Author: Operation Smile Philippines

“From the bottom of my heart I would like to say thank you for making my daughter Jinden a very beautiful girl. This is the most wonderful gift I’ve ever had.” – Eden Rose

Eden Rose and Eugene’s excitement at the birth of their first child turned to despair when their daughter, Jinden, was born with a cleft lip. Both parents had seen people with cleft conditions through their work in the fish industry in Negros Occidental, Philippines, but never imagined that it would happen to their child.

The new parents turned to each other for comfort and looked for support from their parents and the hospital staff. The nurses at the hospital were able to give them some hope by telling them that surgery was possible for their daughter and that they should check regularly with their local health center for news of a medical team coming to the area to help children like Jinden.

Eden Rose contacted several organizations before learning about Operation Smile from a local community leader. After months of checking regularly, she finally saw the dates for an upcoming medical program in Silay. Finally the wait was over and the family traveled, nervous but excited, to the hospital in Silay. They became more nervous when they saw so many other families with the same condition as Jinden.

After Jinden received a health care assessment from Operation Smile medical volunteers, Eden Rose wanted to wait until the surgical schedule was posted, but nearly 2-year-old Jinden was tired and crying, so they returned home to wait for what they hoped would be good news. On Monday the call came; Jinden’s surgery was scheduled for Wednesday.

Eden Rose was so excited that she could not sleep on Tuesday night. Everyone on the Operation Smile medical team fell in love with beautiful Jinden, and soon after the surgery to repair her cleft lip, she was back in her mother’s loving arms. After 24 hours in the hospital, Jinden and her doting parents were ready to return home to start a new life.

Before leaving the hospital, however, Eden Rose approached each of the doctors, nurses and volunteers who cared for her precious daughter to thank them and presented a beautiful letter of thanks.

Joseph walks in his flip-flops behind his father and stepmother through their neighborhood in San Remigio on the Philippine island of Cebu.

The 6-year-old carries a big plastic bag to collect recyclables and scrap metal, asking neighbors to sell him empty plastic bottles, pieces of metal, cans and glass jars.

The family gathers anything that might be worth a few more pesos before they sell it on to “the boss,” who then sells those items to turn a profit.

“The boss” pays Joseph’s father, Julito, a fixed price: 3 pesos per kilogram of cans, 2 pesos per kilogram of glass bottles and only 1 peso per kilogram of plastics. On a good day, the family of five receives 100 pesos, which totals out to $2 at the most.

Joseph is the family’s youngest child and the only one born with a cleft lip and cleft palate.

His mother, who died several years ago due to heart disease, also collected scrap metal and recyclables.

While there are still many misconceptions surrounding the cause of cleft conditions, which can be environmental or hereditary, Julito believes his son’s cleft condition may have been caused by hours of bumpy motorbike rides Joseph’s mother endured while she was pregnant.

Joseph doesn’t attend school.

“He tried once, but came home crying. They call him ‘bungi,’” a derogatory word for cleft, Julito explains.

Sometimes the neighborhood children throw stones at him — the same treatment they give the stray dogs in the area.

“Then, he fights back and comes home angry, crying and upset,” Julito said.

For unknown reasons, Southeast Asia, including the Philippines, is a region where cleft conditions are more common than the rest of the world — around one in 500 children are born with cleft lip and cleft palate.

The global average is closer to one in 750 births. Even though there are skilled plastic surgeons in the country — some who volunteer for Operation Smile — most families cannot afford the cost of surgery.

Joseph’s family is no exception.

Even the bus fare to the hospitals of Cebu City is too costly for some families.

However, when Julito learned about Operation Smile and the free surgeries it provides to children like Joseph, he became hopeful for his son’s future.

After a local nongovernmental organization, Abounding In Love, provided Julito and his family with free transportation and lodging to an upcoming Operation Smile medical program, Joseph was closer than he’d ever been to receiving a new smile.

Following their bus trip to the program, Julito gazed around at the scene before him, surprised to see how many other children had the same condition as Joseph. While relieved to learn that his son wasn’t the only child to have a cleft, Julito soon became worried.

“I have mixed feelings,” he said. “I’m happy Joseph is not alone, but also afraid he will not qualify for surgery since there are so many in need of help.”

Amid the bustling atmosphere of the program, Joseph tries to make sense of the situation.

He keeps asking his father why they are there, and when Julito explains, Joseph looks at him with surprise: “So they are going to fix my lip now?”

After a passing a comprehensive health evaluation, Joseph became one of many children who were selected to receive surgery.

The day after his cleft lip is repaired, Joseph stares at himself in the mirror for a long time.

