S Pre op

The first day of surgery can often be tense. Just like everything so far on our trip, the opening day of surgery went very smoothly. In spite of having very small operating rooms, things worked exceptionally well from the very beginning. Our first patient went to sleep at 8AM and the second one fifteen minutes later. 

S two shot

Waiting for surgery to begin, our moms and little patients relax in the pre-operation waiting area.

Today’s surgery concentrated on patients under one year of age with soft tissue procedures only. The team uses the standard of 10,10,10 where the patient is ten months old, 10 hemoglobin, and a weight of ten pounds to determine the safety of anesthesia and surgery. Adhering to these standards reduces risk to the patient but may require us to turn away those who may not meet the standards. At times there are steps that can be taken such as putting the patient on antibiotics for a few days to eliminate an infection. Sometimes this is just not possible, so the team begins paperwork and starts building a file that may be used in the future. This is the ninth mission and next year’s mission is already scheduled so the chances are that they’ll be seen in the future.

S OR crowded

Even with the restrictions of small spaces and the tropical heat, we're able to treat 3 to 4 patients per table per day, with extra care and teamwork.

Patient transport brings the patients up to surgery from the ward which is three floors down and two buildings away. The patients wait in the hallway until their turn comes. Once in the OR, the anesthesiologists get the patient asleep and prepped for the surgeon. The surgeons and the surgical nurses then perform the procedure whether it’s for cleft lip or cleft palate. Dentists work on necessary extractions and the whole surgical team works under the watchful eye of the medical director and head nurse.

Once the procedure is complete, the patient is moved to PACU (post anesthetic care unit) and watched closely till they wake up. Waking from surgery can be traumatic, especially for our youngest patients who don’t understand what’s happening, they only know they hurt and feel bad. Once the PACU nurses determine that the patient is progressing well, the family is brought in and reunited. After another half hour or so, patient transport goes back into action and moves the family to the recovery ward.

  S Reunited

The look of joy on the faces of the mothers as they are brought in and see their little ones for the first time post surgery makes all the effort worthwhile.

Project Wrap-a -Smile: Each child is given a blanket handmade and donated by Rotary District 5080. As patients come through pre-op they’re presented with a blanket that follows them and is theirs to keep. The blankets are used to cover them during surgery and comfort them during post-op and recovery.  So many of those we treat come from extreme poverty and the quilts and blankets become prized possessions. 


The talent of the surgeons and the transformations made in just a day is astonishing.  Many of these babies start nursing immediately after waking, truly a tribute to the skill of the surgeon and the talent and professionalism of the team.