Fixing Broken Smiles

Singapore-based charity The Smile Mission provides free reconstructive surgery to those born with cleft lip and cleft palate across 13 countries in Asia.

BY AUDRINA GAN
ILLUSTRATION RODRIGO FORTES


Spreading smiles across Asia

The Smile Mission is on a quest to change the lives of those born with birth defects such as cleft lip and cleft palate. From April 2008 to May this year, it has supported 67 surgical missions across 13 Asian countries, resulting in 9,233 medical evaluations and 5,668 surgical procedures.

 

B

orn in Bhutan with a cleft palate, Kuku, 77, thought he would live with his birth defect until his death as he could not afford corrective surgery. However, in September last year, volunteer doctors from a Singapore-based charity gave Kuku a reason to smile when they helped fix his cleft palate for free. “Now I can die handsome,” says Kuku.

His operation was part of a medical mission organised by The Smile Mission. Founded in 2008 by private equity investor Gary Loh and Singapore-based plastic surgeon Vincent Yeow, The Smile Mission provides free surgery and treatment to those born with facial birth defects such as cleft lip and cleft palate. Says Dr Yeow: “We offer free surgery to poor and needy children who suffer from facial deformities, so as to bring new smiles to their faces. We also want to level up regional and global standards of medical care by fostering and creating cross-learning and training opportunities in the field of plastic surgery. We hope to make our region ‘cleft-free’.”

The organisation manages Smile Asia, an international alliance of charities with similar objectives from 18 countries including China, India, Hong Kong, Japan and the United States.

Since 2008, it has carried out more than 9,000 medical evaluations and more than 5,000 surgical procedures across 13 Asian countries.

A cleft lip or palate occurs when a baby’s upper lip, the roof of the mouth (palate), or sometimes both, do not properly form during pregnancy. It is caused by a combination of genetic and environmental factors such as drugs, infections, maternal smoking and malnutrition.

In the whole of Asia, about one in 500 children, or 100,000 every year, are born with the birth defect, says Abhimanyu Talukdar, executive director of The Smile Mission. But they are often left untreated in the rural areas of developing countries due to the high cost of drugs and surgery involved.

“Children with a cleft lip or a cleft palate often have difficulty eating, talking, hearing and breathing, as well as have low self-esteem,” he says. According to him, the cost of drugs and consumables for a simple 45-minute cleft lip operation can range from S$500 to S$1,500.

Smile Asia volunteers preparing a child for surgery during a mission in Bhutan last year.


CHANGING LIVES

A typical week-long Smile mission involves 35 to 40 volunteers from Asia and other parts of the world. The team comprises medical professionals, including surgeons, anaesthetists, and nurses, and non-medical volunteers, such as interpreters and videographers.

“Each mission sees us transforming about 100 lives through safe and effective surgery. It also raises awareness of the impact that facial disfigurement can have on both the individual and his family,” says Talukdar.

Madam Shokhsanam from Uzbekistan, whose son underwent a cleft palate operation last October, is grateful. She says: “I am very happy.

My son Kodirjon is very good and healthy now.” Smile Asia also performs similar surgical procedures on adults, like Kuku, who have lived their entire lives with the birth defect.

Volunteer Coreen Low, a nurse manager at KK Women’s and Children’s Hospital, remembers vividly the time she met a young woman with a unilateral cleft lip, who was reserved and shy, and kept her facial features covered at all times.

“It was amazing to see her transformation after corrective surgery. We saw a really pretty girl, with big sparkling eyes, who was full of hope,” says Low. “The surgeon did a great job restoring faith and hope. This was repeatedly seen in all the patients who were operated on.”

A child waiting to see the medical team at Tashkent Pediatric Medical Institute in Uzbekistan in 2013.

Dr Vincent Yeow checking on a Bhutanese patient after surgery.

LEARNING OPPORTUNITIES

Smile Asia provides a learning platform for medical professionals from both the countries they work in and the international community. Talukdar says: “Often, the local officials and community are sceptical of our motives. We do not tell them we are there to help them. Instead, we tell them that we are there to work and learn from them. Mutual trust is built from there.”

The foreign medical professionals learn how to perform surgery with limited medical facilities from local doctors in developing countries. Local doctors, in turn, learn from the foreign team certain new techniques or processes that improve the medical care of patients.

Natalie Pakiam, a pre- and post-operation nurse at Singapore’s Khoo Teck Puat Hospital, has gone on six missions with Smile Asia. “I learnt things like how to manage the kids after cleft lip and palate operations, and taught them how to take care of their wounds after (they are discharged) with the little resources they have. I also better understood their culture and way of life.”

To improve the skill sets and the standard of medical care across Asia, Smile Asia plans to set up outreach centres in countries like China, India and Myanmar to impart a standard set of surgery and post-operative care to its local partners.

These operations and procedures will be followed up with annual audits to ensure that consistent medical care is achieved in these countries.

The roll-out will be done in a systematic way, says Talukdar. The charity will work with local government officials from the health ministries and other non-governmental organisations to ascertain the demand for their services and the amount of support required.

Its local partners will help to reach out to the local people, and to arrange for accommodation and logistics for its missions.

Through this new alliance with local partners, Smile Asia hopes to increase the number of surgical procedures it can perform to 8,000 a year and grow its pool of volunteers from the current 400 to more than 2,000.

 


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