Changing Lives, One Smile at a Time

By: Terri Klimek, CRNA, MS

7-year old Fatima (preop)

Once the team arrived in Morocco, I was all eyes. I had to adjust to a foreign country, its customs and its people. We had a day of rest and then the work began. The first few days are spent screening patients. The first time you see the mass of people waiting and hoping they or their child will be chosen makes you swallow with a lump in your throat. They come from miles and miles away by mule, or by bus or on foot. They sleep in streets if they have no place else. And yet, as you meet them, they are so kind, gracious, and polite. As the screening process begins, the lump often grows, and for the first time, you understand how the Magees felt in the Philippines 20 years ago. At the end of screening week, the surgery and anesthesia team leaders, the mission coordinator, the nursing team leader and the pediatricians and dentist select the patients. A volunteer needs only to witness the schedule being posted once. When you have screened 300-600 patients and can only operate on 120-160, you again understand how the Magees were driven to dedicate their lives to helping these children. Seeing the faces of the patients that did not get selected is definitely the worst part. It is not uncommon to have people push their babies toward us crying and begging us to help their children.

When you arrive to set up the operating rooms, the words of Forest Gump come to mind, “you never know what you’re going to get”. The conditions of the hospitals vary from site to site and country to country. Some hospitals have equipment that is 30 to 50 years old and open electrical outlets next to the scrub sinks. The BioMed technician is busy wiring and rewiring equipment to make everything not only functional, but also safe. Operation Smile brings all of their own cardiac monitors, ETCO2, Pulse Oximetry, Vaporizers, and emergency equipment. Along with all of the supplies provided by Operation Smile to administer a safe anesthetic, many volunteers also bring and donate supplies.

The posting of children selected for surgery		Anesthesioloigst Dr. Kionel Glassman sings all his children to sleep

Because education and self-efficiency is also a goal of Operation Smile, Saturday is Education Day. Team members from each specialty spend time providing lectures and/or roundtable discussions on various topics.

Surgery week is busy. The multi-national teams are recruited from the United States and the participating host countries. Each team consists of five to seven anesthesia providers (anesthesiologists and certified registered nurse anesthetists), five to seven surgeons, and a host of other personnel including nurses, medical records, dentists, a pediatrician, a pediatric intensivist, a speech pathologist, and others according to the needs of the site. A typical team may consist of professionals from four to eight different countries all working side by side. Team members are required to hold current certification in both ACLS and PALS.

Some people have asked me why I give up my vacation time to work 12-hour days in countries where I need a translator to help me communicate, while sharing living quarters with a stranger. There are actually several reasons why one may choose to do this. First, as I mentioned earlier, you will find it to be the most rewarding thing you ever do with your career. Second, you will meet and develop friendships with people from around the world. Third, every time you go, it puts the important things in life back into perspective for you. Fourth, the feeling you get when you see a child look in the mirror for the first time after their surgery is priceless. I would like to share with you two letters I have received from previous missions:

Greetings Everyone!!

I hope your journey home went well, safely, and without incident. Thanks again for all of your hard work. I’ve learned to appreciate the results of your actions via a good friend in Agadir City. He described one of Operation Smile’s patients from last year. Before the operation, his friend would coward away from any social situation, hiding the scar on his face. After the operation, his confidence, self esteem and personality changed dramatically. You get to see the immediate results of your efforts immediately post op, but I’ve had the chance to hear about the ultimate results from a friend of one of your patients. Translating directly from my friend: “My heart goes out to you, and God bless your parents!! Thank you for everything you’ve given me and to all you have helped in Morocco.”

Sincerely,

Marcus W. Grandjean - Peace-Corps-Morocco

This most recent letter was written in Spanish from the mother of a patient in Nicaragua:

From all of my heart we want to express our sincere thanks for the deed that you have done for my son with this operation. You don’t even imagine how happy this has made him.

Since he turned 13 he would look in the mirror and anxiously ask me for an operation that would fix his nose and mouth. He expressed that he wished that we, his parents, had money to pay for such an operation. He would say, “Mom, I am very ugly and no one will ever fall in love with me.” I as his mother advised him to not think like that. But could they love him? Who would not look at his exterior and instead look at his inner beauty? I would give him some examples. However, he awaited your arrival.

The circumstance at the moment did not allow me to accompany him to the consultation but that did not stop him and he went alone. He also went by himself to see if he was on the list and later to enter the hospital for surgery.

I admired his optimism. He had faith that you would do his operation. May God bless you all for this wonderful work, because you make the children that suffer from this defect very happy. You have made my son’s biggest dream come true. Thank you very much!

The mother of David Arvizo

Surgery day was also Jose Torres' 9th birthday. He came for a palate fistula. We spoke to his mother and offered to stay late and repair his ears. He was so happy the next day and told us "now the kids at school can not make fun of me"

Operation Smile offers new life and new hope. Its success is seen in the faces of the children who receive care. There are many ways to become involved with Operation Smile as a volunteer, sponsor, through local chapters, or via the Student Program for your children. For more information, please contact Vonnie Wray at Operation Smile (757) 321-7645 and mention The University of Michigan Airway, or Terri A. Klimek, CRNA, MS via e-mail at: klimekt@med.umich.edu