Mission Trips

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.

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

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.

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.

March 11^th, 2019
Gitwe, Rwanda

Day 3 in Gitwe proved to be our longest one yet. Beginning early in the morning, we started out with the first two surgeries lined up from yesterday. Drs. Dhingra and Sebelik had a particularly tough first case, with a large discontinuous goiter extending into the chest cavity. After nearly a three-hour procedure, it was removed, and both doctors along with Drs. Chandra and DeBiase moved on to complete a total of seven surgeries throughout the day. After completing all our scheduled procedures, there was no time for rest, as prospective patients had been waiting in the Rwandan heat all day outside the hospital, some even refusing to get food because they were afraid to lose their line. We screened as many as possible before night fell, but some patients will no doubt return tomorrow morning to yet again attempt to get seen by the doctors. One of the highlights from the afternoon was seeing the post-op patients return downstairs after their surgeries yesterday to have their IVs and drains removed along with being given an ultrasound by Dr. Sebelik to check their vocal cord motility. Flavia, a memorable patient from yesterday’s surgeries, was particularly happy upon being discharged, whispering thank-yous to everyone in the room and smiling broadly when showing us her neck, now goiter-less and unremarkable except for her scar. One of the difficulties of practicing medicine here in Gitwe is the language barrier, which nearly always necessitates a translator when the doctors and nurses communicate with the patients. However, Flavia’s thank you smile was one of those simple moments where barriers such as those become irrelevant, and was a promising sentiment to end the day on as we continue into the remainder of the week and our trip.

March 10^th, 2019
Gitwe, Rwanda

Our second day in Rwanda began more ominously than the first, with thunderclouds rolling into Gitwe’s valley as we walked to the hospital in the early hours of the morning. Similar to yesterday, a queue of prospective patients awaited us outside the hospital, with thyroid goiters ranging in size from a ping pong ball to larger than a human heart. The goiters, which are most often caused by dietary iodine deficiency, can cause issues with swallowing and breathing due to their proximity to the trachea and esophagus, not to mention problems with various thyroid hormones. Our day began with a relatively simply thyroidectomy (the procedure involving taking out the goiter), with Drs. Dhingra and DeBiase completing the surgery. Drs. Sebelik and Chandra completed the second surgery, with the teams then staggering to complete a total of six patients over the course of the day.

One of the most memorable patients of the day was a woman named Donatha, a mother of ten whose goiter crossed over the entire front of her neck. The removal of the mass took a few hours in and of itself, with Drs. Dhingra and Sebelik scrubbing in to carefully transect the muscles of the neck whilst avoiding important vasculature and nerves in the region. The procedure became an anatomy lesson in and of itself, with both doctors getting increasingly excited upon finding neck structures not usually visible with goiter removals. Donatha recovered well from anesthesia, and moved to post-op a few hours later. She smiled softly at us when we visited her later, excited in her own soft way about the removal of the mass that had been a constant obstruction to her daily life. The day ended with the sun setting after beating out the rainclouds that had lingered throughout the afternoon as we finished rounding up the patients and finally left the hospital to walk back to our lodgings, preparing to get some rest before beginning again tomorrow.

March 9^th, 2019
Gitwe, Rwanda

This year’s Medical Missions For Children to Gitwe, Rwanda began with a good omen. Just moments after all twenty-one team members arrived at the hospital, a man with a smile as wide as his face came running up to Drs. Dhingra and Sebelik to embrace them. The man, a patient from last year’s successful mission, proudly showed us all his neck, which was goiter-less with just the faintest small scar visible above his clavicle. He wrung everyone’s hands and proudly told us all how he had spent the past nine months travelling around Rwanda spreading word of the prowess of the medical team from MMFC. His mission to spread the word seemed to be a success, as before even unloading the thirty plus bags we had brought from America into the hospital, there was already a long queue of individuals waiting to be screened. After nearly two days of travel, ending with a beautiful (but bumpy) bus ride from Kigali to Gitwe, there was no time to rest up. We began set up in the afternoon, unloading all the medical equipment to set up the pre-op, anesthesia, two operating rooms, and PAC-U. We simultaneously began screening and ultrasounding the patients that had already arrived, getting through nearly a dozen before the sun set. With seven patients lined up for operations tomorrow, and many more will be arriving in the next few days, our work is certainly cut out for us. Despite this, or perhaps because of it, there was an undeniable air of excitement over dinner, and it is clear that the team cannot wait to begin.

