Smile restoration in Santa Marta, Colombia
According to the Ministry of Health, one in 500 to one in 1,000 children in Colombia are born with a cleft lip or cleft palate (Colombia Ministry of Health, 2000). However, to the mother who delivers a child with this ailment, statistics are meaningless.
Sameep Kadakia, MD, fourth-year resident, the New York Eye and Ear Infirmary of Mount Sinai
According to the Ministry of Health, one in 500 to one in 1,000 children in Colombia are born with a cleft lip or cleft palate (Colombia Ministry of Health, 2000). However, to the mother who delivers a child with this ailment, statistics are meaningless. To a mother, her one child is enough to deserve all of the attention and care that society can provide. The physical sequelae and psychosocial implications of cleft disorders affect patients and families tremendously—no number of studies or trials can validate the challenges these disorders pose. Dealing with the daily trials associated with the care of these patients, amidst a society where access to resources and healthcare is limited, suggests a seemingly indomitable struggle.
Healing the Children Northeast (HTCNE) is a nonprofit volunteer organization that has dedicated itself to the service of children worldwide who are unable to seek adequate healthcare due to a lack of societal and financial resources. Since its inception in 1985, HTCNE has organized many successful medical mission trips, providing service to more than 43,000 children. In 2012, HTCNE went to Santa Marta, Colombia, for a successful surgical mission led by a facial plastic surgeon, Andrew Jacono, MD, and 20 other members.
Now having a well-established site, team leader Dr. Jacono, returned to Colombia for the fourth time this past November accompanied by facial plastic surgeon Joseph Rousso, MD, head and neck surgeon Augustine Moscatello, MD, facial plastics fellow Melanie Malone, MD, two otolaryngology residents Sameep Kadakia, MD, and Stefan Shauib, MD, as well as anesthesia, pediatrics, and nursing teams. While many people on the mission were returning for their tenth year, others were joining for their first time, eager to take part in this special project that left people with fond memories, heavy hearts, and a sense of humility.
As the screening day began, first time members of the team were filled with enthusiasm and a sense of uncertainty about what to expect other than stories from previous participants. Initially, 20 to 30 families were waiting to be evaluated; however, by noon this number had reached closed to 150! Children and families travelling by van, cart, and mule for up to an entire day to reach the screening location were not uncommon. This annual screening day was the only access to care these children would know during their childhood.
The variety of pathology seen would make currently accepted statistics seem inaccurate and under-reported. Cleft lip and palate were seen in abundance, along with facial paralysis, congenital ptosis, velopharyngeal insufficiency, and burn injury. Rare syndromes such as Mobius syndrome, were found in multiple patients. At the conclusion of the first day, 64 patients were scheduled for surgery. The day ended with a feeling of excitement for what the next four days would bring.
The first operative day began with a team huddle and Dr. Jacono left the team with an inspiring outlook to carry centered on positivity, compassion, and team bonding. At the end of the week, the team had completed 67 operative cases and left those families hopeful that the quality of their children’s lives would be better. Seeing their children smile normally for the first time left parents with even larger smiles that would bring these volunteers back year after year.
To be part of an experience like this is to be grateful for the opportunity of a lifetime. We are fortunate to have these families entrust us with the care of their children and take the risk of allowing strangers to operate for a favorable outcome. As healthcare workers, we approach these situations thinking of what we can contribute and give to these patients, and while we do not undermine our efforts, we often gain more from these experiences than we realize. The relationships we build from working together, the understanding we gain from dealing with new challenges, and the humility experience give us a stronger sense of our role in human culture.