Rwanda 2019: The Final Days

The last day in the hospital in Gitwe was certainly the most challenging in terms of surgeries. The team had four complex ones to start the day, with the last surgery turning out to be much more difficult and vascular than the surgeons had anticipated, taking a total of nearly five hours to complete. While Drs. Dhingra and Sebelick and DeBiase worked together on that patient, Dr. Chandra finished up remaining cases, and the rest of the team not in the operating room worked on packing up all our medical equipment in preparation for leaving the next day. We left an emergency surgery kit in case of any overnight issues that could arise, but apart from that packed up everything we had brought, only planning on coming back to the hospital very briefly the next day to discharge remaining patients. The night ended with a dinner at Dr. Zachary’s (the medical superintendent of Gitwe hospital) house, which was a lovely end to what had been a long week. The team then headed back home to pack up and prepare for leaving the next day.

Goiter removed on the last day of surgery

Our PAC-U nurse, Courtenay, discharging patients

This morning, we gathered for one final breakfast at Gerard and Justine’s (our hosts) house before walking to the hospital in the Rwandan mist. We arrived to see yet another line of women outside the doors, but this time they were composed of already operated on patients, whose necks no longer were obstructed by large goiters. It was a beautiful way to end the trip, with smiles and laughter and even some singing as the doctors discharged our remaining patients.

I would be remiss if I did not mention the incredible team that represented MMFC on this mission. The team of nurses, comprised of our scrub nurses Adriane, Liz, Julie, as well as our post-anesthesia care unit nurse, Courtenay were at the heart of keeping every day running smoothly and efficiently. The anesthesiologist team, led by Kyle and Cale and Tim, with residents Britta and Stephanie and CRNA Jeff, maintained an extremely high level of care for every individual patient, talking them through their anesthesia and constantly making sure they were safe before, during, and after their operation. Our administrator, Michelle, was the much-needed organizational heart of the mission, and our budding surgeon/pre-medical student Shelby was a constant positive and enthusiastic presence throughout. The surgeons themselves, Drs. Dhingra and Sebelik and Chandra and fourth-year resident Dr. DeBiase, worked unbelievably hard to get through all thirty-two surgeries and never once showed the fatigue they must have been feeling throughout the whole trip. Their skills as surgeons are un-contestable, but they were also incredible teachers and team members for everyone involved. We were joined by some incredible staff at the Gitwe hospital, along with medical students from the local school, who were all extremely enthusiastic to learn and help.

I think I speak for myself as well as the whole team when I say that the trip to Gitwe this year has been a truly incredible experience. The hospitality and kindness of the people here is unparalleled, and getting to give people access to medicine that they do not have otherwise was a true honor for us. Gerard, one of our hosts, put it quite beautifully, thanking us this morning at breakfast and ending by saying, “the people from America and Rwanda, we are brothers”. It is a sentiment not often echoed in this day and age, and certainly rang true for all of us after spending a week here. Even as we leave Rwanda today to head back home, there will certainly be a lingering feeling of homesickness for this beautiful country and its people, along with a desire to continue the work we have begun next year.

~Ananya Mahalingam-Dhingra

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Rwanda | 2019 Day 5

Today was the team’s second to last day here in Gitwe, and it proved to be a long but successful one, with seven more surgeries being completed over the course of a thirteen hour day at the hospital. The morning began with our largest and most complex goiter yet, a surgery that took Drs. Dhingra and Sebelik nearly the entire morning. More post op patients had also been making excellent progress and most were discharged from the hospital this afternoon. Tomorrow will be even more busy, with seven more patients on the agenda along with the added task of packing up our equipment from the hospital in preparation for traveling back to the United States on Friday.

The time here in Rwanda has gone by unbelievably quickly, it is difficult to step back and appreciate the work we have completed thus far. However, with twenty seven surgeries completed (nearly a record number for at this point in the trip), it is clear that the group this year is a special one. Despite the long days, starting the preparations to go home has a bittersweet air to it. Until that begins, however, another day of work awaits us tomorrow.

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Rwanda | 2019 Day 4

Tuesday was yet another successful day here in Gitwe with this year’s MMFC team. The day proceeded much like yesterday, with a total of seven surgeries completed, making our current count twenty surgeries done with about fourteen more scheduled over the next two days. One particularly interesting case involved the doctors taking a very lateral approach to a particularly large goiter, exposing vital veins and arteries in the neck (pictured below). The surgeons’ skills were demonstrated, as despite the risk involved in the surgery, very little bleeding occurred and the procedure went smoothly. The afternoon ended with discharging post-operative patients from Sunday and Monday, which is always a highlight for whichever team members are there to complete it. Drs. Chandra and Sebelik were all smiles as they examined the healthy vocal chords and goiter-less necks of all the patients they had operated on just recently, even asking one patient to sing them a song to demonstrate vocal motility, which she complied with, albeit shyly. The day ended with more screenings of prospective patients, most of whom today were not surgery candidates but were simply seeking to be examined by the doctors. Despite the continuing line outside, out days left here at the hospital in Rwanda are dwindling, and it is clear that when the team returns again next, there will be no shortage of work to do.

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Kigali | Rwanda, January 2019

On January 4th 2019, 13 volunteer healthcare professionals from across the US arrived at Kanombe Military Hospital in Kigali Rwanda with several large bags filled with medical equipment on behalf of Medical Missions for Children. Over the subsequent five days, the team performed 26 thyroid surgeries with the help of local healthcare workers and the hospital staff. We were incredibly grateful for the opportunity to work side by side with local professionals to provide free surgery for people in need. The graciousness and hospitality shown to us by the patients, hospital staff and people of Rwanda made the experience truly memorable and we look forward to returning soon!

