From Hurt to Healing: Efren’s Emotional Change

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.”

After his surgery, Efren smiles for the camera with friends.

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.

Efren jumps down while playing with friends.

“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.”

Efren smiles for the camera after surgery.

Her Name is Jane Rose

Jane Rose plays with friends at her home one year after receiving surgery from Operation Smile Philippines

Jane Rose longed to be called by her name. Writing it repeatedly in her notebook, the spirited 7-year-old hoped that the dream she wrote on paper would eventually come true. 

But in reality, she faced almost constant bullying because of her cleft condition from many children in her community who refused to call her anything besides “bungi,” a derogatory word for cleft. 

Seven-year-old Jane Rose, before surgery.

“My heart breaks every time I hear them bully her. The only way to stop it is to get her cleft lip repaired. They will not stop otherwise,” said Eutigio, Jane Rose’s father.

Jane Rose loves going to school and is very intelligent. She refused to give in to her abusers.

With big dreams of one day becoming a teacher, she felt determined to attend school each day despite the constant bullying. 

Jane Rose's father, Eutigio, watches as his daughter completes her homework.

Her family lives in a house made of bamboo in Cebu City, Philippines. With no access to electricity or water in their home, Jane Rose and her family share the only nearby well with the many neighbors in the area. 

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 a cleft condition. The global average is closer to one in 750 births. 

Even though there are skilled plastic surgeons in the country – some who volunteer with Operation Smile – most families can’t afford the cost of surgery. 

It broke Eutigio’s heart knowing that as a garbage collector, the cost of surgery for Jane Rose was beyond his means.  

In the past, he’s tried twice to get his daughter this life-changing surgery for free through other organizations. 

But both times, Jane Rose was denied because of health issues. 

With each failed attempt, Eutigio’s anxiety and worry for his daughter deepened. 

“My biggest fear is that she’ll grow up being bullied all her life,” he said.

Jane Rose is left to watch as her neighbors play a game together.

It wasn’t until Eutigio learned about Operation Smile Philippines that he believed and hoped their third attempt at surgery would be different. 

Upon arriving at the surgical program, Jane Rose and her father felt excited at the thought that this could be the opportunity for which they’ve been waiting. 

“I am very happy to be here,” Eutigio said. “There are so many children here with the same problem. I thought it was only our family.” 

After the screening process, medical volunteers were thrilled to tell Eutigio the good news. 

Operation Smile medical volunteers check Jane Rose's vitals during screening to ensure that she's healthy enough to undergo anesthesia for her surgery during a 2015 surgical program in Cebu.

“I am so happy she passed all the health examinations since this is the third time we’ve tried. I am very happy and very thankful,” Eutigio said. 

It was finally time for Jane Rose to receive the surgery she always deserved. 

A surgery that can take 45 minutes changed her life forever.

The day after her cleft repair surgery, Jane Rose stared at her new smile in the mirror, not taking her eyes away from what she saw. 

“I’m so happy that she looks so beautiful. Thank you!” said Eutigio.

Jane Rose looks in the mirror after surgery.

Years have passed since Jane Rose’s surgery, and so many aspects of her life have changed during that time.

Today, Jane Rose continues to excel in her studies at school. According to her teacher, Jane Rose is very involved and intelligent. She even received a medal for the time she spent studying. 

With her newfound confidence after surgery, Jane Rose participated in a school mini pageant and has gained many friends. 

But the greatest and most noticeable change is how the children who once bullied her now call her by her real name. At last, she’s living out her dream that once occupied the lines of her notebook.

Eutigio hopes that Jane Rose will now be able to follow her dreams, finish school, and become a teacher. 

“She will have a better future now,” he said.

Today, nobody bullies or teases her – many have no idea that Jane Rose was born with a cleft lip. 

“I am not a ‘bungi’ anymore, I am just beautiful,” Jane Rose said. 

Jane Rose, after surgery.

The Boy In The Mirror Was Smiling Back

Bal Ligot

Who would ever thought that a mirror could make one realize that he is exactly where he needs to be?

This is what Speech Pathologist Bal Ligot found out in 2005 as part of the volunteer team in Bataan.

Fernando Ligot or “Bal” to his family and friends is one of the longest-serving volunteers of Operation Smile Philippines. He has been in countless local surgical missions around the Philippines. Bal also regularly takes part in international surgical missions around the world. His expertise and compassion has also touched the lives of people across the globe.

The start of his journey

Bal had heard about Operation Smile while he was still in his teens. But it was in college at UP Manila that he got to meet Dr. Michael Van Lue, an American speech pathologist and volunteer for Operation Smile. Dr. VanLue was in the Philippines in 1999 and wanted to reach out to fellow speech therapists. At that time, UP was the only school offering speech pathology. After the meeting, Bal was invited to join a surgical mission the following year.

Being the son of a surgeon, Bal was familiar with the work surgeons do. But it was not until he entered the speech pathology program of UP Manila did he get to work and experience working with children with cleft lip and palate.  And when he did join the Operation Smile surgical mission in 2000 in Cavite, he experienced first-hand the difference he can make in the lives of people.

What keeps him going

“Changing the lives not only of the patients but their families as well keeps me going.” This is what pushes Bal forward in his time with Operation Smile Philippines. It also helps that there is a whole community of Operation Smile volunteers driven by the same desire to help other people in need.

“Surgeons, nurses, anesthesiologists, speech therapists, dentists, and all the other volunteers – these people working together to help make the lives of these individuals better is what keeps me going.”, he said. He also added that the word “just” does not exist in the vocabulary of Operation Smile.

He explains, “ I do not believe in the word just”  – “I am just a dentist” or “I am just a medical records person” or “I am just a nurse”.  Each and every person in the mission team who is doing something to help make the life of another better is not “just” doing something, they are doing exactly what needs to be done. So I say – “I am a dentist” or “I am a medical records person” or “I am a nurse” add to that…” and I help change the lives of individuals with cleft lip and palate”. That idea is what keeps me going.”

Most unforgettable mission

Bal was in Balanga Bataan in 2005 when he saw a child looking at himself in the mirror after receiving cleft lip surgery. This seems like an ordinary and typical thing any patient would do after an operation. You would want to check how it went and what the operation looks like. But this was not the case.

Bal said that there wasn’t anything unusual about the scene. That is until the mother of the child with tears in her eyes said “he has never looked at himself in the mirror before his cleft lip was operated on until now”.  The boy in the mirror was smiling back. This was when Bal realized that in that exact point in time, it was a life-changing moment for the boy, his mother, and for him.