip, giving her a beautiful new smile in time for her first birthday.

Since Valeska’s surgery, Operation Smile Nicaragua opened the doors of its new cleft lip and cleft palate care centre in Managua in May 2016. The largest of its kind in the country, the centre serves as the administrative and educational headquarters for Operation Smile’s medical programmes as well as the treatment site for over 800 patients who regularly receive follow-up care. Its presence also helps eliminate resource-draining searches for families like Valeska’s.

Photo: Marc Ascher

Meet Our Patients: Mossoró, Brazil

In 2017, 67-year-old Dona Maria received surgery during an Operation Smile Brazil medical mission. Photo: Marcelo Braga.

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.

In the densely populated city of Mossoró, Brazil, Dona Maria spent her entire life living with an unrepaired cleft lip.

While she undoubtedly faced challenges and overcame obstacles because of her cleft, 67-year-old Dona Maria consistently dreamt of one thing.

Though seen by many as a simple pleasure, what she wished for most was to wear lipstick.

During a 2017 Operation Smile Brazil medical mission, Dona Maria passed her health evaluation and underwent her long-awaited surgery, feeling closer than ever to reaching that dream.

Dona Maria 2

Moments after waking from the operation, Dona Maria felt eager to see her new smile.

After 67 years of living with a cleft condition, she proudly showed the entire medical volunteer team who were thrilled to be a part of that special moment.

After allowing her lip to properly heal from surgery, Dona Maria could finally live out her dream of putting on red lipstick for the first time in her life.

Laine Paiva, a volunteer photographer for Operation Smile Brazil, was so moved by Dona Maria’s story that she arranged a photoshoot with her, capturing images of her dreams becoming reality.

Thriving thanks to timely surgery

Olga and her daughter, Lungile, before surgery. Photo: Zute Lightfoot.
Olga and her daughter, Lungile, before surgery. Photo: Zute Lightfoot.

When Olga gave birth to her daughter, Lungile, her joy lasted only for a fleeting moment before she was overwhelmed with shock.

Lungile was born with a cleft lip, a condition that Olga had never seen before.

Distraught and heartbroken, Olga and members of her family struggled to understand why Lungile was born with a cleft lip*. They also struggled with the uncertainty of whether or not she would be able to receive treatment.

“I was scared the first time I saw her,” said Lydia, Lungile’s grandmother. “I thought there would be no one to help her.”

But as the family’s initial feelings of shock faded, their unconditional love for Lungile only grew.

Olga said that while the doctors and nurses at the hospital assured her that surgery to repair Lungile’s lip was possible, they also explained that the waiting list was very long and that it may take years before she could receive an operation.

Photo: Zute Lightfoot.

It’s critical that babies born with cleft conditions receive surgery as soon as they are old enough and healthy enough to undergo anaesthesia. The longer Lungile’s wait for surgery, the longer her condition could put her health at risk. Her speech and dental development could become impaired. She could suffer from emotional hardships, such as bullying and social isolation, throughout those precious, formative years.

Soon after receiving this discouraging news, Olga met Dr. Vanessa Soares, an Operation Smile South Africa medical volunteer and dentist at the same hospital where Lungile was born. Vanessa told Olga that Operation Smile provides free surgeries for children born with cleft conditions, like Lungile, and provided her with the organisation’s phone number.

Immediately, Olga called Operation Smile South Africa and learned that a medical mission would be coming to the family’s home town of Mbombela just after Lungile’s first birthday – within the ideal time frame for cleft surgery.

Fortunately for Lungile, her cleft lip did not prevent her from feeding properly as it does for so many babies born with cleft conditions. Difficulty in feeding can lead to life-threatening malnutrition which also prevents potential patients from being healthy enough to undergo anaesthesia. To combat this barrier to surgical care, Operation Smile has established nutrition programmes in places where malnutrition is prevalent, such as Madagascar, Ghana and Malawi, to help children gain weight and become healthy enough for surgery.

When the medical mission arrived to Mbombela, Olga was surprised to see so many children with cleft conditions. The Operation Smile medical team conducted comprehensive health evaluations to determine which patients were healthy enough to receive surgery. Olga was elated to learn that Lungile was among those selected to get an operation during the medical mission.

Naturally, Olga was anxious as her daughter was wheeled into the operating room. In less than an hour, she was reunited with Lungile in the recovery room as she woke from anaesthesia.

She couldn’t believe her eyes when she saw her daughter for the first time after surgery.

Olga and Lungile, after Lungile's cleft lip surgery. Photo: Zute Lightfoot.

Olga’s anxiety was replaced by joy and gratitude as she reflected on the compassion of the Operation Smile medical team and Vanessa.

“What she has done for me –” Olga said of Vanessa, pausing as her emotions welled up. “I love her.”

A year after her surgery, 2-year-old Lungile is thriving.

“Lungile loves to dance hip hop, listen to Rihanna and play her brothers’ musical instruments,” said Olga, who has become an advocate for Operation Smile South Africa in her community.

“I was out shopping with Lungile, and I met a lady who burst into tears because her daughter also had a cleft lip, and so I told her she would be OK,” said Olga, who accompanied the mother and her child to the next Operation Smile medical mission to Mbombela. “The baby, Ntando, and Lungile have become great friends.

“I will tell people in my community who have children born with cleft lip that their children can be fixed and they will look nice.”

Photo: Zute Lightfoot.

* Editor’s Note: While it’s difficult to determine the exact cause of an individual’s cleft condition, research from Operation Smile’s International Family Study shows that cleft conditions can be caused by genetics, environmental factors or a combination of both.