March 7, 2014
From November 22-December 1, 2013, MMFC’s team of 18 volunteer doctors, nurses, dentists, speech pathologists, and administrators returned to Cajamarca, Peru for a week of cleft surgeries and dental care.
In one week the team completed 46 surgical procedures, including repairs of 14 primary cleft lips, 8 primary cleft palates, and 5 lip revisions. In addition, 145 dental procedures were done, including 11 under general anesthesia. Our speech therapist gave 16 speech therapy sessions as well as 43 consults.
One of the most interesting patient stories from this week was of Maria Angelina and Magali Davila (below). Magali is Maria’s niece, and they are both from Bolivar. It took them four days to travel to Cajamarca, including a day and a half of walking. Maria’s brother (Magali’s father) joined them on the journey to Es Salud hospital in Cajamarca. Magali is in her first year of primary school. Unlike Magali, Maria is mentally challenged, has never gone to school, and does not know how to read or write. They live in a very rural community where outside communication is limited, and even a telephone signal in rare. They found out about MMFC’s mission from a radio broadcast and decided to make the long trek together. Maria and Magali both received surgery to repair their bilateral cleft lips, making the journey to Cajamarca all worth it.
MMFC would like to thank the Helpers of the Mentally Retarded and the Hess Foundation for their donations toward this mission.
March 3, 2014
From November 1-10, 2013, MMFC sent a 15-person team of volunteers to Tacloban, located on the Leyte island of the Philippines. Working alongside the staff at the Eastern Visayas Regional Medical Center (EVRMC) and the Maharlika Foundation, the team had a full schedule of cleft patients planned for the week.
Led by Drs. Arnold Lee and Pratik Pradhan, the first day of surgeries went off without a hitch, but on Tuesday morning the team learned of a typhoon headed straight for the Philippines. Super Typhoon Haiyan was gaining strength by the hour and the coastal city of Tacloban was expected to be one of the hardest-hit areas. By Tuesday afternoon the tough decision was made to cut the mission short, and tickets were purchased for the next available flight out of Tacloban. MMFC couldn’t take the risk that came with riding out this storm, which was so strong that it didn’t even fall under any of the existing hurricane or typhoon categories.
The MMFC team finished as many surgeries as possible before the end of the day Wednesday, packed up supplies and equipment, and flew out on Thursday morning on the last flight to Manila before all others were cancelled. In three days the team repaired 12 cleft lips and 7 cleft palates – a great accomplishment, especially given the added stress of the typhoon.
MMFC plans to return to Leyte, but it will take time for the needed infrastructure to be rebuilt. The EVRMC was the only functioning medical facility following the typhoon, but it still sustained significant damage.
Our thoughts are with all those who were affected by the typhoon, and we look forward to returning soon.
February 5, 2014
From October 25-November 2, 2013, MMFC Chairman Dr. Dennis Snyder led MMFC’s third annual mission to Danshui, China. This is one of MMFC’s smallest teams, with just 7 doctors and nurses traveling from the US to perform free cleft surgeries. Despite its small size, MMFC’s mission to China was nothing short of a success. The team screened 57 patients, completed 28 cleft lip repairs, 6 cleft palate repairs, and provided dental care to 35 children and young adults.
One of these patients was a girl from Hui Yang Town named Zhao Yong Feng. After she received surgery to fix her cleft palate, the MMFC team received the following letter from her father.
Dear Honorable Hui Yang hospital leader, Honorable MMFC China team, Honorable Local Women’s Federation, Hong Kong Volunteer Team and all other people who worked to support the China mission:
I am from a very poor family in Hui Yang Town, China. I have a daughter. Her name is Zhao Yuan Cheng. She was born with a cleft palate. She could never speak very well, and because of my family’s financial situation, we could not afford the surgery to help her. The mission presented my family with a once-in-a-lifetime opportunity for my daughter to have the corrective surgery. The surgery was very successful.
I thank everyone to whom this letter is addressed from the bottom of my heart. While my daughter was in the hospital, everyone in the hospital ward took such great care of her. I cannot thank them enough. The medical team from both China and the US showed me that love is boundless. I do not know how to express my gratitude. I can only thank you over and over again.
This surgery changed not only the life of my daughter, but our entire family. I hope MMFC will continue to work in China to carry out this wonderful mission–providing life-changing surgery for the most vulnerable, poor and voiceless.
My best wishes for all of you good-hearted people. May you enjoy good health and every success. According to a Chinese Buddhist saying: Good–hearted people are on the path to Goodness and Light.