On January 4^th 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!

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.

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!

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

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.

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!

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

About

The MMFC team comprised of doctors and nurses from Massachusetts, New York, California, Utah, and Hong Kong, arrived at Clark International Airport (formerly Clark AFB) the morning of Saturday February 17, 2018.  After a checking into their hotel and a brief rest, they headed to the hospital to start screening the over 100 waiting children.  After an afternoon of evaluating the children, a surgery schedule was developed consisting of 48 surgeries over the course of 5 days.

Here are some of the children’s stories.

Meet Matteo

Matteo is special. He is an 11 month old Aeta. Aetas are indigenous people who live in the scattered, isolated mountainous parts of the island of Luzon. They are thought to be among the earliest inhabitants of the Philippines. They are very small of stature and frame, with curly to kinky hair. We generally never see the Aetas because they don’t believe in doctors (modern medicine) and don’t have the money to travel to Angeles City.Matteo has a cleft lip. His first cousins on both sides of his parents have cleft deformities, but not his but not his 4 year old sister. Matteo’s mother is 26 years old and his father is 30.  Both parents are under 4’11”. His mother may only be 4’5″.

Matteo and his family live in village about an hour from Angeles City, but it might as well be hundreds of miles away.  They, as most villagers, only have a lightbulb or two and no appliances, running water, or bathrooms. They have communal outhouses, and bathe and wash their clothes in the nearby river. They need to buy drinking water from a tank for 3 pesos.  Matteo’s father catches fish, with arrows, in the same river. Meals  are cooked over a wood fire. Three rocks surround the fire to hold the pot.

Both parents sell coconut water at the local market. The coconuts are husked and the tops lopped off then a  straw inserted to drink the water. These jobs aren’t consistent though and neither are the meals.

Only 3 days a week can they afford to have 3 meals a day and sometimes they have to borrow money to buy milk for Matteo.

I asked if they had any wishes and they replied, “Yes, we would love to have 3 full meals everyday of the week.”

In order to make the trip to Angeles City for Matteo’s surgery, they went up into the mountains to pick Star Apples and sell them in the local market. This enabled them to buy food and milk to bring with them.

Meet Aljun

 Aljun is a 9 month old baby boy with a cleft lip and palate. We will fix his lip this year and next year, when he is older, we will fix his palate. In the meantime, our Speech Language Pathologist meet with Aljun’s mother, MaryAnn, and taught her how to feed Aljun with specialized bottles for cleft palate babies. She had no prenatal care while pregnant with Aljun

MaryAnn, 27, is from the region of Davao on the Island Mindanao. Mindanao and the smaller islands surrounding it make up the island group of the same name. In May 2017, President Rodrigo Duterte declared martial law on the entire island group of Mindanao following the Marawi Siege by the Maute terrorist group.

MaryAnn and her husband had been out of work for over a year and decided to move to Laguna Province about 2 months ago. Laguana is 4 hours from Angeles City and south of Manila. MaryAnn was accompanied by her neighbor, Jackie. Jackie acted as a translator for MaryAnn, who speaks a different language than Tagalog, the most common language  in the Philippines.Then I had someone translate Jackie’s Tagalog to English. Good times!  Apparently, Jackie convinced MaryAnn to bring  Ajun to us for surgery. We are thankful to her.

MaryAnn and her husband now work for her husband’s sister. The sister-in-law raises pigs for roasting on a spit. They sell the roasted meat primarily on weekends, holidays, and special occasions.  They rent a house owned by the sister-in-law. It’s a concrete structure with  electricity and running water.

MaryAnn is 4 months pregnant with her 2nd child. 

Meet Michael V.

Michael is a cute, shy 6 year old in a family of 7 children. He has both a cleft lip and palate. Life hasn’t been easy for Michael. But hopefully it will improve after his surgery and subsequent speech therapy. He is the only sibling to have cleft.

