I have an enormous amount of respect for Operation Smile and the great work they do on their missions. From Op Smile meetings to Operating Rooms I have seen firsthand how the missions are organized and carried out. It was an honor to take part in the Operation Smile 2015 Tana mission. I met and worked with a team of 90 doctors, surgeons, nurses, anesthesiologists, volunteers, coming from 12 different countries. Since I arrived in Madagascar, I noticed the rampant amount of diseases, deformities, and illnesses. Cleft lip and cleft palate rates are very high in Madagascar. Researchers still do not know as to why children are born with this deformity but in a third world country, such as Mada, where formula and feeding alternatives are scarce, many of these babies die early on. I made it my prerogative to search out potential patients in the East Coast region and bring them up for the mission this past month.
I biked to many different villages on weekends, spread the news through churches and eventually was able to find about 10 patients that would be good candidates for surgery.
The trek: The search for patients is not an easy one. Many times people with facial deformities, such as cleft lip and cleft palate are ostracized from their community. If the baby lives and has a chance to go to school, he or she may start and many times ends up dropping out due to bullying and difficulties communicating due to speech impediments. By the time they are adults many have gone through so much backlash from their community that they are shy, timid, and reluctant to accept help,
On my search this year, I decided to use churches and religious leaders to help me reach out to these individuals. Seeing that locals trust pastors and priests much more than a blue eyes blonde haired”vazaha” (term for foreigner in Malagasy). Once I located a location or village where a potential cleft lip or cleft palate patient lived, I organized a trip there. Many took half days, even full days, and some trips amounted to crossing rivers, and trekking in mud for a couple hours. Because the rainy season had just come to an end yet Madagascar’s East Coast was hit with a tropical depression during the same time I was set on finding patients, this caused many hurdles with regards to transportation.
Meeting patients: Gaining trust is crucial. During the first five minutes of conversation, I must convey to the patient and his family that I am going to take good care of him/her. That this program is real and that I am not going to kidnap their child and eat it for dinner. (You can only imagine what stories are told about vazaha.) I tell them that everything from transport, food, and surgery is free, and that they will have the opportunity for a new life after this! If they accept trusting me they show up the date of departure. This year to make things a little easier, I ended up bringing a patient that had previously received surgery from Operation Smile on a mission in Tana 2014. He became my spokesperson, my walking billboard, he shared his story and they listened. I think this helped reduce anxiety and doubts in the family, and produced trust and willingness to join the mission.
Date of Departure: On the date of departure I rented out an entire taxi-brousse (very large van) to accommodate each patient and one chaperone. We left from my village and made our way up to pick up the rest of the patients on the road. Once all in the van, I noticed that there was an interesting energy that had formed between the families. One young girl, looked at another young boy the same age as her, approximately 9-10 years old, and said “you have the same lip as I do”. She has never seen another person with cleft lip. Imagine you are born with cleft lip and everyone around you looks “normal” suddenly one day you find yourself in a van with 9 other individuals that look just like you… its mind-blowing. The energy in that taxi brousee was magnetic mothers helped mothers care for the younger cleft lip patients. The older patients sat next to one another and sang Malagasy songs on the long 10 hour ride up to the capital.
The Ride: The ride up was magical but definitely a long one. 10 hours in a taxi brousse on a windy road necessitated many many “sachets” for car sick passengers. Every one of the individuals in that taxi brousse had never been to the capital. Many had never been in a car. A 45 year old patient screeched when she saw mountains and yelled out, “WHY IS THE EARTH RISING!!!” For me this moment really showed me how much trust I gained. These patients trusted me enough to come this far.