Kezia Mukamana, 66 years old, before surgery

Kezia Mukamana after surgery, recovering well and in good spirits!

The Team

The team was led by general surgeons Fletcher Starnes MD and Peter Mazzaglia MD and Anesthesiologist Brandy Brewer MD. David Elbert, Felicia Castaneda and Faith Chitiyo, all CRNAs, provided anesthesia care. Registered Nurses Adam Sperry, Jennifer Cornell and Chrissy Starnes and physician assistants Amber Saleemi and Nicholas Limoncelli provided peri-operative patient care and assisted in the operating room. Surgical technician Vanessa Horton assisted the surgical teams in the operating room. Rounding out the team were Theresa, Ian and Valentine Starnes, who provided administrative support and helped with documentation.

The team after the first day in the OR. Although many of us met for the first time upon arriving, we were able to quickly bond and work as a unit to provide safe and effective patient care.

Dr. Starnes and Dr. Mazzaglia ended the week by presenting a lecture on thyroid conditions to local medical students. Over 50 were in attendance and hundreds more joined via live stream.

This trip was made possible by Medical Missions for Children, who provided everything from equipment to logistics and planning. Through their coordination, the team was able to travel with a smartphone enabled ultrasound probe, which was invaluable in the preoperative planning of safe and effective thyroidectomies. The team would like to especially thank Dennis Snyder MD, Chairman of the MMFC Board of Directors, for his outstanding guidance and generosity of time and efforts towards this team’s first Rwanda mission!

Vianney Ruhumuliza, RN, originally from Rwanda, worked tirelessly before and during the mission to make sure the team had everything we needed to succeed. He also provided pre and post-op patient care. He was vital to the mission and we could not have done it without him!

Thank you to everyone else who made this mission possible and a special thanks to Dr. Starnes for organizing the mission and getting the team together!

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Quito, Ecuador | October 2-8, 2018

MMFC celebrated the 20th Anniversary of the Quito Mission at a ceremony attended by dignitaries and local partners in Quito during the October 2018 Mission.  MMFC Co-Founders Dr. Rafael Barrera and Dr. Charles Badaoui presided over the moving ceremony.   The occasion was marked by an exchange of awards and honors to recognize the dedication and service of so many contributors who make the Quito Mission possible.  MMFC awarded special recognition to our host for many years, the Fundación Tierra Nueva, as well as to individuals Pedro Alvarez, Patricia Jarrín, Mary Kay Barrera, Fuad Dassum, Susana Chiriboga, Leonidas Naranjo and Claudio Crespo for their extraordinary contributions over 20 years.  MMFC, in turn, was greatly honored to receive 2 special awards, recognition from the Quito Chamber of Commerce and the Fundación Tierra Nueva Hospital.

For Quito and other missions, MMFC attracts and retains an exceptionally talented medical team of volunteer surgeons, anesthesiologists, nurses, dentists and staff from the leading medical centers across the USA and England, including Massachusetts General Hospital, the Mayo Clinic, Northwell Health, Tufts University School of Dental Medicine, and King’s College Hospital of London.   As the team assembles in Quito, the air is charged with anticipation and esprit de corps of the highly motivated team members, many of whom have returned to Quito year after year.  New volunteers (like me!) are warmly welcomed and put right to work readying for the busy week ahead.

Over one hundred fifty patients were screened on day 1 and the surgeons worked up a schedule for the demanding week ahead.  For Quito 2018, 69 surgical procedures were performed, including primary cleft lip repairs on infants, bone grafts to repair cleft palates and other palate deformities, and a range of ENT procedures.  Dr. Badaoui and the dental team performed dental procedures under general anesthesia on patients with special needs.  As a new team member, I was struck by the respect, patience, courage and gratitude of the patients and their families.  Many of them are far from home, having traveled great distances.  Some have returned multiple times, year after year, for follow up surgeries.  There were even several sets of siblings, multiple children born into a single family with abnormalities requiring repair.  Notwithstanding the complexity of the surgeries, even the bone grafts which involve surgery at 2 sites (one to harvest the bone from the patient’s hip and a second to repair the cleft or fistula, along with multiple tooth extractions), almost every patient was able to be discharged the morning after surgery.  The transformations that result from MMFC procedures are stunning and dramatic.  I felt privileged to be a part of MMFC’s Quito 2018 Mission.   In a matter of hours (and sometimes minutes), and with every procedure, MMFC is transforming youngsters and changing lives for the patients and their families forever.    

– Claudia Gilman, Mission Administrator

Here is a special thank you drawing to the amazing doctors, nurses, and volunteers of the 2018 mission to Quito, Ecuador!
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Cambodia | 2018

Meet Mey, age 11, SreyNim, age 12, and Jonron, age 11.

For these three beautiful children, life has been anything but all smiles. Members of the Cambodian Children’s Fund rescued these children from a village-sized garbage dump known as Steung Meanchey, located in the center of Cambodia’s capital city of Phnom Penh. This immense mountain of garbage, toxic and threatening beyond imagination or measure, was home to Mey, SreyNim and Ronjon as well as thousands of other Cambodian children.The Cambodian Children’s Fund(CCF) lifted these children out from this deadly environment, providing a home and education and a future filled with hope. Medical Missions for Children has assisted CCF in caring for these destitute children, providing essential medical supplies and nutritional counseling for the 150+ children that are treated every day in an on-site health clinic.

