Faces of Tomorrow

Faces of Tomorrow Collaborates with the Peace Corps

Abby translating for our speech team

One of the many things that we do to prepare for an upcoming mission is to educate ourselves on the customs and culture of those who we are serving. Key to this process is the involvement of the local Peace Corps Volunteers (PCVs). The collaboration between the Peace Corps and Faces of Tomorrow is very important to the success of the mission. PCVs get to work months ahead of our arrival. They travel to the most remote of villages, islands, churches, hospitals and community centers to spread the word that we are coming. They work with nervous parents especially those who have not had exposure to modern medicine.

Jessica entertaining waiting patients

They calm nerves and help with transportation if needed. When we arrive the PCVs are an amazing resource for us in translating and communicating with parents as well as helping us navigate the city for the smallest of things - say for example if we need printer paper or ink cartridges. During the hustle and bustle of our intake and discharge clinics PCVs help us manage crowds, play with children and keep the parents informed.

Kristen, Jessica, Abby and Kate

This year while on our mission in Tagbilaran City on the island of Bohol,Philippines we were lucky to have worked with four dedicated Peace Corps Volunteers, Kristen, Jessica, Abby and Kate. Each of the girls was an amazing resource and went above and beyond the above-mentioned tasks.

This blog entry from Abby Samuelson covers her experience volunteering for Faces of Tomorrow. Thank you Abby for sharing with us.

From Abby Samuleson's Blog

Sunday, January 23, 2011

Abby's Blog Spot

Abby with a young guy and his his mom before his life changing surgery

I've been sitting in front of my laptop screen for about 3 hours, trying to put together the words to describe this past week. Nothing short of life-changing seems to suffice. A group of 30 surgeons, anesthesiologists, nurses, and dentists - mostly from California - came to my island for a week of free surgeries for cleft lip and cleft palate patients. Several of those involved were ex-Peace Corps Volunteers, and requested locally-assigned PCVs to help in striving to be culturally sensitive in the complete care of the patients. That's where I come in!

Friday, Jan. 14th, after leaving my classes in the more than capable hands of Ma'am Amy Lara, I squeezed into a bus (and not figuratively...) going to the Provincial Capital City, Tagbilaran. When the usual-90-minute ride ended up taking over 3 1/2 hours, I wished I'd paid the extra 40 pesos to get there in an hour via v-hire (van). Anyway, I met up with the other 3 female PCVs on my island (Jessica, Kristin, and Kate) and we braced ourselves for the chaos that was about to ensue.

Saturday morning, while waiting at the airport for the FOT team to arrive, I felt an unexplainable sense of excitement. Mainly, I was looking forward to meeting some other well-meaning Americans and to be the local tour guide/language translator/cultural expert. Little did I know how much inspiration I would gain from their dedication, conversations, and generosity. It was also eye-opening in an introspective aspect - I saw the Filipino culture and my living situation through the eyes of newcoming-Americans. What they saw as shocking was exactly what I found shocking 5 months ago, but is now normal to me - which was all so surprising to me, how much I've gotten used to the culture around me.

Sunday, they had a triage (screening) clinic. About 100 candidates came to the hospital seeking free surgeries. The medical team said they had never seen such a need in any of their previous missions. In the States, for patients with bilateral cleft lip and palate, there are usually 3 basic surgeries involved - one to close the top lip to cover the gums and teeth (done at around 3 months old), one to close the palate, to give the patient a wall between their mouth/throat and nose depending on the severity (done at around 1 year), and one rhinoplasty to fix the inside of the nose and the outside for aesthetics. The medical volunteers said that usually, they're able to do all of the lip and palate surgeries, in addition to some rhinoplastic operations for older patients. However, this year there were so many children in need, so they decided to stay late and squeeze in an additional 2 surgeries per day - bringing the total to 55 patients who would receive surgeries.

The first surgery (lip) was first priority, and only 10 palate surgeries were scheduled; no rhinoplasties, and nobody over the age of 11. It was heartwrenching to have to tell roughly 50 children and adults that there just wasn't enough time and resources to give them surgeries this time; luckily, some of them (the ones who would benefit) still got an obturator, kind of like a retainer, which will help with speech and hygiene by at least partially blocking the hole between mouth and nose, and preventing food from getting into the nose when swallowing. My job for most of the day on Sunday was translating for Heather, one of the 2 Speech Pathologists. Since there isn't a wall between mouth and nose, cleft palate patients can't create pressure to say b, p, v, f, d, t, s, or sh, and can't use the soft palate at the back to say g, k, or ng. I learned alot, and will be able to teach the parents of any cleft lip or palate patients in my area how to help work on their child's speech. So yay, sustainability and follow-up!