The father of Yong Feng
October 31, 2013
MMFC extends sincere thanks to its donors and volunteers for their continued support and dedication, and to the Hui Yang Peoples Hospital for graciously opening its doors and allowing MMFC to complete another successful mission.
January 9, 2014
From October 12th to 20th, MMFC’s 26-person team of surgeons, anesthesiologists, nurses, dentists, nutritionists, and non-medical volunteers from the U.S. and England returned to Quito once again for its annual week-long surgical mission. In five days the team completed 10 cleft palate repairs, 1 cleft lip repair, 7 palate revisions, 2 lip revisions, 4 rhinoplasties, and 26 scar revisions. The dental team also operated on 22 patients.
With such a large team and diverse patient population, our Quito team is able to provide a wide variety of surgeries aside from solely cleft repairs. No matter what kind of surgery the patients received, it will have a profound impact on their lives.
These are just a few examples.
Damiza is a 5 year old girl who came to MMFC with a keloid on her left forearm, which she had as a result of a bad burn. The keloid caused her terrible itching, and removal of the scar tissue would relieve this. During examination on the day before surgery, Damiza was crying and complaining of tooth pain. The dentist discovered a dental abscess, so arrangements were made with the surgery team and on the following day when she went into the OR, the dental team performed a tooth extraction and drainage of the abscess while the surgeons excised the scar. The following morning Damiza was smiling, feeling betting with no tooth pain, and happy to know that the scar was gone and that the surgical incision would heal to a fine line. Her mother was very grateful and appreciative of the care provided as well as the attention she and her daughter received.
Matias Venegas, lip revision
Maria Yumi, neck scar revision
Magali Arcinigas, rhinoplasty
Emi de la Cruz, lip scar revision
September 9, 2013
Sofia Zoullas is 16 years old and lives in New York City. She attends the Chapin school as an 11th grader, and this past June she got to do something that most teenagers don’t get to experience; She participated in MMFC’s mission to Antigua, Guatemala as a junior volunteer, taking all of the pre-op and post-op photos and collecting stories of some of the children she met.
MMFC sends a mission to Antigua, Guatemala two times each year. On June 22-29, our team of volunteer doctors, nurses, and administrators returned for another week of cleft surgeries and dental care. By the end of the five operating days, the MMFC team had completed 34 cleft surgeries and provided dental care to 21 children.
Thanks to the dedication and generosity of our volunteers, donors, and the Hermano Pedro Hospital in Antigua for opening its doors to us, these children received life-changing operations that they normally would not be able to afford. These are just a few of those children.
Juan Carlos Utuye
Juan Carlos is an 11-month old from Media Luna, about 5 hours away from Antigua. The youngest of four children, he was born with a bilateral cleft lip, and his mother brought him to MMFC’s mission with hopes of having it repaired. Juan Carlos’s mother heard about MMFC through an organization in the region that has an outreach program for children in need of cleft lip and/or cleft palate surgery. With his deformity, Juan Carlos required a lot of extra time and attention from his mother, who has three other children to care for. The surgery that Juan Carlos received was the first stage of his cleft lip repair; when it is complete, it will not only life-changing for him, but also life-changing for his entire family.
Santos Moises Lajpop
Santos is a 1 and a 1/2 year old boy, born with a unilateral cleft lip. He lives with his parents and four siblings in Momostenango, about 5 hours away from Antigua. After learning about MMFC at a local clinic, Santos came with his father to have his cleft lip repaired. Before he received surgery, Santos had a difficult time eating and as a result is malnourished – a common problem among children with cleft deformities. Now, with his lip fixed, he will live a much healthier and happier life.
Sebastian is 6 months old and comes from Rincon de los Leones, about 5 hours away from Antigua. He is the youngest of four children. His mother heard about MMFC through the organization Asociación Compañero para la Cirugia, which advertises for us in local clinics. With his severe deformity, Sebastian would not have been able to live a normal life. He had trouble eating, and the local community blamed his mother for his cleft lip. Now his mother will be able to take better care of him and his siblings.
Esmerelda is 16 years old, and was born with a cleft lip and palate. She is one of ten children and just had her lip repaired two years ago. Her neighbor made the nearly 12-hour journey from Tacana with her this year to have her palate repaired, since her parents had to work and take care of her siblings. For the 14 years before her lip was repaired, Esmerelda never left her house – not even to go to school. She couldn’t speak well and was afraid of being teased for her deformity. Now that her palate has been repaired by the MMFC team, she is another step closer to having a more normal life. She now hopes to improve her speech through therapy.