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Cusco, Peru 2018 – Insight from a Volunteer

“Nada por la boca después de la medianoche,” I told parent after parent. “No food or drink after midnight.” My main goal during screening day as a volunteer was to make sure each family understood these pre-operative instructions. I was faced with the challenge of creating a sense of trust between the patients and caregivers. Indeed, patients are more comfortable with health professionals when they speak in their native tongue. Communicating and building trust with a diverse patient population is an important responsibility that requires cultural competency. This is not just a simple consultation, but a combination of medical problems, social circumstances, and diverse socio-economic, racial, and geographic backgrounds. The members of the MMFC team were not only licensed health professionals, but were also empathetic, hopeful, and optimistic caregivers. The team’s focus on the complete well-being of patients rather than just their medical state was remarkable and is something I will never forget.

Max Quispe, the 3-month old boy with a bilateral cleft lip, was surrounded by his family members, all anxious and deeply concerned. Knowing that in Latin American tradition, conversations of health are not focused on the patient but on the family as a whole, the team made sure to address our words toward every person in the room, not just the parents. Today, I will never underestimate the health benefits of a simple conversation: by teaching Max’s family about the importance of regular health checkups, his parents will now try to bring him to see a doctor for yearly medical visits.

My experience volunteering in Peru has taught me the true meaning and importance of social sustainability within the realm of healthcare. While healing patients is our main goal, providing equitable access to preventive care and promoting health and wellness are equally important.

All in all, our mission to Cusco was an incredible success and an amazing adventure. Muchas gracias!

–       Marianne Ruelle

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Gitwe, Rwanda | May 2018

Medical teams from MMFC and the University of Nebraska arrived in Rwanda with two large vans filled with 17 volunteers and nearly 30 large suitcases of supplies and equipment. After arriving in Gitwe,  Rwanda, the team screened nearly 80 patients for surgery and completed 33 total procedures over the course of the week. Patients, hospital staff, and local Gitwe residents were incredibly welcoming and gracious to the whole MMFC team; many were quick to share smiles, hugs, and handshakes throughout the trip.

A highlight of the mission was when Ntirandeka Saaock, a Gitwe patient, who had his thyroid removed in 2017, visited the team at the hospital. Life has surely improved since his procedure. He is an incredible singer and could barely manage to sing with his thyroid issues. Since his procedure he can “sing and sing” all day long. He was so happy to receive surgery and wanted to come say hello and thank the medical staff for their work.  

Patients like 69 year old Mukanbenasebeya Lydia (pictured below) travelled long distances by foot to receive thyroid surgeries that drastically improve their quality of life.

The team is looking forwarded to returning in 2019!

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Cusco, Peru | August 2018

Communication: It is the way we navigate the world around us, interact with our friends, family and coworkers and express who we are. Communication could be something as profound as saying “I love you” to something as essential as saying whether or not you are hungry or do not feel well. For 9 years old Jheny Lupe Florez, communication was not an option as the extent of her communicational skills was a few unintelligible sounds and no speech. As she suffers from poor motor control, she is not able to move on her own or properly verbally communicate; coming into screening day her mother carried her into the speech and therapy room to meet with Byrna Bornstein, the Speech-Language Pathologist on the MMFC Cusco mission.

Upon first impressions and interactions, the ability for Jheny to communicate did not seem promising, but a session was scheduled for her later in week to see what could be done to help her. On Thursday, Jheny was carried into the speech therapy room and sat on her mother’s lap during her session with Mrs. Bornstein. The girl’s mother began to explain that in their village, located four hours away from Cusco, she goes to a school that has one teacher, in one small classroom and every grade is compiled into one class. Already, it was clear that the opportunities for Jheny to learn basic communication skills in the academic environment was not hopeful. Her mother believed that Jheny could read a few basic words, but to her understanding that was the extent of Jheny’s abilities. To start the session off, Mrs. Bornstein took a piece of paper and drew a picture of different fruits in the four corners of the paper. She asked Jheny to point with her hand to the fruit when it was named. With her mother supporting her arm, Jheny was able to accurately point out each fruit. Already this was a breakthrough; suddenly it became clear this young girl who was believed to have little to no communicative response skills was able interact with assistance.

The next step was utilizing emoticons, different emotions drawn through facial expressions such as happy, sad and angry. Similarly, when asked to point out to a named emoticon, Jheny was able to do so with her arm being stabilized. Jheny did the same for words and sentences. It was clear she could read! When Mrs. Bornstein asked Jheny how she was feeling, Jheny pointed to the happy emoticon. Mrs. Bornstein asked, “Are you happy because you are able to communicate,” and through body language it was inferred that she said yes. Then Jheny pointed to sad, and again Mrs. Bornstein guessed, “Are you sad because you want to communicate but it’s difficult for you to do so.” Once again through body language it was clear Jheny agreed to Mrs. Bornstein’s statement. Suddenly though, this whole opportunity for new communication for Jheny became real: Jheny could communicate through pointing. Mrs. Bornstein suggested an organizational system to implement in Jheny’s home; around the house, cards could have actions or objects written on it so that Jheny could point to what she wants such as a salty or sweet snack, or whether she wants to wear a dress or pants, simply by pointing at different cards. Basic everyday decisions that were never imaginable could be at her fingertips, quite literally.

Jheny for her entire life has been physically trapped in her body, unable to communicate with her family and friends and unable to move on her own. However, after nine years, in this one week, this one visit, a window has been opened for Jheny and her family. Hopefully, this skill, the ability to learn to communicate, is now going to be a part of her daily life for the first time in her entire life. Many of us learn to take for granted the gift of communication and expression because it is something that has always been a given; the ability to freely tell our family and friends when we need help, love or support is not a reality for everyone and for many years it was not for Jheny either. Now, with this newfound form of communication that she and her parents learned through the help of Mrs. Bornstein, she will be able to slowly take back her life into her own hands and express the feelings she has and more importantly the person that she is. The ability to communicate will open a whole new world for Jheny, starting this week here in Cusco, Peru.

