All Aboard the Smile Train

The doctors and nurses of GSF and Barthemee hospital

Little Mohammed Ka before surgery...

At the beginning of November I was given the honor of working with a group of thirteen American doctors and nurses from the Global Smile Foundation who came to Barthimee Hospital in Thies to do cleft lip surgeries. In just four short days they were able to completely transform the faces (and lives) of thirty patients, from infants to adults, as well as provide additional training to a group of Senegalese doctors who perform cleft surgery locally. As a Peace Corps volunteer my role was to translate between the American staff and the Senegalese patients and families, as well as provide an extra set of hands wherever they were needed. I spent most of my time in the PACU, where the patients were taken to recover from the anesthesia, playing with babies and reassuring mothers and translating instructions for families. I also got to be in the operating room for a couple of surgeries to watch the magic unfold.

...and after!

Cleft lips and palates aren't as prevalent in Africans as they are in other people groups, but when they do occur in countries like Senegal the odds that the family will find treatment for the child are pretty low. Not only are many cleft patients born into poor families who live far from medical care, but those families also rarely understand anything about the deformity or know it can be repaired. There are a lot of superstitions in Senegal, and many of the families we spoke to believed that the cleft was caused because someone scared the pregnant mother while she was sleeping, or because a cow looked the baby directly in the eye while it was in the womb, or simply because Allah willed it. Although they can make it difficult for a baby to breast feed, cleft lips and palates are rarely life threatening conditions, but in a culture where the smallest difference makes you a social outcast they can still be largely debilitating. It was amazing to see just how life-changing a one hour surgery could be. All of the patients looked so natural after surgery it was almost impossible to remember what they had looked like before.

Abdou Ba right before his surgery, still smiling!

One of my favorite patients of the week was Abdou Ba, a 10 year old Pulaar boy from the Tamba region with a complete bilateral cleft lip as well as a cleft hard and soft palate. I met him several days before the surgeries began when he arrived at the Peace Corps training center with his uncle, also named Abdou Ba, to stay with us throughout the course of the surgeries. Despite his major facial deformities and a pretty serious speech impediment he had the most outgoing and social personality of any Senegalese kid I've ever met. Everyone at the center, volunteers and guards alike, immediately fell in love with him and spoiled him rotten in the days before the doctors arrived. His charm wasn't lost on the Americans either, and he quickly became a staff favorite at the hospital. He was born in a small village in southern Senegal and when his father passed away shortly after he was born his mother remarried and moved to the north, and left him with his uncle Abdou, the man he was named after. Because of the speech impediment caused by his cleft palate he was unable to attend school, but his uncle did his best to give him a normal life and when he heard about the possibility of getting surgery through an NGO he made the 6 hour, $20 journey to Thies several times for screenings from other organizations before being approved for the operation by the doctors of the Global Smile Foundation.

To understand just how amazing this is, you have to first understand that Senegalese men are only marginally involved in the raising of their children and are almost never the primary care givers, and second realize that $20 is an obscene amount of money to the average Senegalese villager. Abdou was the only patient not accompanied by a mother or aunt, yet his uncle was by far one of the most nurturing and competent care takers there. It was really heart-warming to see the special relationship between the two of them, and to see just how much Abdou's uncle cared for him. All of the surgeries were amazing, but the fantastic job the doctors did on this particular case actually brought tears to my eyes. In just two hours he became a completely different person, and after the incision heals and the swelling goes down I don't think anyone will even give him a second glance on the street. He will still have difficulties with speech thanks to the enormous hole in his palate, but his uncle seems committed to finding him the help he needs no matter what the cost, so hopefully he will be able to receive further treatment from another organization.

Abdou just one hour after his surgery, still a  little groggy
but looking pretty good!

   Working with the people from Global Smile Foundation was the single most rewarding experience of my time in Senegal so far. So much of the work we do as Peace Corps volunteers revolves around behavior change and long-term initiatives, and by the time they start actually taking effect our short two-year service is long over. It was so refreshing to work on a project that provided such dramatic and immediate results. We could actually see people's lives being improved right before our eyes, and know that it was a permanent and lasting change. Both the families and the doctors were so thankful for our small contribution to the efforts, and it was then that I realized how infrequently I hear the words "thank you" associated with any of my work here. Not that I'm volunteering just so I can be thanked, but it feels really good to be recognized and appreciated every once and a while. Working with the American's was also a real treat...it almost felt like being back home. Everything was organized, efficient and timely, and we were given clear instructions and a specific task to be done, and then trusted to do it! They were also amazingly kind and accommodating, allowing us to observe and being patient while answering all of our questions about the procedures. Best of all they spoiled us rotten with dinner at nice restaurants and treats from America!

Abdou's before and after shots

After working and talking extensively with the nurses with GSF, I've actually been entertaining the idea of going into nursing. Its not a career path I'd ever given any thought to before, but the more I think about it the more I wonder why it has never crossed my mind? I really enjoyed working with the patients and feeling like I was really helping people, and the medical-related classes in my Exercise Science major were always my favorites. I haven't made up my mind about anything yet, but with my service rapidly drawing to a close (5 more months!) I've been doing a lot of thinking about what my next steps might be. If I did go to nursing school it wouldn't be right away, I would want to save up some money for a year or two before going back to school for any reason, but it's certainly something to look into. Who knows, maybe these cleft surgeries will end up changing my life as well?!