Operation Smile: #HandOverYourSmile Reflection

By Emily Zolfaghari

A smile is contagious. If you don’t believe me, smile to a stranger and take notice of their reaction. But, for some people, this facial expression is near impossible to complete. Cleft palate and cleft lip syndrome effects people of all races and occurs globally; however, it was only after I was selected to participate in the Operation Smile/USC Global Health Institute’s Epidemiology Research Practicum that I was given the opportunity to learn more about this particular birth defect. As one of the two selected students, I was able to not only participate directly in an epidemiology-based case/control study investigating the causes of cleft lip/palate syndrome, but also travel internationally with the organization to collect data in-field.

Oujda, Morocco OpSmile Mission 2014
Oujda, Morocco OpSmile Mission 2014

The combination of my interest in health care availability and global medicine granted me the opportunity to continue my involvement with the organization as an epidemiology researcher  even after the Practicum term had ended. As a result of being selected for the USC Global Health Institute/Operation Smile Practicum,  I have been able to work with a  team of international volunteers in Mexico (July 2014), Philippines (June 2014), Morocco (September 2014), and Vietnam (November 2014).

Davao, Philippines OpSmile Mission 2014
Davao, Philippines OpSmile Mission 2014

Operation Smile is a non-profit organization that provides medical and surgical assistance to children in developing countries with facial deformities. In order to determine the etiology of oral clefts in children, I collect saliva samples from families while also administering questionnaires before the child goes into the operating room. It has been, by far, the most heart-wrenching, stressful job I have had up to this point in my career. It has also been the most intellectually stimulating and rewarding job I have ever had the privilege of performing.

During my time as a cleft lip epidemiology researcher, I have seen children forced to wear scarves in order to cover their faces from the public’s view. I have spoken to mothers who have traveled over a week by foot, using their entire life savings to support them during the journey, in hopes that their child will receive a surgery. I have heard of children having to drop-out of school because of the stigmatism that came as a result of their facial deformity. But, I have also cried alongside mothers the moment they see their child wake up from the anesthesia and form their first, complete smile while still in the post-operation room. I have been able to watch a team of global surgeons work together to improve the well-being of others, and for this reason, I have never been more inspired to pursue this profession in the future as a MD/Ph.D. applicant.

Nghe An, Vietnam OpSmile Mission, 2014
Nghe An, Vietnam OpSmile Mission, 2014

Over a year ago in June 2014, I traveled abroad on my first Operation Smile mission in the Philippines to collect research data and distribute questionnaires. However, this past May 2015, I was nominated by a friend who I met during a surgical mission in Morocco to participate in the #HandOverYourSmile campaign started by Operation Smile to spread awareness for cleft lip/cleft palate birth defects. As I sat down to take the picture–and tagged others to continue the efforts–it made me realize how my involvement in this organization over the year has really impacted my life and future goals. Even while I write this, a book titled “More Than Genes” sits next to me on my desk, proving to myself that this experience has influenced my perspective on global health and human development.

#HandOverYourSmile Operation Smile Campaign
#HandOverYourSmile Operation Smile Campaign

Sure, when I went on my first mission in the Philippines I was excited, but I was also a little scared. It wasn’t because it was the first time I had to travel internationally, but it was more because my dream was finally becoming a reality. My whole life, I had always wanted to be given the opportunity to work towards public health issues on a global scale. What if I didn’t like it after all?

Stepping off the plane in Manila last June 2014, I could instantly recognize I was in the Philippines. I had never experienced such humidity–and my hair was not approving of it at all! After about a three hour bus ride with the rest of the surgical team, we had arrived in Davao City. Being on this first mission taught me several important lessons about myself and about the non-profit Operation Smile.

Pompanga, Philippines 2014
Pompanga, Philippines 2014

1–Volunteers with the organization genuinely care about the health and well-being of others. I had never been so proud to be surrounded by a group of people as humble and inspiring as those who were on this mission with me. It’s hard to re-capture the exact feelings and thoughts experienced during surgical missions–let alone write them down in words–but the memories I have will always remind me that some people will do anything to help others above themselves.

