KIGALI, RWANDA – Kamikazi Priscilla, 9, says she now has a reason to smile – because now she can. Kamikazi, from Kirehe, a district in eastern Rwanda, was born with a cleft lip. And she says it used to affect more than just her smile.
“Life was very complicated for me,” she says, crying. “Eating was a hard task. Sometimes I was struggling to make people understand what I was saying because it was not clear.”
She says it also led to social isolation as some people said it was her family’s fault.
“Some people were telling me that it was a satanic curse from my family,” she says. “I was always ashamed.”
But thanks to Operation Smile South Africa, a partner country for Operation Smile, an international charity organization that heals children’s smiles, a doctor recently fixed her cleft lip for free. Thanks to the operation, she says that she can now drink easily, express herself clearly and eat boldly “with a good smile.”
In conjunction with the Rwandan government, Operation Smile South Africa came to Rwanda last month to perform free cleft lip and cleft palate surgeries on more than 250 patients who otherwise couldn’t afford it. Operation Smile volunteers say the surgeries transform the lives of people facing social and health problems because of a fixable condition. The organization, which also does surgeries in other countries in Africa, plans to return to Rwanda for future missions as Rwandans currently in training to perform the surgeries themselves aim to eventually become self-sufficient.
Cleft lips and cleft palates are the fourth most common birth defects in the world, with one in every 750 babies in Africa born with a cleft, according to Operation Smile South Africa. A cleft is an opening in the lip, roof of the mouth or soft tissue in the back of the mouth. The exact cause of clefts is unknown, but scientists attribute them to genetic and environmental factors, such as drugs, infections, maternal illnesses, maternal smoking and alcohol use, malnutrition and vitamin-B deficiency in folic acid.
Clefts are usually corrected after birth, but medical treatment is not available for many children in rural areas around the world, according to Operation Smile South Africa.
This was Operation Smile’s second trip to Rwanda. They operated on 248 patients with cleft palates or lips last year and 253 patients this year, according to the Ministry of Health.
According to a press release from Ministry of Health official Bonavanture Nizeyimana, the operation took place during nine days at the Central University Teaching Hospital in Kigali, the capital.
Operations typically take between 45 minutes and an hour, according to a press release from Natalie Miller, Operation Smile’s vice president for Africa. On average, about 45 cases were taken per day at the hospital as the rest of the patients stayed at the Rwandan Red Cross until their turn.
The team of 50 medical experts started with the most critical cases. Not just cosmetic, clefts also make it hard to eat, speak, breathe and socialize – leading to malnutrition, medical and psychological problems, according to Operation Smile South Africa. Ear disease and dental problems are also common.
“The patients live in a less humane and dignified situation,” Nizeyimana says in his press release. “These operations restore hope to them.”
Some people with clefts are even subject to frequent ear infections, which can eventually lead to partial or total hearing loss.
“Five years ago, I didn’t have any problem about hearing, but now I partly lose my hearing senses,” Emma Ndayambaje, 15, says. “You have to speak loudly so that I can hear you.”
The Ministry of Health arranged free accommodations, meals and transportation for all patients.
Surgeries to fix clefts are expensive, costing about $7,000 USD each, according to Nizeyimana. The per capita income is about $500 USD here, according to the World Bank. The majority of Rwandans live on less than $1 USD a day, and nearly 90 percent live on less than $2 USD per day, according to the United States Agency for International Development, a government agency that provides foreign economic and social assistance.
According to Miller, she started working with Operation Smile nearly a decade ago to help the many people who can’t afford the operation.
“I started [working for] this program nine years ago, and I was moved to see how people can feel fully integrated in the society and avoid social stigma after such operations,” she says in her press release. “It is a humanitarian initiative.”
She says she never imagined it would be so successful.
“When I started, I never thought it would have such an impact,” Miller says. “I even never thought I would come to Rwanda and perform such operations here. The government through the Ministry of Health has been very supportive.”
Patients who were not selected for the surgery program this year were given cards to return next year to receive the surgery and transportation to their homes.
“This problem can be solved,” Miller says. “It can even be prevented. Much [of] it is genetic.”
Operation Smile South Africa has missions planned for the rest of this year in Democratic Republic of the Congo, Madagascar and South Africa. She says that the plan is to treat adults so Operation Smile can then focus on children.
“Our aim is to treat as many adults as possible, so that we can concentrate on young children in the future,” Miller says.
Nizeyimana says that the Rwandan government hopes that the country can eventually take over Operation Smile’s mission. Doctors and medical students are currently in training here to learn how to operate on clefts.
“We intend to eradicate this problem and [focus on] cases of newborn babies,” Nizeyimana says. “In a period of two years, we may not need foreign specialists to deal with these cases since there are Rwandans who are currently undertaking the course.”