Michael was bullied relentlessly when he started school.  Not only does he have cleft deformities, but because of his cleft palate his speech was difficultly to understand. This is typical when children don’t have their palates fixed  He would go home crying early everyday and finally he stopped going to school altogether. That was 2 years ago. His mother has been trying to teach him at home. One of our local nurses has been encouraging the family to get the cleft surgery for years. Until now, they haven’t been able to afford for Michael Sr. to take time off from work to accompany his son to the hospital. 

His father, Michael Sr., is 39 and a construction laborer who lives on site where he is needed. This might be in Manila or another island in the Philippines. On-site laborers live in barracks provided by the construction company. They must buy their own food though and generally the laborers share

their food with each other (i.e., communal meals).  Michael Sr. goes home every two weeks to see his family and give them money. 

Michael’s mother, 39, stays at home with the 7 children. The eldest is 19 and is now employed at the local Pepsi plant. The other children are 17, 13, 10, 7, and 4.  

Home is about 30 minutes from the hospital. It’s a rented single room structure that has bamboo walls and thatched roofs. These houses, called “Bahay Kubo”, are built on stilts and are indigenous to rural Philippines. There is only an electric fan and no other electricity. There are no appliances. They cook outside on a wood fire. There isn’t any running water, so they use a communal outhouse and buy spring water for drinking. 

Hopefully, after surgery and speech therapy, Michael will return to school and live a normal 6 year old’s life.

Meet MJay

Mjay is an engaging 10 month old boy with Cleft Lip.  His mother and father meet while they were both working in Manila. She worked in a factory that makes baby oil and rubbing alcohol.  They moved to an area about 30 – 45 minutes from our hospital.

Mjay has a brother who is 5 and don’t have any cleft deformities.  His mother is now a housewife or as they are called in the Philippines, “housekeeper”. His father works in a furniture shop near their home. My understanding is that he is involved in assembling the furniture. 

His parents rent an old, one room house. It does have electricity so they have a fan and TV. They also have a propane stove. Unlike many families I have spoken to, they have indoor running  water with a tub and toilet. But the water can’t be used for drinking. They still must buy mineral water.

His mother took medication for IBS when she was pregnant and believes this caused the cleft lip.

That is probably not the cause.  Since MJay’s cousin has both cleft lip and palate, it is more likely and inherited trait at this point.  Either way, we are fixing it!

MJay’s mother wishes for her family to be healthy and happy. She is happy with her life, but would like to be working again. But it isn’t possible with 2 small children.

Meet Prince

Meet Prince a 11 month old boy whom we all fell in love with this year. He is an engaging, inquisitive child, who is lucky to have two parents whose lives are better than many people we see at the hospital. Prince was born with a Cleft lip and has 2 siblings ages 9 and 4 years old. None of his siblings have cleft and there is no family history of  cleft.

Prince lives with his mother and father about 45 minutes away in Magalang, Pampanga.  His father is a plumber and his mother stays home with the children. They own their own home that has electricity and running water.  

Prince’s mother tells me that she was sad when Prince was born and is happy that we are able to fix his cleft lip. She told me that they are all happy and that she as a good relationship with her mother-in-law.

Meet Baby Arcel

Baby Arcel is 10 days old and was born with a cleft lip and palate. Her mother brought her to us on our 3rd day of surgeries hoping we could operate. Arcel has extreme difficulty sucking from the breast or bottle and therefor underweight. Although we can’t operate on her this year, because she is too young and small, we will see her next year.

 Our Speech Language Pathologist on this mission gave her 2 bottles that are designed for feeding cleft palate babies. These babies need to feed in an upright position so the milk pools in their mouths and then swallowed.  The bottles enable the mother to squeeze the milk into the baby’s mouth simulating the sucking action.

Arcel’s mother was taught how to feed her baby and burp her. She was given instructions in her native language as well. Her husband filmed the session on his phone, so they could rewatch at home.

Hopefully, we will see Baby Arcel next year to fix her lip. Depending on her size, we may wait until 2020 to fix her palate.