– Daniel Kelly

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Quito, Ecuador | September 30 – October 8, 2017

About The Mission

This year marked the nineteenth mission in Quito, Ecuador. The MMFC team saw a number of new patients as well as repeat patients for follow up surgeries. They screened over 75 medical and 20 dental patients, conducted 46 surgeries, and provided dental care to 16 special needs patients. It’s amazing to see the impact MMFC has had over the course of the week, let alone nineteen years. The children and families of Ecuador along with MMFC doctors, nurses, volunteers, and staff are grateful to the Alvarez, Dassum, and Barrera families for their continued support of the Quito mission since 1998.

Family Returns, October 3, 2017

Jefferson Parco Guadalupe (Age 15)

First featured in 2014, Jefferson returned to MMFC this year for his 5th surgery.  He has been coming since he was 3 months old. Over the years, Jefferson has returned as has his sister, Keila.  Magali Guadalupe, their mother, makes the 5 hour bus trip, 1 hour taxi ride with one or both of the children each year from their home town of Napo.  She appreciates and relies on the medical support she has received from MMFC for her children.  The veteran surgeons and nurses working the mission enjoy seeing the steady progress of both children!

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Cuzco, Peru | July 31 – August 4, 2017

A beautiful smile, a loving heart and girl in need of help: Her name is Luz Ricardina Cabrera Sumari. We had the amazing opportunity to learn this little girl’s story on MMFC’s 2017 medical mission to Cuzco, Peru. The little girl came in for a dental cleaning done by our dental team, however what made her so special was the story she carried.

Only six days before she came to us, Luz Ricardina was left at at the local police station. Not only was she abandoned but she was also left with a broken arm. Luckily, Luz Ricardina found her way into the loving hands at Kusi Wasi – Hogar de las Bienaventuranzas, a disability foster home in Cuzco; she was an exception as she was the only foster child of the home with a normal mental status.

Priscilla Heinemann, the caretaker who brought her from the foster home to the mission, explained that her broken arm was most likely caused by abuse from her parents gone way too far. What was truly remarkable about this little girl was that even though she was faced with so much adversity and so recently, her smile and joy could not held back. On a screening day before the mission started Luz Ricardina was seen running around and posing for pictures with the nurses and doctors. We, the MMFC team, were so happy to have given her a reason to smile!

-Daniel Kelly

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Guatemala II June 24 – July 1, 2017

Rios Carcamo, Thania Yeraldin

Feliz Cumpleaños Thania

She is back celebrating her third birthday as she undergoes surgery for palate repair.  Each year, Thania has spent her birthday in the hospital.  First was for heart surgery. Last June, Thania had her lip repaired by the MMFC team and she’s back this year for her palate.  PACU nurses and volunteers made Thania a birthday sign to hang up over bed.  Her father was very happy to see her, and grateful for the MMFC team who spent the week helping Thania and many other children.  Together, the team completed 46 surgeries and served 20 special needs patients.

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Gitwe, Rwanda | June 8, 2017

OR Day 5!

Today the team will finish up an amazing trip with 8 more thyroid surgeries on the schedule.

More pictures to come as we pack up and say good bye tomorrow.

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Gitwe, Rwanda | June 7, 2017

Greetings from Gitwe in the Southern Province of Rwanda!

All team members from various parts of the United States including Nebraska, Boston, Rochester, Michigan and Atlanta arrived in Gitwe after 2 full days of travel, including the last part of 4 hours on a  van that navigated the dips and turns of the unpaved road to Gitwe from Kigali.

Shortly after arriving on Saturday evening, we worked late into Saturday night unpacking and setting up the suites.  Within 4 hours the empty space was transformed into a fully functioning OR suite with 2 OR rooms, 1 recovery room and preoperative suite.  Screening began after dinner; we saw over 50 patients, and selected over 30 suitable surgical candidates.  Some of these patients had traveled over 100 kms, while others had waited over a year as we were unable to do their surgeries the previous year.

So far,  we have successfully operated on 26 patients, with a day and quarter to go.

Urayeneza Gerard discusses the next few days of the trip with Dr. Sebelik.

Dr. Jagdish Dhingra, Dr. Merry Sebelik, Dr. Ameer Shah, Tim Glidden, CRNA, and Dr. John Simms screen patients for the days to follow.

Dr. Dhingra and Dr. Shah operating Day 1.

Dr. Dhingra marking a patient with the largest left sided goiter of the trip.

Dr. Sebelik scanning vocal cords post-op day 1.

Bikorimana Aloys (interpreter), Dr. Sebelik, Kim Ferguson, CRNA, Dr. Shah, and Dr. Megan Chacon between hugs from the patients post-op day 1.

Stay tuned for more updates to follow.

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Angeles City, Philippines | February 10 – 17, 2017

Day 1 – Blizzard/Arrival for Some/Screening:

As the geographical dispersed MMFC team of surgeons, anesthesiologists, nurses, dentists, and non-medical volunteers converged on Angeles City, I was stuck in a Blizzard. I was scheduled to fly out with the Boston team, but was unable to get to the airport due to blizzard conditions on Cape Cod, where I live.  So, the team arrived in Angles City without me.  After a quick stop at the hotel to freshen up, they went onto the hospital to screen the waiting children for surgery.

Day 2 – Surgery Begins:

I arrived in Angeles City, just as surgeries started for the day.  This year, we had two surgical beds in the operating room. This allowed us to preform 8 cleft lip/palate repairs a day.  We had 40 scheduled for the week, with a few possible additions. Some children were sent home from screening with antibiotics to clear up lung infections. We would check them later in the week and if they had improve would be added to the schedule.

