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Operation Smile

Program Offers a Normal Life for Children Born with Congenital Deformities

By Anirban Nayak

What if you were born with cleft lips and lived in a society where people with such deformities are considered a curse?

That was the predicament faced by a Liberian girl. When she was born harelipped, neighbors feared that she might bring bad luck and suggested that she be abandoned in the jungles. Mercifully, her family did not heed the suggestion.

“Such cases are common in the developing world,” said plastic surgeon Lawrence Kurtzman, while addressing a group of MIT pre-medical students during the Independent Activities Period.

In many developing countries where superstitions abound, people with congenital deformities are often stigmatized, and expensive reconstructive surgery is usually not available to them.

Then, in 1982, Operation Smile (OS) came and brought some hope to the afflicted. This organization, based in Norfolk, Virginia, enabled a team of plastic surgeons, anesthesiologists, pediatricians, opthalmologists, dentists, and nurses to visit developing countries and perform medical treatments, including reconstructive surgery, at no charge to the patients.

Dr. Kurtzman has been involved with OS since 1986. He has been on 15 medical missions thus far in places such as the Philippines, Vietnam, Liberia, Ghana, Kenya, Columbia, and Nicaragua. For the last six years, Kurtzman has served as OS team leader, performing hundreds of surgeries on children with deformities. These operations have enabled many young people to come out of seclusion, attend school, and lead more normal lives.

Kurtzman’s team visits the developing world usually once or twice a year for about two weeks at a time. The team members work hard, putting in 14-hour days and performing some 150 surgeries. Usually they correct cleft lips and palates and graft skin onto burn victims. However, during some of his visits, Kurtzman has also rectified syndactyl (webbed) fingers, removed obtrusive tumors from people’s faces, and rebuilt facial parts destroyed by diseases.

Sometimes a person’s deformities are so severe that he will need several complicated operations. One such case involved a teenage boy from the Philippines.

“His entire nose and upper lip were eaten away by a combination of infection and malnutrition,” said Kurtzman. The boy was flown to the US to undergo extensive reconstructive surgery.

“He went back to the Philippines [and] became kind of a hero in his community. Since then he has gotten married, has had children, and has become one of our biggest advocates in that country. It was really exciting to see such a dramatic change in his life,” added Kurtzman.

The good work that the OS team does in developing countries is not limited to surgery. One of its jobs is dispelling native superstitions on congenital deformities. In addition, it must often educate the locals on nutrition and dental hygiene. Furthermore, Kurtzman’s team frequently finds itself teaching local doctors and nurses various operating techniques and procedures so that they can continue to help patients after the OS team departs.

While in the developing world, the OS surgeons work under conditions that are far from ideal. Accustomed to working in the best of facilities in the US and with the latest technology, this team must adapt to working in overcrowded hospitals with poor ventilation and equipment. In fact, once during a blackout, Kurtzman had to perform surgery with the aid of flashlights right in the hospital hallway.

Moreover, the equipment with which the OS surgeons have to operate is often recycled. This is because many hospitals in developing countries lack the funds for new supplies.

“Here [in US hospitals] everything is disposable, everything is thrown away. What we throw away in a day here, they’ll use it there for months,” maintained Kurtzman. In one Filipino hospital, for example, used disposable gloves are washed, repaired, sterilized, and reused.

What is more frustrating to the team than the adverse working conditions is that it cannot operate on everyone who seeks its help. There simply isn’t enough manpower or time to accommodate everyone during a two-week stay.

Despite the obstacles, Kurtzman loves visiting and working in the developing world. He said, “It’s just so interesting to go to these countries, not from a medical standpoint, but from a humanitarian standpoint and from a psychosocial standpoint -- just to meet people and see what the rest of the world’s like.”

Kurtzman added that the people in developing countries are some of the friendliest and that they tend to be very creative with limited resources. He also maintained, “Being involved with Operation Smile has been one of the most rewarding experiences in my life.”

Operation Smile is a charitable organization that depends primarily on corporate sponsorships. For more information or to get involved, contact its Boston chapter at 951-1162.