The incredible lightness of grinning

opinion June 08, 2014 00:00

By Veenarat Laohapakakul

3,114 Viewed

Operation Smile founder William Magee talks about the charity's challenges and successes over the last 30 years

A non-profit organisation founded in 1982 by American plastic surgeon Dr William Magee and his wife, Kathy, Operation Smile aims to enable underprivileged children with cleft lips and palates to smile again by offering surgery that’s totally free of any charges. Magee, who is also the chief executive of Operation Smile, was recently in Bangkok to discuss the medical charity’s challenges and goals as it expands to cover more than 60 countries all around the globe.
Operation Smile started after a trip to the Philippines in 1982. What happened there?
It was a magic moment for us. I was a young plastic surgeon with a dental degree and medical degree and very interested in taking care of children with cleft lips and palates. Along with my wife, a paediatric nurse, I was invited to go with a group to the Philippines. That trip changed the direction and course of our lives, our values and our purpose in life.
We went to Naga City, where 350 families came to us and every one of those children had a gaping hole in their lips and roofs of their mouths. They couldn’t eat or say intelligible words. Every parent was tucking at our sleeves, begging us to take care of their child. Sadly, we could only take care of 40 in that first year so 300 children were turned away. 
The next morning, the mother of an eight-year- old we had turned away presented us with a basket of bananas. She said ‘I would like to give you these bananas as a gift.  It’s the only thing I have to give you. It’s a gift for trying to take care of my daughter.’ It was horrible. At that moment we decided to come back with a group of our colleagues to take care of those 300 children who we turned away.
What causes cleft lip and palate?
Nobody knows exactly. We know there’s a genetic component as well as a nutrition component. We know that B-6 folic acid deficiencies can lead to it. We know that smoking and drinking can increase the incidence and that smoke from charcoal fires inside the house may be a contributing factor. We are working really hard right now on nutritional and genetics elements to try and find the cause.
Is there any region in the world with a higher number of children with cleft lip and palate?
Asia has a high number of cleft lip and cleft palate cases. In the US, about 1 in 800 children are born with clefts and here in Thailand it’s about 1 in 700. It’s very difficult to get statistics because in many countries, children are not born in the hospitals. 
In Thailand, we are taking care of about 8,000 patients right now. Going by the statistics that means somewhere around 90,000 children are born with clefts.  There are other organisations working in the same field but there’s still a huge backlog somewhere. So where are they?
A lot of them may be in the remote villages, further away from the big cities and nobody knows. Right now we are working with companies like DTAC and using that technology for people to tell us where they might be and what their problem is.  
How does Operation Smile work?
It’s a volunteer driven organisation. We have about 300 employees worldwide, and we will send out 180 missions this year around the world. The overwhelming number of people on those missions are volunteers, meaning they give their time for free to be able to treat children that they have never seen before.
By volunteers, do you only mean doctors and nurses or can anyone volunteer?
There are all sorts of people. We bring high school students on our trips. We need logistical people to volunteer. We need people to keep medical records of all the patients that come in.  
And there aren’t a lot of doctors that take care of cleft lips and palates. So I think we have to start training people outside of the medical professions. We train people to do technical things that we supervise.
Isn’t that risky, to have non-medical professionals to do the job?
Not if you do it in a very well-organised way. We have a group now in Assam, India and in the past two and a half years, we have operated 12,000 children with clefts.  It started out with plastic surgeons volunteering. Then there is an oral surgeon came and worked side-by-side with us. Now he has done 1,500 cleft lip and palates. He does a beautiful job. A friend of his, who is a dentist, also wanted to learn. If you have the digital skills and artistic skills, and the volume is high enough to work with someone who knows how to do it, then you could learn how to do it.
How do you ensure the quality and safety of these operations?
We have standards that we follow rigidly. There are certain prerequisites and until volunteers have the credentials, they are not allowed to operate by themselves. 
In the United States, in surgery, 1 out of every 18,500 can die. In Operation Smile now, it’s about 1 in 35,000. So Operation Smile is better than the best hospital in the United States. We put emphasis on quality and safety and that’s our mantra no matter where we go in the world. 
Where does the funding for the missions come from?
From everybody and we always need more of it. It can be just $1 from an individual or $5 million from a corporation. We have direct mail and direct response TV. We have major gifts from companies and foundations. For as little as $240, we can change a child’s life forever.  Without those donors, it will never happen. 
Operation Smile Thailand has been in action for over 10 years now. How is it doing?
Beautifully. The team in Thailand is unbelievable. The majority of the time, they do their operations with local funding. They’ve gone to about 15-16 different sites around the country. Now the challenge is to go deeper into the country for the children left behind. 
What is the ultimate goal of Operation Smile?
To work ourselves out of a job is the ultimate goal, just like any humanitarian organisation. There is a tremendous amount of work to do to get rid of the backlog that exists right now. Once we get rid of that backlog, there are always things that we can expand like speech therapy, orthodontic care, or general overall health of these patients. But in the beginning you just want to get the lips fixed so they can get a life.  You fix the palates so that they can speak normally and go to school.
There’s a girl we took care in the Philippines who I remember very well. She was about 4 years old and her classmates teased her all the time because she couldn’t speak intelligibly. She loved to sing. We fixed her palate and ten years later, she won the equivalent of American Idol in the Philippines for her singing. That’s a truly wonderful reward for our volunteers at Operation Smile.
See it, hear it
_ The full interview will be aired on Nation TV’s “Mong Rao Mong Lok” programme on Juen 21 at 7.30pm.