August 7, 2013
Cusco, Peru is one of MMFC’s longest-running missions. This year, with Dr. Helen John-Kelly as the team leader, we returned from June 14th to 23rd with a 24 person team of doctors, nurses, speech pathologists, volunteers, and administrative staff, ready for a busy week of cleft, microtia, and dental surgeries.
By Saturday afternoon most of the team had arrived. With Cusco’s elevation being over 11,000 feet, altitude sickness is a big concern, so in order to avoid having any sick team members, Sunday is a day of rest on this mission, a low-key day to acclimate to the altitude. Many team members went to the Sunday market in Pisac to get their souvenir shopping done early. With so many first-timers on this trip, there was a lot of nervousness and plenty of questions, but everyone was excited and anxious to get to work.
The team arrived at the EsSalud hospital on Monday full of energy and focus, and was welcomed by a lobby jam-packed with patients and their families waiting to be screened. This was screening day – always the most hectic day of the week on any mission, but especially so with such a large team. Thanks to careful planning and coordination with local staff, the team screened over 100 cleft, microtia, and dental patients in just a few hours, and by that evening MMFC had all of its cases scheduled for the rest of the week.
Throughout the course of the four operating days, using two operating rooms, the MMFC team completed surgeries on 13 microtia patients, 16 cleft patients, and 25 dental patients. Those numbers did not come easily, though; the days were long (12-16 hours!) and exhausting. But thanks to everyone’s hard work, we were able to help many beautiful and deserving children.
Saul is a 12 year old boy who lives with his parents three hours outside of Cusco. He was born with moebius syndrome, a rare neurological disorder that causes facial paralysis. It’s hard to imagine what it would be like to not be able to form any facial expressions, which play a huge role in our daily interaction with the world around us. This year, our surgical team successfully completed a thigh muscle graft on Saul. This was the first of this type of surgery for MMFC, and the biggest reward is that now Saul can finally smile.
Rommel is two months old and lives with his parents in Anta, a town about an hour away from Cusco. When he was born, the doctor told his parents about MMFC’s annual Cusco mission and suggested they bring Rommel to repair his cleft lip. Our team operated on Rommel on Tuesday, and his parents were so thrilled with the result that they wanted Dr. John-Kelly to be their son’s godmother! Rommel’s father is a driver, and he even offered to drive our team around when we return next year. This is a terrific example of how MMFC’s commitment to its mission sites, and the fact that we return annually, allows local physicians to refer patients to us that could not otherwise afford a cleft surgery. They know from year to year when we will be returning and more important, that we will return.
Sebastian and Luciano Ripa
Sebastian and Luciano are four-year-old twin brothers. They were both born with a cleft lip – one with a bilateral cleft and the other with a unilateral cleft – and they had both come to MMFC’s Cusco mission in prior years to have those repaired. This year, they returned to receive dental care and have palatal obturators fitted. No one likes going to the dentist, especially if it means having teeth pulled, but these two boys seemed to always be smiling. We love to see past patients return – especially when they have a smile on their face!
Cesar celebrated his 18th birthday while recovering from surgery to repair his primary microtia.
Zoraida, three months old, received surgery to repair her unilateral cleft lip.
Our mission to Cusco was a success once again, and it would not have been possible without so many different groups of people working together to make it happen – MMFC is extremely grateful to EsSalud for welcoming us into their facilities, to Edouard Ruelle and the Children of Peru Foundation for their generous sponsorship of the mission, to our wonderful local coordinators Ani Forsyth, Patty Galup, and Susana Mayer, and especially to this year’s team of extremely hard-working and dedicated volunteers.
April 2, 2013
Mary Beth Hagey is a docent for the Fine Arts Museums of San Francisco and a board member of a private foundation awarding scholarships to students demonstrating outstanding service in their communities and academic excellence. For the past 25 years, Mary Beth has been an active volunteer for the local schools (room mother to PTA President), in her community (scout leader, coach and mentor), as well as on a global level (participated in and organized the AIDS Walk Africa for the Elizabeth Glaser Pediatric AIDS Foundation). The “Greg Feldman, MD, Memorial Surgical Mission to Rwanda” is Mary Beth’s first trip with MMFC.
