Helping Children Smile

Helping Children Smile Mission 2008

Helping Children Smile is an Australian based charity organization which conducts a yearly mission to the Philippines to offer free Cleft Lip and Palate surgery to children.

In late February 2008, the organization conducted its 12th mission, this time to the town of Santa Rosa (population 200 000), approximately 45 kilometers south of Manila.

Sta Rosa is an up and coming industrial town, home to Toyota, Hyundai and Coca Cola factories, to name but a few, but despite this there is extreme poverty in certain areas and proper medical care for patients with clefts financially unreachable for many of the poor. I worked out that in the Philippines, repair of a cleft lip would cost the yearly income of a labourer (approx A$5000), therefore it is not unusual to come across children and even adults who have never had their cleft repaired. Added to this, cleft lip and palate is twice as common in the Philippines as it is in Australia, and in some areas perhaps 3 times as common. All of this adds up to the potential of an extremely busy mission and this year we were not disappointed.

The 2008 team consisted of 2 Plastic Surgeons (Mihaela Hriscu and myself, both from Hobart), 2 anaethetists from the North Island, several nurses from Queensland for theatre, recovery and the wards, a team manager and a gofor. Traveling with the team was 400 kgs of medical luggage (mostly disposables and consumables), the theatre hardware being stored in Manila and collected on the way out of the city to our destination. Meeting us at Manila Airport, as always, was Judge Laurie Veneration, a High Court Judge (and one of 3 in the Philippines able to pass the death Sentence!) : a very useful contact and one able to wave us through customs without us having to explain what the suitcase of narcotic agents was for. Also there to meet us were our hosts, the Rotary Club of Sta Rosa, curiously an all female club. Later, I was to discover, much to my pride and amusement that their "sister" club was the Rotary Club of Deloraine, right here in Tasmania.

We arrived in Manila on a Saturday night, loaded up, wended our way out of the hubbub of Manila on the week end and headed for Sta Rosa. After a brief but refreshing sleep, Sunday am began early with us heading out to Sta Rosa Community Hospital to begin work. Day one begins with a tour of the site, meeting the management, setting up and unpacking, and screening the patients in the afternoon. Each member of the team has a lot to do on day one because operating starts on day two. As usual, each mission has an early drama, and this year, not to be disappointed, we discovered that quite a bit of our essential equipment, such as the suction and diathermy machines had sat under water whilst in storage in Manila and had been converted into rusty relics salvaged from the bottom of the ocean. However, our motto is the Lord will Provide, and He did. One thing about working in the third world is that just about anything can be fixed if you try hard enough. Our head rings had also rotted away whilst in storage, but we made our own out of small bags of rice which could be moulded to hold the patients head during surgery.

Day two. Monday. Up at six, quick shower and breakfast, in the bus at seven to arrive at the hospital at seven thirty. Knife to skin at 8. Operate solidly until 7pm. Post op ward round, in the bus at 730pm and back to our hotel. And so our daily routine for the next 6 days became. Day seven, an early ward round, then a well earned day of rest of which I will say more later. Day 8,9,and 10 more of the same. Total, 92 patients and 115 operations. All were cleft cases, lips, palates and in some cases both at the same time. Day 11, post op checks and pack up, leaving for Manila at mid day and on to the airport that evening for the flight back to Australia.

So what was it like?

The Hospital was excellent and the best we had ever been to in the Philippines. The theatre complex had just been refurbished and was clean and modern although the fittings were basic by Australian standards. We had 2 operating tables in one theatre with the two surgical teams working side by side. Plenty of opportunity for "peer" review, although a novel approach by our standards. On day one, the transformer of one of the operating lights blew billowing a spectacular cloud of putrid smoke, and this light remained out for the duration of our mission. Poor Mihaela had to operate with a LED campers light attached to her head but as it was her maiden mission, this was her initiation to the third world.

The wards were very clean, the beds arranged in the Florence Nightingale way, the parents and family sleeping with the children, and also feeding and attending to them. The nurses dressed like nurses as I fondly remember them doing here a long time ago. They were very keen and followed out orders to the T. I noted with interest that a lot of Filipino doctors were retraining as nurses to be able to emigrate to America , Canada and other first world destinations.

Our hosts, the Rotarian ladies, looked after us very well. They provided the whole team with lunch in theatre every day as well as going out on chores to keep the mission running smoothly. Each day, a different selection of yummy Filipino treats would be on offer, although we declined the offer to try balut (a boiled duck egg containing a well developed duck embryo). On our rest day, we were taken to Taal Volcano, for a boat ride across the lake and then a horse ride to the top of the volcano with spectacular views into the still active crater and the surrounds. After a fantastic lunch by the lakeside, we went for a swim at the local hotel and then on to a neighbouring town for a spa and massage.

The Medical staff at the Hospital were excellent hosts and did everything in their power to ensure the smooth running of the mission. The honorary specialists at the hospital helped out sort out kids who were obviously not fit for surgery by screening them beforehand, and helping us look after children post operatively who developed unexpected problems, such as severe asthma(one case) and urinary retention (one case) as well as sourcing medication which we may have not brought with us. One of our Rotarian hosts was a dentist and was very helpful in providing advice and contacts of a dental nature.

What was it like for me? Awesome. Fantastic cases, greatful patients, unbelievable experience, feel good factor 10/10. I can highly recommend stepping out of your comfort zone to help the less fortunate in far away places. You return exhausted but professionally rejuvenated.

Frank Kimble