Meet the Children of Angeles City:

Meet Irish

Irish is a 3 month old girl with cleft lip and no cleft palate.  Her mother’s cousin has a cleft palate. No cleft deformities on her father’s side of the family.  Her mother is 36 and did not have prenatal care. She does smoke and did smoke through  pregnancy.  Irish and her family live 2 hours away. Her mother saw signs for the free surgeries that MMFC provides.

Meet DeJay

Dejay is a healthy 3 month old boy who was born with a unilateral cleft lip and palate. He is one of 4 children, but the only one with cleft deformities. There are instances  of cleft lips and palates  on his father’s side.  Because of his young age, we will fix his cleft lip this year and have him return in 2018 or 2019 to fix his cleft palate.  As a rule children need to be healthy, at least a year old, and 10Kg in order to have the cleft palate surgery.

Dejay’s family home is in Pangasinan, which is more than 3 hours away from Angeles City. He and his siblings live there with their Grandmother. Dianna, his mother, told me that she and DeJay’s father live and work on a watermelon plantation from Monday to Saturday here in Angeles City. They go home only on Sundays to see their family.  Dianna cooks for the plantation workers and her husband works in the fields.  They have been doing this for 13 years.  The company provides free housing and a meal for their workers.

Pangasinan is a farming area and jobs are scarce.  So, people need to find jobs elsewhere. This is not an uncommon practice.  Dianna’s other children are 11, 8, and 4.  She gets 2 months unpaid maternity leave when she gives birth. She and her husband have no paid vacations, although they can take some time off.  She had permission from her boss to take today off because of Dejay’s surgery.

Dejay’s grandmother made the journey from Pangasinan to be here for the surgery.  She carried Dejay into the Pre-Op because Dianna was afraid.

DeJay’s operation was successful and we will see him next year to fix his cleft palate.

Meet John Luke

John Luke is a 2 1/2 year old boy with Cleft lip and palate. He also had some chest congestion that turned out to be more severe than we initially thought. This year we fixed his cleft lip and we will followup next year by fixing his palate.

John is the 3rd of four children and the only one with cleft deformities. His mother is not aware of any other family member with a cleft lip or palate. They live in Angeles City, having moved there 8 years ago for a better life.

His father currently works as a security guard in the subdivision where they live. His mother stays home with the children. Prior to moving to Angeles City, John’s father was a farmer in the Province of Zamboanga Del Norte, which is in Mindanao, Philippines.  They grew rice and fruits. Moving to Angeles City has provided a better life for the family. 

John’s surgery was complicated by his chest congestion and needed multiple treatments with Albuterol prior and after surgery.  About 40% of the children we saw this trip had coughs and/or chest congestion. This is common due to the poor air quality and lack of medical treatment.

John’s surgery was a success and we look forward to seeing him next year.

Meet TJ

TJ is a 2 year old boy, who was born with a cleft lip and palate.  Two years ago his cleft lip was fixed and this year we are repairing his cleft palate. We were scheduled to do the palate repair in 2016, but because he had a fever and congestion, it had to be postponed until this year.  TJ has difficulty with his speech because of the cleft palate. In addition, when he sneezes with food in his mouth it comes out his nose. Typical issues for a child with a cleft palate.  His cleft deformities come from his mother’s side of the family.

Modesta who is 65 is TJ’s grandmother.  She takes care of him and his brothers. His mother abandoned TJ, his brothers, and father awhile ago.  His mother took TJ’s sister with her. Apparently she found another man.

The family moved from Negros Occidental about a year ago.  Negros Occidental is a province in the Philippines located in the Negros Island Region southeast of Manila.  TJ’s father was a farmer, which is a hard life.

He brought the family to Angles City to find a better way of earning a living. They had previously travelled here to have TJ’s cleft lip repaired.

Today, TJ’s father works from home making barbells, while Modesto takes care of the 3 children.

Meet Rhaine

Rhaine is 2 year old girl with cleft lip and palate.  This year we will repair her lip and schedule her for palate repair next year.  Her 19 year old mother, Myla, did not have prenatal care and took iron tablets during pregnancy. In addition, her father has cleft deformities on his side of the family.  

Cleft lip and cleft palate are thought to be caused by a combination of genes and other factors, such as things the mother comes in contact with in her environment, or what the mother eats or drinks, or certain medications she uses during pregnancy.

Myla meet Rhaine’s father when she was 16 and he was 19.  His parents would not allow him to marry Myla and they don’t accept Rhaine as their grandchild. They haven’t provided any support  for her either.  Myla doesn’t know where Rhaine’s father is at this time.

Myla moved from home about 4 months ago to earn more money in Angeles City and left Rhaine with her maternal grandmother.  She works in a massage parlor and her housing is provided by her female boss. Myla is taking care of Rhaine while she is having surgery. Rhaine will soon be going back to her grandmothers about an hour away.

Meet Maria Ann 

Maria Anne is a 3 month old girl with cleft lip and palate.  She is small for her age, since she was underweight when she was born.  Her biological mother became pregnant from a man other than her husband. The bio mother’s other children don’t know about Maria Anne.  Apparently both the birth parents have cleft deformities in their families. This year, we will fix her cleft lip and if she’s healthy and weighs at least 20lbs next year, we will fix her cleft palate.

Meet Maria’s Mother

Annalyn and her husband have been trying to have children for the last 7 years.  They live 2 hours away.  Annalyn is a massage therapist and her husband is a construction worker.  They were couple #2 in line for the adoption of Maria.  After the Maria was born with cleft deformities, the couple said they didn’t want her.  So, Annalyn and her husband adopted Maria.  They didn’t care about cleft. Maria is a beautiful little girl to them.  They saw the advertisement for MMFC’s Mission to Angeles City on a banner in their town.

Kudos to Annalyn and her husband.

