The weather has been very pleasant with blue skies and high temperatures in the 70’s. Our first day of surgery started early with two operating rooms as Dr. Granger is still in transit from the United States. Most of the cleft lip procedures are revisions as most of the children had prior surgery. Marlene, our team speech pathologist, examined a girl named Jinxlao who required palate surgery. Jinxlao’s open palate reduces her ability to speak. Her voice is very soft and when you can get her to talk she talks like a six year old. Your heart goes out to think she has not been able to express herself like other children her age. I spoke with her father with the help of a translator. Her father said she is not a good student, which is not a surprise considering her limited ability to talk. On a brighter note, our head nurse Sandra who has been on 10 missions reported that it was a good first day overall. The 10th and final surgery of the day left the ward by 6pm.