Sunday, March 10, 2013
“Muraho, Odette. May I take your photo?” all the while pantomiming with my camera. My Kinyarwanda vocabulary is limited to a few pleasantries. I needn’t have worried though. Her infectious smile lights the room; words seem unnecessary. The goiter on Odette’s neck resembles a lumpy grapefruit. With the help of a local interpreter, I come to understand that Odette and her younger sister have walked for 3 days to Gitwe Hospital in hopes that she will be selected to have this life changing surgery performed by American doctors and nurses donating their time and skill with Medical Mission for Children. She made this identical trek last year, but by the time she arrived, the schedule was already filled. Her enthusiasm and gratitude are palpable. Odette recounts her difficulty breathing when she carries her burdens on her head as well as when she sleeps. Odette asks to see her “before” photo as I head for the door. She wants to remember what she used to look like. Somehow I think she will be excited to see the “after” photo as well.
Surgery Day 1 – “Hitting Their Stride”
Monday, March 11, 2013
Today had fits of rain so intense that you might liken the downpours to being doused with a fire hose. The power comes and goes, but the team is adept at rolling with the havoc mother nature wreaks…perhaps the most difficult to contend with is not in the OR, but back at the guest house where showering involves icy water in an inky stall after a walk home along the dusty path. Despite the unpredictable weather, the team has hit its stride and each case proceeds with remarkable efficiency. Doctors adapt to each situation/complication by tapping into their bank of experience and also knowing the depth of the professionals supporting them. The OR nurses anticipate the surgeons’ needs and the Post-Operative nurses are an incredible balance of professionalism and warm empathy. One patient that was vomiting after surgery necessitated a return visit to the hospital after the team had settled back into the guest house and eaten dinner.
A nice reminder of what an incredible impact MMFC has on the lives of the patients occurred today. A beautiful Rwandan woman introduced herself to me. She said that she had received an operation on her goiter at MMFC’s Rwanda mission in 2012. She exclaimed that it was truly a miracle! She was hopeful that the doctors might consider helping her with her arthritis. Our mission is goiters so unfortunately this will not be possible, but it was wonderful to see a patient thriving twelve months later. Obviously the gratitude survives and lingers even after the team heads back to their practices in their home countries.
Surgery Day 3
Wednesday, March 13, 2013
There is quiet calmness to the start of day 4. The team stayed up late into the night discussing a patient named Liliane after a return visit to the hospital. Today’s schedule includes another very large goiter, although not as large as the previous day. Many of the previous patients that had drains will be released today. There is much to celebrate today as patients head home and return to their families. The surgeries just seem to click off at a sustained, even pace. The patients go to the post-operative room and then head up to the wards. The most angst today does not seem to be focused in the operating room, but rather in that breezeway where the patients have been waiting all week for their chance to have their name added to the surgery schedule. Given our departure timing, it is apparent that we will be unable to operate on everyone. Dr. Dhingra does another pass through to prioritize the women and tighten up the schedule. Unfortunately, some that have been waiting will need to be turned away. Naturally, some restrained emotions well up in the women that need to head home. They have been given instructions on medications and ultrasounds and reminded to return next year for the mission in 2014.
A treat awaits the team tonight… Our in-country partner, Vianney, has graciously arranged a brisk hike to his family home here in Gitwe and a delicious Rwandan barbecue dinner. The team gathers around the fire in the courtyard and listens as the young neighborhood children serenade us. We head home and hit the sack… it’s a 5:30am breakfast and back to the hospital.
Surgery Days 4 and 5
Thursday, March 14 and Friday, March 15, 2013
Music is a large part of these next few days. We’ve been serenaded by the small school children around a fire. We’ve heard locals harmonizing in halls and churches on our walk back to the guesthouse and the faint sounds of the Beatles can be heard when entering the operating room. Spirits are high. We are over the hump. The first patient is prepped and in the OR by 6:30am. There is a sense of familiarity and camaraderie among professionals now. A minor hiccup comes after lunch, when one of the patients exhibits signs of hypertension. They decide to cancel her surgery and one more name to the schedule. Being flexible is critical to our success.
The upbeat, almost festive mood carries over to dinner. The team is energized by the impact they have made in a short amount of time.
Friday is our last day of surgery with two straightforward cases. The doctors and nurses complete their mission and discharge all but Liliane and the last two patients. Now it’s time to take apart the operating and recovery rooms. It’s bittersweet as we pack it all in the bus and head to Kigali. We will scatter back to the places we all call home (SF Bay Area, New York, Boston and Washington, DC) richer for having had this experience. Murakoze, Rwanda!