Closing Words from Dr. Denny Snyder (Chairman MMFC):

This past week is living proof of what can be accomplished when all minds and all hearts have the same goal, focus, and intent.200+ children have a new life because of our work over this past week, which in every way is work that began the day we left Angeles in February last year. Judith Feliciano and Timothy Paul Llanos Dee began planning then, and their efforts since that time are immeasurable. None of what we accomplished this week would have been possible without each of you-the sacrifices and commitment and dedication reflect right back at all of us on the faces of children we are privileged to serve.And every thanks to Dr. Abbie Li Cheng, Peter Cheng, the Chow Tai Fook Charity Foundation and Joy Venturini.  Without your tremendous generosity, all the many beautiful children would still be waiting for help that may never arrive.

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Phalodi, Rajasthan, India | July 30 – August 9, 2015

About The Mission

Nearly a decade ago, MMFC established a relationship with the Kalapurnam General Hospital after meeting its director, Dr. Kanti Jain.  Since establishing a cleft lip and palate clinic, MMFC teams have returned to the hospital every year and sometimes twice in a year.  To learn more about the extraodinary efforts and life of the hospital’s director Dr. Kanti, please read the featured magazine article below from the February 4, 2007 edition of The Week that highlights her valiant dream of helping the poor and downtrodden of rural Rajasthan.

The Journey Begins, July 30, 2015

Medical teams from the East coast, West coast, Colorado, and Georgia converge in Istanbul and begin the two day journey to Delhi then onto Jodhpur, and finally, a three-hour van ride to Phalodi.

Arrival in Phalodi, August 2, 2015​

Check in with patients and meet with local medical professionals.

Surgery & Patient Care, Aug. 3-6, 2015​

The team awoke early Monday morning, fueled up with spice-infused masala chai, and headed over to the hospital on foot.  We were greeted with a waiting room full of children and vibrant colors.  The morning was filled with patient screenings as the doctors checked to see which children were ready for surgery.  Nurse Natalie and Doctor Gary prepped the OR while Nurse Terri got to work setting up the PACU.  A brief meeting was held to decide the week’s surgery schedule, and then the doctors and nurses were off!

The first surgery began a little after 11AM and involved a toddler who was having a cleft lip repaired.  It was followed by two more lip surgeries on a five-month old baby and a six-year old boy.  The temperatures here are hot and humid due to it being monsoon season.  The operating room started out cool in the morning thanks to a hard-working air conditioner, but the OR’s many machines and devices caused the circuits to trip and the doctors were forced to go without A/C as the day wore on.

By 5:30 the surgeries had wrapped up, and the sweat drenched docs headed to the ward to check on their patients.  Relieved moms and dads cuddled with their children and the local night-shift nurses took over care of the patients.

Tuesday in Phalodi, August 4, 2015

Lots of little ones in the OR today—some were there for the first time and others, like Jagdish, were returning from previous years for follow-up surgeries.  Despite the stifling heat, the recovery ward was full of content children and parents. 

An interesting practice here at the hospital is how they distinguish between male and female patients.  The title “Baby” is used to designate female pediatric patients, and the title “Master” is used to designate male pediatric patients. 

Master Chandaveer’s parents were especially grateful for his care.  While in the recovery ward, his father called me to his son’s bedside and requested that his picture be taken with a thumbs up.  The family traveled from a village over two hours away using a variety of transportation modes including auto rickshaws and busses packed with passengers.  In this sweltering heat, the journey is even more taxing. 

The patients will stay in the ward all week so the nurses and doctors can continue monitoring their recovery.  The children sleep on the hospital beds, and their parents sleep on the cool marble floor on either side of the bed—they use no mats or sheets.  The nurses report that these children are amazingly easy going and are a delight to work with! 

Farwell Assembly, Aug. 7, 2015

Hospital Director, Dr. Kanti Jain holds a ceremony to honor the patients, families, doctors, nurses, and hopsital employees who made the week a success. The MMFC team returns to Jodphur.

The Team

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Gitwe, Rwanda | March 15-21, 2015

A group of nine team members traveled on a long 24 hour journey to Rwanda, Africa. The group spent the next morning setting up the operating and recovery rooms while simultaneously triaging patients. By the early afternoon, the Kibagabaga Hospital was set up and the teams had screened numerous potential patients for the early part of the week.In total, we screened about 15 individuals in the morning. Two were unfortunately turned away, one for a pregnancy and one for high blood pressure, but they remain strong candidates for surgery next year. After a few hours working through the language barrier with the aid of interpreters and local patients with English understanding, we narrowed down a list of patients for the next few days.The afternoon’s agenda consisted of two surgeries. The first patient, a beautiful young 22 year old woman from Kigali, named Patricia, got the group off to a great start with a very successful surgery.

Surgery Day Two Sunday March 16, 2015

Day two started with a beautiful sunrise and a jog around Kigali for a couple members of the team. With the patients already screened the night before, the team got right into pre-op procedures upon entry into the hospital.

A group of residents followed the team around today, learning and actively participating in the surgeries. These people proved very valuable, especially in dealing with the language barrier between our group and the locals. The team was able to perform five surgeries, although delayed throughout the day by instrument sterilization.

Each patient carries their own unique backstory and personality. Nyiraregwa is the mother of eleven children and has worked on a farm her entire life. This was her first time going to the doctors. Her positive energy filled the hospital and she soon gathered and entertained a group of women around her in the pre-op room.

Surgery Day Three Sunday March 17, 2015

Day three proved to be very busy here for the team. With a schedule full of patients, we grabbed an early breakfast at 6 and went straight to the hospital to start work.More residents and local nurses came to observe and learn in the OR today.  A Swedish medical school student and a Swedish doctor, conducting research in Kigali for a few months, joined us to observe surgeries in the morning. In addition, the two residents from yesterday remained with us along with local two anesthesia techs, and a nursing student.

