Changing the Faces of Poverty, One Surgery at a Time

Doctor Thomas Samson, M.D.

They travel, sometimes for days – families clinging to hope, making sacrifices and praying for help. Across India, across Vietnam, across Colombia, they come with dreams. With them are children, teens and adults whose medical needs – so easily remedied in the United States – have halted future prospects for them in their own communities. They are willing to risk everything for a chance at normalcy. They are the faces of individuals who were born with cleft lips and palates.

According to the Centers for Disease Control, national statistics indicate that approximately 7,000 babies with cleft lips or palates are born each year. In America, babies diagnosed with this common birth defect have surgery within the first year. In fact, it’s considered a routine procedure. But in second- and third-world countries, poverty-stricken citizens have neither the access to plastic surgeons nor the means to pay if they can somehow get to a clinic or hospital. Consequently, millions of children needlessly endure the negative aesthetic, functional and cultural effects of having cleft lips and palates.

This is the reason doctors including Penn State Health Milton S. Hershey Medical Center’s Dr. Donald Mackay and Dr. Thomas Samson invest their time into organizations like Operation Smile.

Operation Smile, a nonprofit global organization that provides children (and some adults) with free cleft lip and palate procedures in more than 60 countries, has emerged as a leading entity since its inception in the early 1980s.

Mackay, currently the chief medical officer for Operation Smile, has been involved for years and has performed surgeries in several countries. His activity as a volunteer includes helping establish centers in places like India, the Dominican Republic, the Congo and Uruguay.

These centers form the infrastructure needed to handle all aspects of cleft lip and palate care, such as speech therapy.

“The locals take ownership,” he explains.

A well-respected plastic surgeon, Mackay has tremendous experience helping patients with congenital anomalies, including cleft lips and palates. Surprisingly, cleft-lip surgery is relatively simple under the right conditions, but those who can’t afford it are hampered before they get a start in life.

As Mackay is quick to point out, the stigma of looking different is the same regardless of social strata or culture.

“A defect can isolate people,” he notes, adding that people are the same wherever you go. “We can transform them and their community in about an hour.”

Dr Mackay

For this reason, Operation Smile aims to do as many surgeries per trip as possible, usually 100 to 140 each week. Although the focus is on babies and young children, all cases are screened, allowing some older individuals to undergo surgeries.

Like many of the residents at Penn State Health Milton S. Hershey Medical Center, Samson trained under Mackay, which led to his involvement in Operation Smile.

“I was fortunate to get a scholarship [fellowship opportunity],” Samson explains.

The fellowship paid for his mission trip to India, where he performed surgery after surgery in a makeshift facility.

“It was this huge, open room.  …There were eight operative tables and wide-open windows,” he says.

Despite the radically different environment that included flying insects and constant breezes, Samson found the experience incredible.

“We had local anesthesiologists and plastic surgeons, as well as professionals from Operation Smile. The bonding was interesting.  …There was no hierarchy.  Everyone had the same mind set.”

Samson rapidly came to the same conclusion as Mackay: Screening kids and adults, and performing as many cleft-lip surgeries as possible in a short amount of time is beyond rewarding. It’s addicting, and almost, acknowledges Mackay, “an obligation.”

For Samson, it was also an eye-opener.

“You realize what an opportunity it is to volunteer,” he says. “…The people – the parents, the children – were so thankful. They were literally apologizing. …I’m not even sure why. I think of these people all the time. They were so happy and privileged to be there. In fact, it was us who were privileged.”

Though Samson has only been on one trip for Operation Smile, he’s looking forward to returning when his own children are a little older.

Mackay agrees with Samson’s views.

“We get far more than we give,” he says. “This is really good for your soul. You learn that there are incredible surgeons, spectacular surgeons, all over the world. It makes you a broad, well-rounded human being. It’s a life-changing event.”

No doubt the countless patients who have been touched by Mackay, Samson and Operation Smile would agree.