2–Research has an incredible impact on medicine. Before participating in this practicum, I had always viewed research and medicine as two separate categories; however, I was now able to understand its correlation with one another by contributing towards the epidemiology study. Collecting a family’s social background and health history via the epidemiology research questionnaire prior to a child receiving surgery allowed me to put into perspective the impact research can have on medical practices, thus making the days I shadowed plastic surgeons in the Operating Room more meaningful.

Operating Room of Nghe An, Vietnam OpSmile Mission.
Operating Room of Nghe An, Vietnam OpSmile Mission.

3–Don’t be afraid to try new experiences or stand out. Diversity can be either accepted or ignored by most people. After traveling to the Philippines, I learned to accept our own individual backgrounds and learn from others who are different. Medicine is unique in the sense that it can be universally understood, thus bringing people together from all parts of the world to work together. But, I don’t just mean talking to others from a different culture (although that’s great too!) Rather, experience the native culture, stray away from the tourist locations, eat street food, meet the locals! When I was in the Philippines, I tried Balut for the first time and even had the incredible experience of being able to go scuba diving!  Going abroad truly taught me to view everything from a more global perspective, and for that I am truly grateful.

Scuba diving at Talikud Island, Philippines
Scuba diving at Talikud Island, Philippines

Near the end of Summer 2014–right before starting the last semester of my Master’s program at USC–I was invited by the research PI to join another surgical mission with Operation Smile in Oujda, Morocco because of my background in the French language…and I couldn’t have been more excited (I might have even done a lap or two around the house once I opened that email). While I did miss about a week and a half of classes, and even had to do some assignments while waiting outside terminals at the airport, it was well worth it.

 Moroccan Medina (shopping bazaar) in Oujda.
Moroccan Medina (shopping bazaar) in Oujda.

However, my journey to Morocco was far from easy. What was supposed to have been three domestic and two international connecting flights prior to arriving in Casablanca, Morocco ended up with me being stuck at an airport in Chicago because of hurricane storm warnings. While I was re-routed to travel through Paris, it came with a cost: all of my checked luggage (filled with research supplies) got lost abroad! To this day, I still have no idea which continent those saliva kits are even on…

Moroccan Berber Traditional Music
Moroccan Berber Traditional Music

Perhaps it was because I was able to communicate with the locals or because I am familiar with Islamic traditions and cuisine, but traveling to Morocco with Operation Smile was my favourite surgical mission. It’s not very often that you can put a group of people together for a short amount of time and have them feel like they have known each other for years, but this is exactly what happened during the Oujda mission.

Additionally, in November 2014, I was fortunate enough to travel abroad to Vietnam to collect research data on another Operation Smile mega mission–meaning that multiple sites had been coordinated to perform surgeries across the country at the same time. After landing at the airport of Hanoi, Vietnam during the middle of the night, I was taken to a local hotel with other Operation Smile members to get some rest before having to wake-up at 5am the next morning in order to begin the journey over to our mission site. The bus ride to Nghe An took about 7 hours, but I was able to see incredible views of the country. Aside from having the opportunity to see the “non-tourist” sites of Vietnam while we drove through mountains and past rice fields with grazing water buffalo, the ride to Nghe An also enabled the  team to bond with one another before arriving at the hospital.

Hanoi, Vietnam
Hanoi, Vietnam

During the mission in Vietnam, I was able to appreciate the genuine help from local volunteers. Because of “politics”, the research team at my site was only provided with one volunteer to help with translations, which is crucial for a study that relies heavily on questionnaires in a foreign languge; however, that didn’t stop the eagerness of other local volnteers to come by the research station to help. The local volunteers that help at  missions are dedicated to the values of Operation Smile. During the mission at Nghe An, I saw volunteers arriving at the hospital to help–even after attending classes and their own work-shifts. At every possible free-time that they had, the local volunteers were more than willing to join us at the hospital. Without local volunteers, the whole mission would not have been possible, including the research portion, and for reason I am completely grateful.

Research Team after first night in Nghe An, Vietnam

(To be Continued…)

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