Monday through Friday were all surgery days, in which I worked 6:30am-9pm at the hospital. Basically, there were 8 patients in each of 2 rooms, no air conditioning, with one bed per patient (and whoever else was there to help care for them, parents, siblings, etc.) and about 1-foot aisles of moving space between beds. With mosquitos, lizards, pained crying babies, the smell of dried blood, and surrounding doctors and nurses and translators and dentists and speech therapists squeezing in to visit each patient, you can only imagine the environment. It's no wonder everyone was cranky and tired!

Besides helping with cultural and language translation, and odd jobs, I also got to play with the incoming (still well) patients, build relationships with them and their families, which made everything go smoother - both by calming down the chaos around recovering patients, and by easing nerves before surgery by establishing a familiar face. Because I wasn't dressed in scrubs or a lab coat and spoke their language, I felt a lot more approachable. I also had the time to just hang out, with no specific pressing, needy patients. The simplest idea and cheapest of toys - blowing bubbles - was a big hit for everyone: crying babies, patients' siblings, the parents, and recovering patients. It helped w/ speech therapy for pre-surgery patients, and was entertainment for post-surgery patients because they didn't have to physically exert themselves, but could just look at them. My strategy was to find the loudest crying baby or most rambunctious kid to be victims of what I call Bubble Therapy. It was really really cool to get to talk to the patients and their families, to hear their stories, and get a glimpse of how life-changing this surgery would be for them. Children and adults with cleft lip and/or palate usually get teased for the way they look and for their speech, and mothers who give birth to these children are often left, beaten, or verbally abused. Some drop out of school, some develop other related medical problems like ear infections or deafness (because they can't swallow normally or pop their ears by creating pressure in the mouth). BUT, after surgery, they are given a chance at life, at success, at a decent job. It's so humbling to get the opportunity to be a part of something like this.

Saturday, we had a discharge clinic, where all patients from the week came back for post-pictures, more care instructions, to pick up and learn how to use their obturators (if they didn't get palate surgery and needed it), and to have more speech therapy sessions. We also gave out coloring books and crayons, other toys, some infant clothes people from the States had donated to the FOT team to bring over, toothbrushes, and information brochures (that I helped translate!) on oral hygiene, post-op instructions, obturator care, etc. There was an insane amount of chaos, with not only the post-surgery patients, but also those picking up obturators and getting speech therapy, in addition to all of the families.

But alas, everything went smoothly. Amazingly, there were no serious complications, for any of the 54 operations all week! The biggest problem was that 3 of the mothers breastfed their babies past the time the anesthesiologists said was ok (because if they gag during surgery they can choke on anything they've eaten and die). It's no wonder -not feeding your child when he/she is hungry is a completely off-the-wall, insane idea for this culture, especially when you know it could make them stop screaming in this tiny roomful of also-trying-to-sleep people. Anyway, the surgeons were able to move around the schedule and I think all but one patient got their surgery (who had a fever, as I understand).

Personally, I've been so inspired by the patients, their families, and the incredible FOT team to get involved in community health and education (like nutrition, hygiene, and reproductive health). I also learned first-hand how stressful and emotionally draining a job in the medical profession is, and that I could never be a surgeon. My language skills improved dramatically this week (especially medical-related vocabulary), and I gained confidence in my fluency. Also, socially, I finally met some Filipinos my age! It wasreallyfun to get to know the nurses, all between 20 and 30 years old! At my site, I haven't really met anyone my age (besides trike drivers or groups of drunken men yelling at/sexually harassing me as I pass by) so it was really great to talk w/ someone who isn't my 13-year-old student and doesn't already have 7 kids. For the first time during my peace corps service, I felt partially integrated into the community and able to carry on conversations in Cebuano.

I think I can speak for all 4 of us Peace Corps Volunteers when I say it was a rare and amazing opportunity. Unlike our usual long-range, vague, community-development plans, this week gave us the instant gratification of seeing a 3-year-old come in with a gaping hole in his face and leave with a quickly-healing smile. We heard the family backgrounds from the poorest of the poor, and how their lives are changed. In a culture where showing any kind of emotion (especially negative) is taboo, it was a HUGE honor to see parents break down in tears of joy.