I’m beginning to feel more like a beneficiary than a volunteer helper in this Operation Smile mission in Dhaka because I’ve been allowed to experience and learn so much.
I watched the entire surgical process in the operating room yesterday to learn more about the work that Operation Smile does, to understand more intimately what happens on the operating table that helps transform the lives of cleft patients.
The surgeons and other members of the surgical crew are always generous with information, patiently explaining medical procedures and stuff if you care to ask them.
Our mission team of 48 arrived in four vans at the hospital at 7:40 am. Work started immediately. The surgical crew prepared the operating suite to receive the first patients while nurses prepared the pre- and post-op rooms.
It took maybe two hours or more for the operating rooms (four of them) to be ready. I don’t know what they did in there. I was at that time with the student volunteers decorating the wards with balloons and things so our patients could recover in a bright and cheery environment.
Eliza Boggia, student blogger for OS International, and Kristabella Low, president of the National Student Chapter for OS Singapore.
Meanwhile, in a room beside the wards, called the Child Life Room, the children who are up next for surgery are made to feel relaxed and happy before they’re carried into surgery.
The first two patients of the mission.
Non-surgical team people weren’t allowed into the O.R. for the first round of surgeries, just to first ensure that everything was going to run smoothly for the day.
So I decided to follow baby Jannati, who’s scheduled to receive surgery in the second round.
Cute and smiley Jannati is 15 months old and has a cleft lip as well as a cleft palate (some patients have one or the other, some have both).
Well, she’s not smiling in this picture. She’s got her bewildered “what’s going on” look, which I find most precious. But she smiles if you talk to her.
With her are her father and her grandmother. I didn’t think it was polite to ask where her mother was, so I didn’t. I could never make a good journalist cos I feel bad about hurting feelings, making people feel embarrassed or putting them on the spot.
Not saying that good journalists are insensitive, but you have to have a certain detachment in order to be able to pry into the personal lives of strangers and to dig up truths and secrets, don’t you?
Anyway, Jannati can’t have her palate surgery yet because she’s too young and light. Palate surgery will induce more blood loss and OS surgeons don’t want to put too-young children under the risk.
So, her lip would be fixed first and then she’d have to go for the next mission when she’s older and stronger for her palate surgery.
When Jannati was born with cleft deformities, her family was devastated. They knew she could be fixed but they couldn’t afford the fees. So they went around trying to beg or borrow money but were unsuccessful.
Fortunately, they eventually heard of Operation Smile and her dad was really happy to be able to register her as a patient for this mission.
I’m really happy for her, too, and all the other patients her age, because while they do suffer the physical inconveniences of having clefts, they would be spared the emotional trauma that older cleft kids face when they start making friends.
So, finally, it was Jannati’s turn in the operating room.
I waited for her inside, all geared up in surgical gown, mask and cap so I didn’t dirty the sterile operating suite.
It says Yun on my name sticker because Justyn wrote that out for me. Justyn refuses to call me Qiaoyun because he says Chinese names are too complicated with all the different intonations and funny pronunciations.
Supposedly, only surgeons and immediate assistants who have direct contact with patients wear paper surgical gowns. The others wear surgical scrubs, those short-sleeved ones. Everyone has their own scrubs from their jobs back home but I don’t, so I had to wear a paper gown.
It took about 20 minutes for Jannati to be prepared for the operation. This is when she is anesthetised and put to sleep.
I never realised it took so long for someone to be put under general anesthesia. (Or maybe babies take longer. I forgot to ask.) I always thought it was just stick a needle in or cup the breathing mask on and you’re good to go.
When Jannati was ready, plastic surgeon Karina came in and took her place at the head of the operating table. I was allowed to stand beside her and watch her perform the surgery.
Into the first minute when incisions were made, I started feeling a bit light-headed. I’m okay with blood but I don’t like seeing raw flesh, especially when it’s being manipulated. I thought I wasn’t going to make it through to the end of the surgery.