Meet Newborn Alex

The delivery room here at Mabalacat District Hospital is right across from my working area and between our operating room and post-anesthesia care unit (PACU).  Women are wheeled past me and into delivery and shortly later wheeled back out. The baby  follows in the arms of the nurse a few minutes later. Mothers are discharged from the hospital the next day.

Imagine my surprise when the delivery nurse came out and beckoned me to come and see the newborn with a cleft lip and palate. I didn’t have my camera only my cell phone, so the first pictures I have of this child is minutes after birth while he was under the heating lamp.  

The following morning we were able to talk with Alex’s mother and encourage her to come to us next year’s for Alex’s cleft lip surgery.

In the meantime our Speech  Language Pathologist talked to her about feeding a cleft palate baby.  Alex’s mother, Ailyn, will be given the special bottles for cleft palate feeding and detailed instructions in her native language. 

Ailyn is 22 years old and has 2 other children ages 2 and 1 years old. They have a different father than Alex.  Alex’s father left when Ailyn was 7 months pregnant. Her two older children live with other relatives at this time. Since she won’t be able to care for them while she has a newborn.

Ailyn currently lives with her Aunt and Uncle and their 5 children.  So there will be 9 people living in a two room house once Ailyn returns from the hospital.  The house has a sand floor with some electricity but no plumbing. There are no appliances.  An outside communal bath and toilet are used. The toilet is just a hole in the ground covered by a commode. There is a basin for laundry as well.

The family supports themselves by going through garbage and selling the items they find.

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 5^th 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!

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

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.

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.

Stay tuned for more updates to follow.

Hospital Offers 40 Kids Free Cleft Lip, Palate Surgery—szdaily多媒体数字报刊平台

BY the end of today, 40 children from across the country will have undergone free cleft lip and palate surgeries at the University of Hong Kong-Shenzhen Hospital (HKU-SZH) since Thursday.

It’s the fourth time that the hospital has offered free diagnosis and treatment to children with cleft lip and palate since it launched the program in 2015, which has helped over 100 children — most of them from poor families or welfare centers — repair their cleft lips or palates over the past two years.

At least one 1-year-old boy from a rural village in Jiangxi Province, identified as Tongtong, is benefiting from this program for a second time. This time, to repair his cleft palate. He joined the program late last year when he was 7 months old and his cleft lip was fixed in the first surgery.

“I’m really grateful to the hospital,” said Tongtong’s aunt, surnamed Wei. “We used to avoid bringing Tongtong out in the daytime before he received the surgery because other people might point fingers at him.”

According to Wei, the boy’s family couldn’t afford the medical cost of repairing his cleft lip and palate when he was born. Thankfully Tongtong’s cleft lip has been successfully repaired and the family is glad that the boy has been given another opportunity to repair his cleft palate, Wei said.

“Tongtong has recently been learning to speak, but he couldn’t say words very clearly, probably because of his cleft palate. I think the problem will be solved after the second surgery,” Wei said.

Lo Chung-mau, the hospital’s president, said that the program was not only about doing charity, but also providing a professional exchange and training platform for the hospital’s medical workers by cooperating with other medical institutions, such as Medical Missions for Children (MMFC), an American nonprofit organization that offers free medical services to children across the globe.

According to Lo, the hospital has also set up a charity fund to help patients who are in need of financial support. He said that doctors are prohibited from taking gifts or red envelopes from patients, and when the hospital fails to return gifts or money to the patients, it auctions off the gifts publicly and donates the money to the fund.

The charity fund has collected over 100,000 yuan (US$14,700) since it was launched in 2013. “We don’t want the hospital to be polluted by the stink of money. If the patients really want to show their gratitude to the hospital, they can donate money to the fund and help more patients,” Lo said.

According to the hospital, the program will continue recruiting children with cleft lip and palate from across the country and provide free surgeries to another 50 children at the end of this year. Residents can check the hospital’s official website (www.hku-szh.org) for more information.

Apart from MMFC, the program is also supported by the Rotary Club of Hong Kong Northwest, Hong Kong Association for Cleft Lip and Palate, Lee & Man Paper Manufacturing Ltd., and Hong Kong Society of Plastic, Reconstructive and Aesthetic Surgeons.

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.