Operation Smile-Cambodia, Mission Complete!

Los Vichika Post-Operative Day #1

Los Vichika Prior to Surgery (Photo courtesy of Ashleigh Sim, Singapore)

Pre and post-operative photos of Los Vichika, a delightful 6 month-old boy with an incomplete unilateral cleft lip deformity.

Our Operation Smile mission was held at Takeo Provincial Referral Hospital, located approximately 90 km south of Phnom Penh. The mission was successfully completed. It was such a pleasure to volunteer with my colleagues and to get to know so many Cambodian children and their families. We officially screened over 160 patients (unofficially over 300 patients) and 98 patients had surgeries with safe outcomes.

The first day of surgery started with visits from VVIPs (very very important people) including Cambodia's Prime Minister's son, Hun Manet (apparently he's being groomed to be Cambodia's next prime minister). He's a graduate of West Point, has a PhD in economics, and seems to be well liked by the Cambodian people. He was very kind and genuinely interested in our mission, as he visited with our patients and their families. Oh, yeah, he's handsome too!

Our oldest patient, Neo Keang, was a lovely 81 year-old woman who also had a unilateral cleft lip deformity. Here is a link to her story: http://ow.ly/54K11 She was so grateful following her surgery! I was fascinated by her life and her experience of living in Cambodia. Consider how different Vichika’s life will be, both temporally and personally, compared to Neo. Simply amazing.

The major key to the team’s success was Professor Mok Theavy, MD, Cambodian plastic surgeon, his assistant, Ho Thavry, and their cadre of Cambodian medical students and health professionals that volunteered in every aspect of the mission (including translation)! A special shout-out is due to David Fruitman, a Operation Smile-Cambodia board member and “always there when you need him for anything” volunteer. Thanks to everyone!

Cambodia At Last!

As luck would have it, I am preparing to leave for Cambodia. As many of you know, I have a great interest in Southeast Asia, its people, culture, and history. To have the opportunity to visit Cambodia is amazing! I will be leading an Operation Smile medical mission to Takeo, Cambodia. It is a friendship mission sponsored by Operation Smile-Singapore. It is always a pleasure to work with my Singaporean colleagues. We will have team members joining us from Cambodia, Italy, the Philippines, the United Kingdom, the United States and Uzbekistan. As luck would have it, I was able to eke out a few extra days prior to the start of the mission. I will be visiting Siem Reap and the Angor Region, including Angor Wat, Angor Thom, and surrounding temples. I hope to make posts to my blog during my adventures. A big Khmer “ar kun” (thanks) to everyone for your encouragement and support!

http://cambodia.operationsmile.org/

More Work To Be Done

Well, the Jamshedpur mission is over, and the majority of my team members should be home by now...India, China, Vietnam, Singapore, Japan, Australia, etc. However, it was apparent our work is not yet done. I spent the final day of the mission working with the patients and their families on the post-operative ward, doing discharge planning and teaching. Although we had completed our surgeries, many patients were still arriving in anticipation of having operations. It was difficult to send them away, with only a promise of returning in the future. One of my colleagues had a similar "message from the universe." She was shopping in the market on the same day, and saw some street kids running through the market...one of them had a large cleft lip. Here is a photo of me with a new friend, Ganesh. He had arrived with his parents on our last day. He's six months old, but the size of a newborn baby. He will have to gain some weight before undergoing corrective surgery.

I wandered the hallways on our final day in Jamshedpur, and found some of our patients and their families. Here's a photo of a little guy and his mother, as well as a photo of the son of one of our patients (that's his mother behind him; she had her cleft lip repaired the day before).

We held education sessions for different disciplines on the final day of surgery. I had the pleasure of speaking to nursing students. They were in their final year of studies. They helped take care of the children on the post-operative ward. It was evident they had very good training. They were ambitious and eager to learn, and a pleasure to work with...

India is full of life, excitement, and colors. Here are some photos taken on my final day in India.

Fruit Seller

Country Ladies

A field of Green

Train Dudes (they insisted I take their picture!)

Fields of Marigolds

Turban Man (one of our porters)

Swimming

And so ends yet another terrific international volunteer experience. I am blessed and fortunate to have such supportive friends, families, co-workers, and fellow volunteers. You make this all possible, and it's a pleasure to share my experiences with all of you. Thanks for your support and encouragement.

Wrapping Up

We've completed five days of surgery, and I'm happy to report that all the kids and their families are doing well! All of the patients have been discharged, and we just completed packing up all of our equipment and supplies, which will be shipped back to Mumbai. Some of our team members toured the Tata Steel Factory this morning. It sounded very interesting, but also very hot! We'll have a party tonight, then board an early morning train back to Kolkata. A group of us are planning to visit Mother Teresa's grave. "Peace begins with a smile...

It's been great to be part of such a terrific team! Here is everyone posing in front of our host hospital. I'm going to miss everyone!

