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Transforming the world with a Smile
For most people in the developing world, access to the free, safe healthcare we take for granted is out of reach. Clinicians from the West Suffolk NHS Foundation Trust (WSFT) support the charity Operation Smile, which works across the world to transform the lives of children affected by cleft lip and palate.
WSFT paediatrician Dr Arun Saraswatula has recently returned from Morocco, where Operation Smile has been caring for people for 20 years. He was joined on the 11-day mission near Agadir by WSFT theatre nurse Lindsay Anderson, where they helped to treat 217 patients and carried out 273 procedures during five days of surgery. The rest of the time involved preparation, after care, teaching and training local clinicians and support workers.
Cleft lip and palate is the third most common birth defect in the world, affecting one in every 500 to 700 people. Although in the United Kingdom the condition is quickly and easily treated, in 75% of cases worldwide it is left untreated. One in 10 children affected and untreated will die before their first birthday, and for those who survive, cleft conditions can cause other health problems, and can also be stigmatised by society, to the extent of being ostracised or even abandoned to die.
“Cleft lip and palate surgery is something achievable in the developing world, it’s safe, and most children are discharged 24 hours after surgery,” said Arun, who has been volunteering for the charity for three years. “The mission was awesome, good fun, and I made lots of new friends”. Arun’s role sees him deliver pre-operative screening and post-operative care to the children who are having the surgery.
Arun, 49, who lives in Cambridge and has worked at the Trust for 10 years, became interested in the charity after attending a lecture by WSFT anaesthetist Dr Clive Duke, who has taken part in 17 missions since becoming involved with the charity in 2010. “I wanted to be involved straight away,” said Arun.
“Volunteering refreshes my soul,” said Clive. He described the feeling as “volunesia”, explaining, “It’s the moment you forget you are volunteering to change lives - because it is changing yours.”
Clive explained: “We provide free, safe surgery performed to global, gold standards of healthcare, with safe staffing levels, good quality equipment, pre-op and post-op care and recovery. Each operation costs as little as £150, lasts about 45 minutes, and literally transforms the lives of our patients.
Dr Duke (left) with a young patient before their surgery in Ghana in 2017.
“Our usual team numbers about 40 people, including surgeons, anaesthetists, theatre and ward nurses, paediatricians, intensivists, dentists, therapists and support staff, taking part in missions that last an average of 12 days. If patients are not in an ideal state of health, or we pick up on other issues, we can refer people to local health centres or other charities for treatment. We will return and treat them once they are well enough – we don’t just fly in and fly out.”
Clive, who is 52 and lives near Bury St Edmunds, emphasised that Operation Smile is supporting the World Health Organisation campaign for safer surgery in the developing world. He said: “There are 312 million surgeries carried out worldwide ever year, but people living in the poorest third of the world access just four per cent of that surgery. That four per cent accounts for 50% of all surgical complications.”
Arun and Lindsay also took supplies of powdered milk to Ghana, to help poor families whose children need operations but are currently malnourished.
Clive explained: “In some countries powdered milk is incredibly expensive, quite beyond the reach of the families who need us, so at times we have helped fund supplies.” Arun, Clive and Lindsay take annual or study leave to take part in the missions, as well as making a financial contribution.
“It is our families who make the real sacrifice,” said Clive, who has worked at WSFT for 15 years. “The charity has made a point of thanking my wife for supporting me to go on the missions.”
Operation Smile was founded by US plastic surgeon William Magee in 1982, and is now the world’s biggest volunteer-based cleft charity. With more than 5,500 volunteers, the organisation carries out 150 missions a year, mostly in the developing world.
Clive has recently given a presentation at the Bury St Edmunds branch of Bannatyne Health Club and Spa, where £1,600 has been raised for the charity by staff and members. “The support we receive from the public, as well as from clinicians, allows us to do this work,” said Clive, looking at photographs of two sisters treated by Operation Smile who now have a future full of hope. “It changes not only lives but whole communities – to see the joy this brings is the best thing in the world.”
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