Dr. Paul with the two residents, Drs. Tuyishimire and Nkurunziza

As word spread about our procedures here, more potential patients journeyed to the hospital to be examined. Madaline and I continued to triage individuals, with the help of Dr. Nkurunziza. In total, another twenty potential surgical patients remain on the waiting list for the remainder of the week, with more expected to come in tomorrow. Madaline joked as we screened these patients, asking if we could stay three more weeks instead of just three more days. That’s one of the hardest parts of the trip, not being able to perform surgeries on all of the well-deserving people that come here. We’re just touching the surface on the people we can help here

Surgery Day Four and Five Sunday March 18-19, 2015

Finally settling in to a consistent sleep schedule, the team arrived at breakfast well rested and ready to go. The local media joined us today, interested in seeing our work here and the great results from yesterday’s surgeries. The news coverage brought in a flow of more people interested in receiving the medical treatment so many desperately need.

Dr. Jag being interviewed by the media on our work here.

A boy named Christian and his mother arrived today, the youngest boy we’ve seen by far at just four years-old.

After another long day of operating the team had conducted 19 surgeries thus far, and headed home to enjoy some native dancing and food.

A driver of wheat from Tanzania to Rwanda, David was one of the kindest and most professional patients we dealt with. After about an hour and a half in the operating room, he emerged with rest results. Hours later, after he woke up from the anesthesia and felt strong enough to return to his family, I stopped over to visit him one last time. With tears in his eyes, he grabbed my hand and muttered a humble ‘thank you.’ Little moments like those almost brought me to my knees at the work we were doing here. In just a short time, we were able to change the lives of so many deserving people and their families, and it was humbling to see how much it meant to them.

While the last few surgeries went on, Vianney and I continued to screen more and more patients. Another 20 people showed up on our last day of surgery, all unable to receive our help until next year. This was one of the hardest and heartbreaking things to do. It was hard to believe the full week had gone by and I would have to leave these amazing people and beautiful country.

Overall, the team blew me away with all of their work and selflessness throughout the trip. Each person gave up vacation time to travel across the world, working extremely hard in tough conditions to make a difference in other people’s lives. I’m humbled to be part of such an incredibly gifted and caring team. When asked about my favorite or most memorable part of the trip, I respond without question that it was the people. From the doctors and nurses on our team, to the staff at our hotel, to the patients and their families, I was in constant awe of how truly amazing these people are.

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Quito, Ecuador | October 18-26, 2014

This year marked the sixteenth mission in Quito, Ecuador. During the “sweet 16” mission, the MMFC team saw a number of new and repeat patients for follow up surgeries. They screened over 145 medical and 50 dental patients, conducted 72 surgeries, provided dental care to 36 special needs patients, and fitted 3 children with hearing aids. It’s amazing to see the impact MMFC has over the course of the week, let alone sixteen years. The children and families of Ecuador along with MMFC doctors, nurses, volunteers, and staff are grateful to the Alvarez, Dassum, and Barrera families for their continued support of the Quito mission since 1998.

Meet some of this year’s patients…

Jefferson Parco Guadalupe (12 yr) & Keila Valeria Alvarado Guadalupe (4 yr)

A brother and sister returned to MMFC this year, both for lip surgery. Over the years, Jefferson has had 5 surgeries and Keila has had 3. They traveled over 5 hours from their home town of Napo to be seen by the MMFC doctors. After seeing how the MMFC team was able to help Jefferson, their mother was not worried once Keila was born with the same deformities as her brother. Jefferson, Keila and their family are grateful for the care provided by MMFC which has allowed them to be accepted within their society. Without MMFC, neither child would have received the surgeries they needed.

Esteban Issac Quimbita Pucha (2 yr)

During this mission, Esteban had surgery to repair his lip. MMFC had also operated on his palate during a previous mission. When Esteban was born, his mom was scared when she first saw his cleft lip and palate deformities. It was something she had never experienced before with her other child. After seeing that MMFC could treat his condition, his mother was relieved. She and her family are grateful to MMFC for bringing a smile to Esteban’s face. They are thankful to the team of doctors and nurses for returning each year to provide care for her son and many other children in Ecuador.

Robert Alexander Tipan Masabanda (9 yr)

Robert is another patient that has received various care from MMFC over the years. This year, Robert had another surgery to repair his lip along with a tooth extraction. He was also one of the children who was fitted with hearing adds during this mission. Robert and his mother have gotten to know the doctors and nurses over the years and are appreciative for the consistent and quality care they’ve received.

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Dar Es Salaam, Tanzania | July 18-August 2, 2014

On July 18th the MMFC team of volunteer surgeons, anesthesiologists, dentist, and nurses headed to Tanzania for another two-week mission providing free cleft surgeries and dental care, working alongside the wonderful staff at the CCBRT hospital in Dar Es Salaam.

Thanks to the generosity of 14 year old Tori Cargill of Beverly Farms, MA, the biggest winner of all at MMFC’s 17thannual charity golf tournament turned out to be a young girl who has never once in her life seen a golf course.

But 12 year old Jackline Lukinga, who lives in a small and impoverished village some 8,000 miles away in a remote corner of Tanzania, knows just how lucky she is.

And so does her family.

Two years ago, in the summer of July 2012, Tori spent two weeks with MMFC’s surgical team in Dar Es Salaam, Tanzania, and during that time Tori bonded with over 40 children who where in desperate need of medical care. For long hours every day, Tori taught the children about music, art and dancing — and perhaps most of all, she comforted these frightened and terribly sick children both before and after their surgeries.