Heating Up In Jamshedpur

It's been a busy few days here in Jamshedpur. Things are going great. I have a fantastic team, and we're really working well together. We've completed our third day of surgery, and all of the kids are doing fine. It literally is heating up here. Today was a record high temperature of 42 degrees Celsius (107 degrees Fahrenheit)! We have air conditioning in the "operating theatres" but not on the ward. It's made the work difficult, but it's worth it. Our program coordinators make sure we have plenty of food and bottled water.

A lot is happening in India. We received a report today that Maoist terrorists bombed a railway in Patna, India, the "Rajdani Express." Also, there is a political strike that started today in Jamshedpur's state, Jharkhand, as well as four surrounding states. This is unfortunate, as it will make it difficult for our patients and families to travel to Jamshedpur. Apparently these political strikes are quite common in India, and things should return to normal within a few days. I hope so, as we have train reservations to return to Kolkata!

As I mentioned, our team has a multinational spirit. For example, my OR nurses are from India, Singapore, China and Vietnam. They're all so young and energetic. They call me mom, which makes me experience mixed emotions...feeling old, yet also feeling very excited about the next generation of volunteers. The future is certainly bright! Here is a photo of some of my OR crew, from left to right, Giang (Vietnam), Blessie (Singapore), me, Leila (Singapore), and Lily (China).

Here's a photo of some of my kids and their mothers, which was taken as I was preparing to bring them up to the operating rooms.

The post-operative ward is quite warm, but the rooms are open and have fans that keep the air moving. Here's a photo of a mother and child in the ward following surgery.

This is a photo of some of the families spending the morning following surgery together. The families help each other out with caring for their children.

This mother really caught my attention. She was so proud of her daughter and her appearance following her surgery. Her daughter had a large cleft lip prior to her surgery. Once her incision heals, it will be difficult to detect she had a lip defect. When Jamshedpur families are asked about why they think their children are born with clefts, a common response here is they feel it is a result of being exposed to an eclipse. Parents are worried their children won't be able to marry because of their deformities.

To sign off, the air here is hot, heavy, humid, and smokey. Although it makes breathing difficult, it also makes for great sunsets.

Settling In

We've had a few busy stays getting established and screening potential patients for surgery. Our Jamshedpur hosts, the kids, and their families are terrific! Unfortunately, we haven't screened as many patients as we had hoped for. We have currently evaluated 89 patients, with 72 patients scheduled for surgery. We planned for at least 125 cases, and hope more candidates will arrive during our surgical week. We will set-up our operating rooms, a.k.a. "theatres" today, and will begin our surgical week tomorrow.

India is a special place. The people, the culture, the geography, the food, the colors, and the aromas are quite captivating. Everyone has been welcoming and hospitable. It was a lot of fun screening our potential patients. The children and their families are very happy.

Happy boy and father

Cutie pie

Mother and son

These are some of my new friends. We couldn't do our work without the help of the local volunteers. As you can see, I fit right in. Hmmmm, why does everyone stare at me?

Finally...Jamshedpur, India

Now that's some serious traveling! It took over two days, but I finally made it to Jamshedpur, India, through a configuration of car rides, jet flights, trains, and buses. We did have a little free time in the city this morning, and had a chance to experience some of the sights (and smells) of old Kolkata. I took a taxi into the city and roamed around. The city is such a juxtaposition of the old and the new, e.g., the Colonialization influence, and the age-old Indian ways. Here are some photos representing this.

Of course, the poverty is staggering. Some of my colleagues from New Delhi tell me this is one of the poorer parts of the country. The orphans are ubiquitous. Here are a couple who were begging at my taxi. The only English word they knew was, "Chocolate," which they kept saying and then brought their hands to their mouths.

Although all of this traveling is tedious and tiring, we start our real work tomorrow. We will begin screening our potential patients. We have a cornucopia of volunteers from ten different countries. It will be great to begin working together. Things will be a little challenging, as we were unable to get our supplies through customs, so we will need to start sorting through the leftovers from the recent "mega mission" held in Guwahati, India. It's going to be an interesting day, to say the least!

Return to the Indian Subcontinent

It's time to prepare to depart for another mission with Operation Smile, destination Jamshedpur, India. This city is located in the mid-eastern part of the country, near Kolkata (map reference: red dot).

The team composition list again has an international flair, which includes volunteers from India (of course), China, Vietnam, Singapore, Italy, and the United States. As many of you are aware, the planning for this mission has been filled with challenges, from cargo delivery issues, customs protocols, equipment problems, and staffing issues. Last I heard, we are still down a nurse or two. I apologize for being so distracted. In the end, things always seem to work out. I was reviewing some of my photos from my last mission to India. Seeing the children and their families' faces reminds me what all of the hard work is about.

Surgical screening

Playground kids

Rajastani girls

Henna Hand...with a few rupees to boot!

Colorful saris for sale

Thanks to everyone for their patience and support. I hope to make some posts to the blog during my mission, Internet permitting...

Finally a Family!