But it only took me about five minutes to get over it. I had to keep telling myself that Jannati was going to be a happy baby when she woke up (well, not immediately after surgery, but after she’s recovered a bit) and that her life was now being changed forever.
I think squeamishness mostly comes from people imagining those things happening to themselves or to the people they love. It’s like that for me, anyway. So I tried not to think in that direction and it kinda worked after a while.
The actual surgery (not counting anesthestic procedures) took about 45 minutes but I’ll try to summarise it.
Since the lip is split apart, the surgeon has to join them together bit by bit, which is why incisions are made and then tissue and muscle separated to be joined up correctly.
The inner lining of the lip is first joined using a very thin hook-shaped needle and fine surgical thread that is safe to remain permanently in the body.
Next, the muscles inside both sides of the split lip are identified then sutured together.
Then the outer layer of the lips all the way up to the nose. On the outside, a dissolvable thread is used. It will dissolve in seven days once the patient starts washing her face.
Karina also reshapes Jannati’s nose (because it’s too wide) by doing something with the cartilage and then making a couple of sutures on the inside.
It’s kinda strange how that all works out. At times, I imagined that I was watching an expert seamstress sew up one of those felt craft creations I was crazy about some time back. The work is very fine and requires a lot of skill, precision and patience.
I now think surgeons (and the people who assist them) must be the most patient people in the world. I don’t think I could sit there for hours and hours just cutting and stitching. So I think for the medical crew to be doing this voluntarily on a regular basis is really remarkable.
When the surgery was over, it took another 20 minutes or so to wake Jannati up so she could go to the recovery room.
Karina wrote up the operation report while the anesthesiologists woke Jannati.
In the recovery room, Jannati’s grandmother was allowed to comfort the baby girl who was flitting between sleep and wakefulness. She woke and cried, then dozed off, then woke and cried again.
After a bit of that, Bruce, the pediatric intensivist, spoke to Jannati in a gentle voice and fed her some orange liquid with a syringe. After one dose, he allowed me to take over the feeding. Jannati loved it, using her tongue to regulate the sweet liquid flowing down her throat. Her mouth was wide open after the surgery.
She cried for more when each dose was done and I was refilling the syringe.
Jannati will rest in the wards for a couple days or so before going home with her father and grandmother, taking with her a new smile she can be proud of when she grows up!
And I will now proceed to show you Justyn’s photos because his photos tell the Operation Smile story a lot better than my crappy photos taken with scant disregard for lighting and focus.
Justyn Olby Photos
First patient of the day. I don’t know who this baby is but he or she is just adorable. I have trouble telling the gender of babies.
Second baby. This one is a she. You can tell from her wrist tag.
The ward that the students have decorated into prettiness. I’m sitting on one of the beds making origami.
Here’s Jannati with a big smile before her operation. I have seen many happy, smiling babies on this trip. They really arrest your heart!
Me and Ryan inside the operating suite. Ryan is the president of the Hwa Chong Institution Student Chapter. In his first mission, he is learning the role of Patient Imaging Technician, the person taking before and after photos of patients’ clefts from different angles.
This was the spot where I stood for 45 minutes watching Karina do her magic on Jannati. Bidhan on the left is a plastic surgeon in Bangladesh. He assisted Karina in the surgery.
On the left are the three female student volunteers, Yun Yi, Karen and Kristabella. (Ryan’s the only male.) On the right is May, the Medical Recorder. The girls help with medical records among other miscellaneous duties.
Karina focused on her work. She’s really nice. She occasionally explains to me what she’s doing while she’s doing it, and doesn’t mind me asking questions.
The girls entertaining a kid in the Child Life Room.
Me feeding Jannati her syrup mixture.
Inside the Child Life Room.
To see more photos of the mission taken by other photographers, please visit the Student Chapter Facebook page. And do “like” the page to support the cause!
For more information or to learn ways you can help, please visit the Operation Smile Singapore website.
Thank you for reading!