Faces of Tomorrow

Today I saw a cute 4 year old girl named Paola Estafania Saula Guamian. She
had a repaired cleft lip and a cleft palate that was still unrepaired. I
asked the mother who repaired the lip.  It turns out that I was the surgeon
who repaired her lip when she was 6 months old. Tomorrow I will be doing the
surgery for her palate. Mother was very happy to hear we could do the
surgery. 

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This mission to Ecuador is a tremendous experience. I am blessed that I get to do work that brings me immense personal satisfaction and that I get to work with a team of wonderful people. Together we are changing the course of people's lives. Just imagine what it must feel like to have been stared at for as long as you can remember. In the course of one surgery you are able blend into the crowd, no longer standing apart as an oddity. Imagine being the parents of that child. Unexpectedly a miracle has touched your baby. With this one surgery we can improve the life of a child and all of the people surrounding that child. The emotional impact of this event leaves me at a loss for words. I am overwhelmed.

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These are the wonderful young students who have joined the FOT team!  Kylie Thompson, MC and Jonathon Lovely are 14 year olds from Davis, California.  They are all former students of a Spanish immersion school, Cesar Chavez in Davis and will be incoming freshman at Davis High School in the Fall. 
One of the benefits of the Spanish immersion program is that these young individuals are well prepared to help with translation between the patients, families and the staff of FOT.

All three of the amazing young teens have been indispensible as patient care helpers.  The children patients love them!   Everyone on the FOT team has been wowed by their ability to handle the long days, pressure situations and demands of this developing country of Ecuador at an elevation of nearly 10,000 feet.

We are so fortunate to have these 3 great young people on this mission with us.  We are hoping they will be the future leaders of our medical mission group, Faces of Tomorrow.

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Yesterday we encountered one of our most interesting stories yet!

We are all amazed by Marisol Tapui, a 30 year old mother of three who brought 6 children(not her own) to our triage clinic on Sunday. Marisol is a community leader from the town of Tena, 5 hours away from Quito.  In addition to being the chief administrator at the local orphanage, she works with the American Timmy Foundation to find medical resources to help the people in Tena and the surrounding villages. 
After spending a very long day in the triage clinic on Sunday, Marisol traveled back to Tena to bring 4 more children and their families back to Quito to the hospital.  Several of these families traveled 2 hours by canoe, followed by the 5 hour bus ride to get to our location.  The 10 children have all received various cleft and lip surgeries and are all doing great!

Marisol is a passionate volunteer who was born and raised in Tena and is unbelievably dedicated to helping the people in her community.  She hopes to go to college to get her MSW degree and learn English. 
What an honor to witness such a giving individual help so many children! 

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It is now Tuesday afternoon, and the patient load has increased dramatically.  We have had several new patients arrive on Monday and Tuesday, and thankfully we have been able to accommodate all of those that have required surgery.  We now have a completely full schedule through Friday, which is great news.  The names of the children that we have had the pleasure to meet stay with you forever -- Said, Edison, Richard, Paolo, Estefany, Fatima...All kind and generous patients and families.. 

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Dear Friends, Family and Supporters,

 

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THANK YOU ALL!!!!!!!!!!! It probably was the most difficult mission for Faces  of Tomorrow (FOT) but it was a job well done. The numerous poor people that you have come to help will be forever grateful to this wonderful team. I would personally thank Dr. Charles Shih for his interest of bringing FOT to this little island of Bohol. Politics is such a big issue in the Philippines but I'm very thankful that it did not stop Brian's desire of coming back again to help the poor children of Bohol. To each & everyone of the FOT team, I want to say thank you in behalf of the recipients of this life changing gift that you have given to them. Chona Torregosa-Chatto

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I would like to thank FOT team for helping the people in the poor island of Bohol,from the bottom of my heart-DAGHAN KAAYONG SALAMAT! (thank you very much)-these words could never be enough to convey how truly grateful we are for having FOT touch the Boholanos..This work means so much to me,i feel so fortunate  being part of this endeavour, you brought out the best in me,and forever i am indebted to you for taking a lot of care and so much kindness and generosity to my fellow Boholanos.
again, thank you so much!!!!!!!!!!!!God bless you all!!

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Our amazing week of mission work here ended yesterday and I am still overwhelmed with emotion at the kids and families we met and and were able to help. There were so many babies and small children whose lips and palates we repaired in a timely manner before their deformities could cause any more undo stress, health and speech issues. However, the older kids we treated in record numbers this year truly broke my heart. These kids have been living with their deformities for many, many, years which in turn has lead to poorer health, severe speech issues and worst of all, lots of teasing. I felt so grateful to be  a small part of changing these kids' lives.

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This may have been my most difficult mission to plan since we started FOT (Faces of Tomorrow) almost 5 years ago.  Most people don't know this but less than 2 weeks before the mission started, the City Mayor of Tagbilarin City, Bohol cancelled his support for  our mission.  Politics became involved with the province Governor and he withdrew his support for the mission.  We were encouraged to cancel the mission, but we scrambled with the support of our collaborators on the ground in Bohol (Charina) and arranged our own transportation, and hospital arrangements and a million other things.  We also had to change our government permit to work in the Philippines and received the permit  the day before we left. 

All of the stress, frustration, and sleepless nights all disappeared as the week progressed.  After seeing one dream realized after another during the week of surgeries, made it all worth it. 

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Just a quick note to thank all the helpers we have had this year.  All your help has made this mission possible. Thank you! YOU ROCK!