Yonathan

It is with great pleasure for me to share with everyone my friend Lisa's news. She and her husband Andy are in Addis Ababa, Ethiopia, and have finally been united with their adopted son Yonathan. Here is her blog entry from today:

We are roughly 24hrs with Yonathan. We picked him up at the orphanage yesterday around 1. It was a remarkable experience meeting his caregivers. Many became emotional when we took him. They became very attached to this boy and we can see why after having him of only 24hrs. He is simply amazingly beautiful. He loves being held and we love holding him, especially while he sleeps. Most of the children are well cared for but are not held enough.

When we hold him next to us we can feel the immediate sense of safety and relaxation, which means a lot to us knowing his rough start in this life. We love him more than words and it brings tears to my eyes as I write this entry for many reasons. It deeply saddens me to think how many thousands upon thousands of children could be available for adoption. The poverty here is staggeringly sad. We feel fortunate and incredibly lucky for the gift of Yonathan and also want to thank the countless people who gave us so much support in the past couple of years. We are finally in Ethiopia with our son. This is one of the best days of our lives. Take care. Andy and Lisa

Hanging Out in Ho Chi Minh City

We made our way back to Ho Chi Minh City (HCMC). It was a five hour bus ride from Can Tho. I enjoyed the ride, as there is always something interesting to see. Aflac?!!

It was great to return to HCMC. I was spent the afternoon exploring some of the city, saw the Reunification Palace, and had a drink at the Rex Hotel. I'd like to stay longer, but instead will have to compromise and return in the future. The majority of us are returning, but some of my colleagues are going to explore the Cu Chi tunnels tomorrow. Others are visiting different parts of Vietnam, including Ha Long Bay, and Sapa.

All of the southern Vietnam Operation Smile Teams are here, and we had a big celebration tonight. It feels like a class reunion, seeing so many friends and colleagues from previous missions. Bill and Kathy Magee, the founders and CEO/president of Operation Smile International, visited our site in Can Tho. Dr Magee performed a surgery on one of our children. Of course, they both attended the celebration. They have motivated me to take the initiative in re-starting a Minnesota Operation Smile Chapter. Here's a photo of Bill, me, Kathy, and Khai, our mission coordinator, at the celebration

As long as I'm posting photos of myself (yuck), I thought I'd include a photo from last night. Some of my colleagues bought me gifts...including not one, but two traditional Vietnamese outfits, called, "au dai." This is me and my friend Dao. We're both wearing an au dai. Of course, she's quite elegant!

It's almost 1:00 AM in HCMC. And so begins my very long day. I fly out this morning. Due to the time zones and crossing the International Date Line somewhere between Tokyo and California, November 15, 2009 will last 37 hours for me.

Before I log off, I'll post some of my photos of some of the people I saw on my trip down the Mekong (Hau) River.

A Girl Named Nhu

During my time in Can Tho, I had the pleasure to meet many patients and their families. They all have special stories to tell. For example, Nhu is an eight year-old girl with a severe bilateral lip and palate deformity. Our lead surgeon, Rafael Gottenger, was immediately taken by her during patient screening. She was so scared, she was shaking. She had never met a foreigner before.

Nhu's father also has a facial deformity. He had surgery twelve years ago. Although it is evident that Nhu inherited this trait from her father, we do not have a very good understanding of the genetic relationship with deformities suh as cleft lip/palate. Based on our current state of knowledge, currently only 10% to 20% of all cleft deformites have been shown to have a genetic relationship. We had a genetic researcher who was present during the mission. Over 500 genetic specimens were collected from patients with cleft deformities and their family members. Hopefully we will be able to learn more in the future.

Rafi performed Nhu's surgery, and she did very well with her immediate recovery. When she was discharged from the hospital, Rafi presented her with a bicycle. Afterwards, he was waxing philosophic, mentioning that the next time he's frustrated with traffic or issues at work (for example), all he'll have to do is think of Nhu and what she's had to endure to give him some perspective. This morning, Rafi and some of our team members visited Nhu at her home. Although she only lives a few kilometers away from Can Tho, the trip took almost two hours via various modes: taxi, motorbike (the road became too narrow for cars) and then walking the final few kilometers. Her home, which is essentially a small shack, is nestled between a banana plantation and rice paddies. She and her neighbors were quite surprised with today's visit. She gave the team a tour of her village and showed them her school. She is and bright girl, and is appears to be doing very well. She will need additional surgery in the future.

Photo courtesy of Graham Wilson

Rafi has been on numerous Operation Smile missions. He was the surgical team leader for this mission, and I had a wonderful time working with him. He is an amazing human being. Rafi had actually been to Can Tho with Operation Smile ten years earlier. Rafi had operated on little boy with a bilateral cleft lip deformity.

photograph circa 1999

The boy returned to be screened. He still has a cleft palate, but had a wonderful outcome from his lip surgery. Although he showed up too late to have his palate repaired on our mission, we were able to arrange for him to be evaluated and and hopefully receive surgery from Dr. Phuong in Ho Chi Minh City.