One of those children she comforted and cared for was Jackline, who was ten years old at the time.

However, when Jackline was admitted to the hospital two summers ago, a bronchial infection forced the cancellation of her planned cleft lip surgery. Jackline was treated with antibiotics and sent home four days later, her family heartbroken and despondent.

But now fast forward to June 23 of this year, when over 600 golf balls were dropped from a helicopter and onto the 18th fairway at Marshfield Country Club in MMFC’s first ever ‘golf ball drop’ contest. The numbered golf ball nearest the marker belonged to Tori Cargill, who was about to make Jackline one very lucky girl.

Now what would you do if you were 14 years old, your pocket suddenly several hundred dollars heavier?

Spend a day shopping for clothes, perhaps?

Find a jewel or two to sparkle around your neck or wrist?

Maybe even a watch for all to envy.

Would you be tempted?

Tori was tempted alright…tempted to do exactly one thing: to donate her winnings towards the 2014 Tanzania mission so she could sponsor Jackline’s cleft lip surgery.

You can see the difference this surgery has made, and will continue to make, in Jackline’s life. When she first saw herself after surgery was complete, she couldn’t stop looking at her new smile in the mirror and saying how happy she was. This will, in many ways, be life changing for her.

Jackline wasn’t the only one to receive life-changing surgery — there were many other just like her, ranging from babies to adults who had lived with their deformity for far too long.

The team is now back home in the US, but there will be many more stories like this when we return to Tanzania next year. Thanks to MMFC”s many supporters, the CCBRT hospital for welcoming us, and mission sponsor Margie Rotchford of Saratoga, NY for making this mission a huge success.

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Angeles City, Philippines | February 14-22, 2014

Roberta Anslow is an artist and professional photographer who has been volunteering with MMFC for several years now. She designs MMFC’s print and web based marketing materials, and coordinates our annual Marshfield Charity Golf Tournament. This year Roberta went on her first MMFC mission as the trip administrator, where she put her artistic skills to work by documenting the week’s surgeries with a blog and some beautiful photos.

This past February, Medical Missions for Children returned to Angeles City, Philippines for a week of free cleft lip and palate repair surgeries.  Thanks to the entire team of volunteer doctors and nurses, Holy Family Academy Batch ’83 (our host organization), and the Mabalakat District Hospital, 15 cleft lip repairs, 7 cleft palate repairs, and 2 lip revisions were completed in just four days. In addition, 10 patients were fitted for obturators.

Meet John Paulo

This is the story of John Paulo, one of many children Medical Missions for Children helped in Angeles City, Philippines. He is 8 years old and suffers from untreated asthma. John Paul0 was born with a cleft lip and cleft palate. His lip was repaired at some point during his 8 years, but it was not done well and he was left with a very noticeable scar. Because of his cleft palate he doesn’t speak like other children and is bullied at school. When he eats, some of the food will come out his nose. A beautiful, sad, shy boy.

When he and his mother arrived for screening on Sunday, he was wheezing quite badly. We scheduled his surgery for Wednesday. The surgery he needed to correct the lip and close the cleft palate was estimated to be 2 1/2 hours long.

John Paulo arrived Wednesday morning for surgery, but his asthma was still bad. Our PACU team spent time treating him with a nebulizer filled with Albuterol, and after a couple of treatments, our Anesthesia team decided he was ready to go into surgery. During the almost 3 hours of surgery his mother huddled just outside of the operating room area. She did not want to be too far from her son.

Immediately after coming out of surgery, once in the PACU, he was again given Albuterol, and again the next morning. His lip and palate are fixed and now he will need to learn to speak all over again. Our local hosts, HFA Batch 83, will try to find and fund a pediatrician to treat his asthma.

Meet Andrei

Andrei is 6 years old and was born with a cleft lip. His two brothers don’t have any facial deformities, but a cousin on his father’s side does. Either the mother or the father can pass on genes that cause clefting. Cleft lip and cleft palate may be more likely to occur in pregnant women who smoke cigarettes, drink alcohol and take certain medications.

Andrei is in kindergarten and so far has not been bullied, and his cleft lip doesn’t affect how he eats. He has lots of friends, loves basketball, singing, and learning English. This is often not the case, however. Left unrepaired, cleft lips can unfortunately result in people being ostracized from their community, making it difficult to make friends and find work.

His mother found out about MMFC from her neighbor. The surgery was quick and successful, and both Andrei and his mother were excited about the changes this would bring about in him and the effect it would forever have on his life.

Meet Angelique

Angelique is 2 years old. She was born with a cleft lip, and at some time during her short life there was an attempt to repair it. As you can see, it wasn’t a very good job.  Angelique was a team favorite, in part because she is a stunning child, but primarily because of her sassy attitude. You see that reflected in her photos.

The MMFC surgeons performed a lip revision on Angelique — an improvement from her initial surgery.

Angelique and her mother came back to the hospital 3 days later on our final day for her checkup. She was dressed up in her fancy headband.

Meet Danica

Danica is 7 months old and was born with a cleft lip and palate. When she eats, food comes out her nose. Since she is so young she has not been bullied yet; nor does she get many strange looks. This would change as she gets older, though. Her mother was excited but also very worried about the surgery. Sometimes parents are so worried about the surgery that they never return with their children on the scheduled surgery day.

Thankfully, the team was able to schedule Danica for surgery despite her history of chronic coughs. She returned with her mother on the day of her surgery, and left with a repaired cleft lip.

Next year Danica will return to MMFC’s mission to have her cleft palate repaired. The earlier we can fix their palates, the easier it will be for these children to learn to speak and eat normally. Danica’s mother feels the surgery will make life easier for both herself and Danica.

See you next year, Danica!

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