Putting smiles on faces

PULSE volunteer Len Friedland talks about his experience working with a non-governmmental organisation (NGO), Rotaplast, which provides cleft palate surgery for children in Bangladesh. Len is VP of North America Clinical/Medical Affairs for Vaccines.

"Last year I had the wonderful opportunity to volunteer on a medical mission providing free reconstructive cleft palate/cleft lip operations and treatment for children in developing countries. The volunteer work initially took place in rural hospitals in Udaipur, India and Chittagong, Bangladesh.

The opportunity came about through our employee volunteer programme, PULSE. PULSE is a GSK initiative, designed to give employees an opportunity to use their professional skills and knowledge in a three or six-month placement with a charity, non-profit or non-governmental organisation.

My particular assignment was with Rotaplast, a non-profit humanitarian organisation specialising in cleft lip/cleft palate surgery and treatment, and educating local physicians, nurses and families about how to prevent cleft palate anomalies. Owing to my background in paediatric medicine, I worked with the families and children preparing them for surgery, and also helped provide follow-up care.

Why is surgery needed?

A cleft is the separation of the parts of the lip or roof of the mouth that usually come together during the early weeks of pregnancy. A cleft lip can range in severity from a slight notch in the red part of the upper lip to a complete separation of the lip extending into the nose. A cleft palate (roof of the mouth) may occur as part of the cleft lip deformity or in isolation.

A cleft may cause a child a number of problems from difficulty with feeding and speaking, to increased risk of ear infections and the disfigurement can contribute to social stigmatisation.

The causes of a cleft anomaly are various: a genetic predisposition, poor diet, lack of adequate vitamins (especially folic acid), smoking in pregnancy and pollution. A cleft anomaly can also be triggered in those with a genetic pre-disposition by any of these factors, so the poor are at greater risk.

Helping to put smiles on faces

Along with a team of doctors from the US, I travelled with Rotaplast to Chittagong in Bangladesh. There are thought to be around 300,000 individuals in Bangladesh with untreated cleft lips and palates. The team I was with operated on 105 patients, creating new smiles and improving the lives of children and their warm, friendly and resilient families.

The story of Ayesha encapsulates the difference this sort of intervention can make to lives. We met this beautiful seven-year old on February 1, when her father brought her to the screening clinic. She captured the Rotaplast team's attention with her sweet disposition and her stunning black and gold dress.

 Dad had six children, all girls. Among the rural Bangladeshi society, sons continue to live with their parents when they marry, while females move to the home of their in-laws. Parents look to provide for their sons as the sons will provide for them when they age. When it comes to their daughters, some poor and uneducated parents consider their daughters a liability since they will be moving out of the home once they marry to provide for their in-laws. The result is that daughters are sometimes not well-educated or properly nourished.

 Ayesha's parents were very poor and lived in a village of 250 people a four-hour bus ride from the hospital in Chittagong. Ayesha's dad was gentle and his behaviour showed he loved his daughter. I felt comfortable asking him to describe how he felt about having six girls and no boys. He said he was very proud of having a family of daughters. He and Ayesha's mother were illiterate and he wanted all of his girls to be educated. 

Ayesha had her cleft lip repaired by one of our surgeons, Fred, who was 78 years old and still donating his skills and talents on three or four medical missions each year.  The photo shows the beautiful new smile Fred created for Ayesha.

While Ayesha and her family no doubt have economic struggles ahead, she has the support of her wonderful parents and she goes into the future with a transformed, normal appearance.

And I could return home full of the memories and tremendous feeling of purpose that having the great fortune to volunteer with Rotaplast brought me."