With love and hope for his son, Julito won’t give up until Joseph receives cleft palate surgery.

A year has passed since Joseph’s surgery.

While Julito still struggles to provide for his family, life has drastically changed for Joseph since arriving home after the program.

“When we were discharged from the hospital and arrived at home, all our neighbors were very excited to see Joseph and told him he looked so handsome,” Julito said. “When we came to our house, he got a mirror and looked at his face and said, ‘Oh, I’m very handsome now!’”

But Joseph’s confidence isn’t the only bright spot in life after surgery.

Joseph has returned to school, eager to learn and become friends with those who once bullied and teased him.

“The first day at school, Joseph prepared himself carefully,” Julito explains. “He washed himself and prepared his school bag and dressed in his school uniform. When we got to the classroom, he asked if I was going to stay there with him. I said, ‘Yes, of course, I’m going to wait for you,’ but my son then explained that there was no need; he could manage to go home on his own.

“He’s not shy anymore. Unlike before, he likes going outdoors. And even if children still tease him sometimes, he doesn’t get mad at them — he knows his face is different now. Hopefully, the surgeries will bring him a different life than mine. He has more confidence now, and maybe this will give him a chance to get a proper job in the future.”

At 9 years old, Efren’s schoolmates were his worst enemies. He lashed out against his bullies, who constantly targeted him with insults because of his cleft lip and cleft palate. He came home in tears almost daily, his father, Efren Sr., recalled.

After receiving life-changing surgery from Operation Smile in the Philippines, Efren now carries himself with a sense of dignity and his outlook on life has been fundamentally changed – he’s happier, more confident and now looks forward to going to school.

“Those who have bullied him have now become his friends,” Efren Sr. said. “When he goes to school now, he is never in a fight. Now, the other children are happy for his sake.”

In the years leading up to Operation Smile’s intervention, Efren and his family lived with so much hurt in their hearts. When he was born, Efren’s mother, Juditte, was stricken with overwhelming sadness when she saw first saw her baby’s deformity. Juditte struggled to understand how her baby could be born this way. She thought it could be related to a fall she took when she was nine months pregnant with Efren, or it was a result of Efren sucking his thumb as he developed in the womb.

“We didn’t have any relatives with cleft, so we wondered why this happened to us,” Juditte said. “We felt so sad about his situation, and I have cried a lot.”

Scientists do not believe that either possibility Juditte pondered causes cleft conditions. In an effort to understand all known causes of cleft, both genetic and environmental, Operation Smile and its partners are leading the International Family Study, which seeks to translate medical research findings into preventative measures to help families like Efren’s in the future.

When Efren was 6 years old, the family was hopeful that he could receive surgery at a surgical program led by another nonprofit organization. During screening, the medical staff discovered that Efren had an irregular heartbeat and believed that surgery would be too risky to perform.

Living in extreme poverty severely limited the family’s options for a future surgical solution. It would be three years before the Philippines-based nonprofit Abounding In Love would connect Efren’s family with Operation Smile in June 2014. During that time, the family’s home was destroyed by Typhoon Yolanda in 2013. A tent provided by the United Nations Refugee Agency served as temporary housing for the family as they waited for their new home to be built.

With Abounding In Love covering their transportation costs, Juditte’s sister and Efren arrived at the Operation Smile surgical program site in Cebu for another chance to heal Efren’s smile. His parents had to stay home on Bantayan Island as Juditte had to care for their six other children and Efren Sr. could not afford to miss work.

A comprehensive health evaluation performed by Operation Smile medical volunteers found that the irregularity of his heartbeat was so minor that surgery posed no threat to Efren. Finally, he was cleared for surgery to repair his cleft lip.

After Efren’s successful procedure was complete, his aunt could breathe a sigh of relief. She looked forward to also relieving Efren’s parents’ anxiety by returning to Bantayan Island with Efren and his new smile.

“I am so happy now – I can’t express in words how happy I am. It hurt so much every time I saw him come back from school crying before,” said Efren Sr., whose son’s speech abilities dramatically improved in the months following his cleft lip surgery.

Without the help of Operation Smile, Efren’s parents would not have been able to afford surgery for their son. Efren’s father is a fisherman and struggles to make enough to feed his family of nine. The older children work with their father, instead of going to school, to help supplement the family income. However, Efren Sr. envisions a brighter future for his son.

“I am hoping Efren will continue school up to a high level and go to college – I would like him to become a teacher,” Efren Sr. said. “He has big dreams, but couldn’t do it without surgery – without Operation Smile.”