By the end of the last surgery day, the team had finished 25 goiter cases. One of those patients was Liliane, a slim, attractive 38 year old Rwandan with clear skin and close cropped hair. When you first meet Liliane you can’t help but feel overwhelmed by the enormous goiter that has taken over her neck and wraps up the side of her face to her ear. Liliane’s goiter will prove to be the most complicated and challenging surgery of the mission here in Rwanda. She will be in surgery all day and spend the night with a doctor on vigil in the recovery room. She will be the last MMFC patient discharged from Gitwe.
It was sheer luck that Liliane made her way to Gitwe this year. If not for the fact that she has a friend with a goiter who heard about the American doctors coming to Gitwe to donate their services from an employee of Gitwe, Liliane would have been unaware of this unique opportunity and forced to continue to live with this honey dew melon sized growth on her neck and face. As it was, Liliane has seven children at home and walked 6 hours to Gitwe. While all of the operations performed by the doctors here are life altering, Liliane’s change in appearance is the most dramatic. Despite the pain associated with the recovery, her gratitude is deep and authentic.
In addition to the incredible marathon performance by the doctors and nurses in the OR, I’d also like to highlight the incredible compassion and care given to Liliane by the recovery room nurses. A couple days after her operation, Liliane was back in the post-op room for observation and care. This was rough going for sure…as much as she wanted to mask the pain she was in, even the casual observer recognized that wince. The two nurses knew she was in need of a boost. One went to her secret stash and pulled out a brand new pair of fuchsia and blue flip flops and slid them on her feet. She tucked her old, worn-out ones in a canvas tote that she filled with socks and a “Race for Survival” t-shirt. She slid three red, white and blue beaded bracelets on her arm to accompany the hospital one she got when she was admitted. She embraced her shoulders and let her know she understood that this was difficult. The exchange was touching and just what Liliane needed.
Another patient treated was Joseph, who was hard to miss in the sea of women waiting to be examined. Although he is 18 years old, he emits an aura of youthful innocence. His slight frame reinforces the notion that he is younger than his years suggest. His openness and his understanding of the English language allow a playful banter between doctor and patient. Dr. Dhingra teases Joseph about the female patients having been very brave and stoic when it came to accepting injections in their neck without so much as a flinch. Joseph carried the burden of proving that the men could also tolerate this somewhat scary needle coming at their neck! If this was not enough pain to endure, Joseph had been clearing the land with a machete a couple days before and had accidentally whacked his knee open and needed a tetanus shot as well.
I met Joseph’s mother in the recovery room as well as later on the ward. She was anxious to tell me that Joseph was a diligent student. She kept repeating ‘murakoze’ or ‘thank you’ for the surgery and care Joseph received. We will miss that disarming smile and bravado!
Rwanda is known fondly as the Land of a Thousand Hills and a Million Smiles. Let’s continue with that theme and consider the 2013 MMFC Rwanda “by the numbers.”
The mission included:
- 13 health care professionals from 3 US states and the District of Columbia as well as one local Rwandan
- 2 surgeons and 2 surgical residents
- 2 anesthesiologists and 2 anesthesiologist residents
- 2 surgical techs
- 1 operating room nurse circulator
- 2 post anesthesia recovery room nurse practitioners
- 1 in-country partner
- 1 MMFC alumni Ob/Gyn
- 2 local translators
- 1 administrator
- 44 pieces of luggage carrying supplies and equipment traveled across 10 time zones and over 9,400 miles as the crow flies
- 1 lost preppy pink suitcase finally surfaced after 3 days time and finally made its way to Gitwe
- 1 very happy team member after its arrival
- 1 tire blew out traveling from Kigali to Gitwe
- 25 life-altering surgeries were performed on:
- 24 women and 1 young man
- 71 years old was the oldest patient
- 17 years old was the youngest patient
- >850 grams was the largest goiter removed
- 7 hours and 10 minutes was the longest time spent in the operating room (surgery time was shorter)
- 50 minutes was the shortest time spent in the operating room
- 3 days walking was the longest distance traveled by a patient to have this surgery performed
- 1 hugely inspirational human spirit for whom this mission is dedicated – Dr. Greg Feldman. Numbers seem insufficient in quantifying the lasting impact Greg had on MMFC, the doctors and nurses, the patients, and the community of Gitwe. Not unlike the red dusty earth of Rwanda that found it’s way under our skin, between our toes and permanently enmeshed in our clothes, so too has Greg’s spirit. Each morning as we crossed the threshold of Gitwe Hospital we passed his memorial tree – one that has taken root and is thriving. We felt his presence each day and were grateful for the reminder and inspiration to be the best version of our selves. Peace and Murakoze, Greg!