Cleft surgery: possible

Making his way to the Operation Smile medical programme site in Quelimane, Mozambique, Domingos didn’t know what to expect. He never knew that surgery could repair his cleft, so all he had was a faint hope that his neighbours and village headman were correct, and that a poster he quickly glimpsed could be the start of a new life.

“My neighbors and headman came to me a month ago and told me about this opportunity. I thought to myself, ‘Is this actually possible?’” Domingos said.

Growing up in a small rural community in Mozambique’s Zambesia province, Domingos said that he always felt lost and alone as the only person he or his family knew that was born with a cleft lip. As he spoke about being bullied and judged because of his difference, his eyes reflected the pain that he’s endured over the years.

But Domingos proved to be resilient despite being so cruelly mistreated.

Though the social stigma of cleft is severe in Mozambique, Domingos surrounded himself with people who loved and accepted him. He married his wife, and together they raised a son who’s now 20 years old and helps him farm a small piece of land.

Unfortunately, Domingos’ wife passed away several years ago. When he arrived to the programme, he told the volunteers that he had no other family members besides his son.

While his son was unable to miss work to attend the programme, Domingos said that he was sure that his son would be waiting anxiously for updates.

As Domingo’s story spread around the programme’s patient village, he rapidly became well-known and admired by the other patients and family members. Still, Domingos was unsure that his cleft lip could be repaired after living with it for so many years. When a volunteer showed him the before-and-after images another adult with cleft from Ghana who received cleft lip surgery, he exclaimed, “It’s not possible!”

After Operation Smile medical volunteers determined that Domingos was healthy enough to receive surgery, his operation was scheduled for the programme’s first day of surgery.

Sitting in the pre-operative room, Domingos looked both nervous and determined. He was welcomed into the operating room by the volunteers, including Dr. Geronimo Brilao, a Mozambican surgeon who was observing the programme. They exchange a few words in Portuguese before the course of Domingos’ live is changed over the next hour.

After the final suture was closed, Domingos looked at his new smile for the first time. The doubt he once expressed became nothing more than a memory.

Adult with cleft, Domingos. Photo: Margherita Mirabella
Adult with cleft, Domingos. Photo: Margherita Mirabella

When I look in the mirror, I am very happy because something has changed, I am a strong man now.

Domingos, patient at Operation Smile Mozambique
As he rests after surgery, Domingos reads post-operative instructions on how to care for his new smile. Photo: Zeke du Plessis.
As he rests after surgery, Domingos reads post-operative instructions on how to care for his new smile. Photo: Zeke du Plessis.
Domingos visits with his brother and sister after his surgery. Photo: Zeke du Plessis.
Domingos visits with his brother and sister after his surgery. Photo: Zeke du Plessis.

A whole life with cleft changed in 45 minutes

The day after his surgery, volunteers and staff saw Domingos sharing laughs and celebrating with people they hadn’t previously seen around the patient village. To their surprise – Domingos had said that he had no other family except for his son – it was his sister, brother and cousin.

“I have experienced this before,” said Carlos Mahalambe, an Operation Smile patient advocate in Mozambique. “I think it’s often easier for people to say they don’t have family when they are still dealing with shame, and so they try and wait to see what will happen (with their surgery).”

Domingos’ brother, Alberto, said that life was very difficult for his sibling growing up, and even when they heard that he would be attending the programme, they remained skeptical about his potential surgery. But on the day, the beaming smiles and lingering glances at Domingos’ new smile showed that they are now true believers.

“We thought there was no cure, but now we have the proof that there is a cure,” Alberto said. “The day he goes home, everyone will admire him because no one expected this. Now his life has changed, and he is different from what he once was. He is a new-born man.”

His cousin, Daniel, added: “To me, he was always a good man with good fellowship with others. And to those people who have rejected him, I hope Domingos can forgive them and carry on with his life.”

As a widower, Domingos had been reluctant to seek a new partner because of his cleft lip, but after his surgery, he said that he is thinking of a new future: “I think it might be time to start thinking about getting married again one day.

“I don’t know how to thank the team for everything they have done for me. I thank God. They must continue to do this.”

Adults with cleft before and after

Clefts in adult only occurs because care wasn’t available when our patients were young.

Cleft care in Mozambique since 2014

boys with cleft palate and cleft lip. . Photo: Margherita Mirabella
Group of boys at surgical programme in Mozambique, 2018. Photo: Margherita Mirabella

Nobody should live with untreated cleft conditions