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I was really taken by a little 8 year old girl in a fairy dress.  She walked into the triage room with a HUGE cleft lip .  She  smiled really big, only to show a maze of missing/rotting/misplaced teeth.  I don't think she even knew it.  Her smile was huge and her eyes bright.  I watched her twirl around while she watched her dress swing. Again, a huge smile.  She was so cute, smiley, and seemingly unaware of her deformities.  Unlike most other cleft kids who won't even look you in the eye she looked and smiled.  I asked her if I could take her picture.  She quickly posed with her fingers in  front of her face creating the hand sign that  signified guapa (beautiful).  I was so touched by her confidence and beauty.  I was also touched by her parents.  What a huge feat.  This little confident girl knows she is beautiful.

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It's so amazing here with all the things you get to do. Yesterday I was medicating the kids in pre-op. They get that versed and they turn all happy and floppy. They look a little drunk and don't seem to care about anything. I medicated this little five year old. She was just the cutest little thing. Took her medicine just like that. She wasn't afraid of me at all. She still had about 20 minutes before surgery so I went out and started doing other things. On one trip by the window I saw her mother holding her up so she could look at everything going on inside the OR. She was smiling so big and then she saw me and started waving the princess wave. I couldn't help but stop to see her. She just kept on grinning and her smile was so big I slid outside the OR to pre-op to get closer to her. When I leaned in she said "I love you" in english. Now she is my new best friend. That versed works so well... anyway if any is missing...... I might be using it to get a few more of those i love you's.

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Kyle Patrick was one of our more heartwarming cases this year.  He showed up in  a Captain America T-shirt that he was very proud of.  He is 11 years old, and right after his mother died this year, his father abandoned him, and now he is living with his aunt.  Although he does not have a severe cleft lip,  he told us that he gets teased constantly at school about his appearance. You could tell he was a brave kid, and very polite.  He also spoke good English, and liked when we spoke with him.
Brian did his surgery, and it come out perfectly.  His new lip looked great, and we are hoping that the teasing will stop.  We really wanted to bring this kid home with us, and Karen Westmoreland, one our nurses, and I were fighting over who he would come live with . Great example of why we do these missions...

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Everyone has finally hit their groove.  The days are running smooth from preop to OR to PACU to patient discharge.  We 've had a couple go down with a  stomach or GI  bug, but after a well placed IV most have rebounded.  It is quite impressive how FOT has thrown a group of strangers from different parts of the country together and really put forth a cohesive team.  At times I feel like i'm with Pierce and Trapper in the 4077 where a days shenanigans end with a job well done.  Can't wait for tomorrow.

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We had a long first day of operating. My first case was Marvin who is a 17 year old boy who has a wide bilateral cleft lip and palate that has never been repaired. Imagine going through your first 17 years of life like that.

It turns out that he had come to see FOT for surgery last year but unfortunately was turned down due to the excess number of patients. Fortunately he came back this year and we decided to repair both his lip and his palate together. The surgery took 5 hours but went very well and he went home the following day.

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Yesterday was a bit rough and fairly chaotic but all the kids did great. The team did 11 procedures.  Today, we got our groove on and it has been smooth sailing.  16 cases today!  This is my 4th mission trip with FOT and I am still continually amazed at the transformation's  that take place in the matter of a few hours - makes me smile right along with the patients.  :)

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Joan and Karen are working in PACU. Joan was recovering a 10 year old girl named Mary Ann.She had been in recovery for some time and was stable. Our Philippine nurses and her mother were at her bedside, attending to her. She was close to finishing her first liter of fluids and began to squirm. It became obvious that she needed to use the bathroom. The nurses called me and I asked the Philippine OR nurse for a bedpan. This nurse went to the phone and started calling. I looked at the patient and decided she was big enough to walk to the bathroom. I didn't want to wait for someone to bring a bedpan. She walked with assistance to the bathroom, took care of her urgent business and we headed back to her room. As she was sitting back down on the bed, a breathless Philippine peds doctor arrived at her bedside responding to the 'emergency' he had been telephoned to attend. It took a few minutes to explain the bathroom emergency. I thought I had asked for a bedpan.

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This is the first chance for many of us to get a chance to write, as the internet has not been available much at the hotel.  It is now Tuesday afternoon, and we are in the middle of our second day of surgeries.

Here's the recap. After leaving Davis by bus on Thursday afternoon, we finally arrived in Manila on Saturday AM after a short stop in Guam in the middle of the night. We then had another short hop to the island of Bohol, where we were greeted by a marching band.  All of the team arrived safe and sound. We unloaded supplies at the hospital and got all settled at the hotel.  After the long journey, it was an early night for most.  We did awake early Sunday morning to prepare for the triage day, ( but not before watching the 49ers beat the Saints (on a small PC with no sound). The game was on at 5AM, but many of us were up to watch the glorious triumph)...

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Last year, the Magan family had 3 children's lips repaired.  I remember how shy they were, hiding their faces, barely speaking.  Here are pre- and post-op pictures from last year:When they saw me for the first time this year while waiting to be evaluated for palate surgeries, I heard a chorus of "Ate (big sister) Abby!!! Ate Abby!" and a family of overwhelmingly happy faces.  I wish I could share the eagerness with which they showed me their smiles and told me how their lives have been completely transformed.  Hirve proudly announced to me that he had SIX friends now at school!  Virgil was the opposite of shy, talking nonstop - transformed into a gregarious 8-year-old.  Berlyn just sat there, beaming, posing every angle of her face for me.  I'm incredibly fortunate to be able to see firsthand the transformation in these kids' lives - it shows in their eyes, in their personalities, in their emotional states, and in their smiles.

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