The impact of an untreated cleft 

In Madagascar, many families have never seen a cleft before, so it’s a condition often greeted with fear and superstition in some rural communities. The news of Lanto and Rindra’s cleft, although devastating for Rolland and Adeline, wasn’t so much of a shock, because Rolland’s cousin – a man in his fifties – had lived his entire life with an untreated cleft.  

Having a relative with a cleft meant the family weren’t fearful of the condition itself or superstitious about the cause, but they had seen the negative impact an untreated cleft can have on a person’s health, and the quality of their life. Like any loving parents would, Rolland and Adeline wanted a better future for their children. 

Photo – Margherita Mirabella

Life-changing news on the radio 

Rolland heard an advert on the radio about an Operation Smile surgical programme in Antsirabe, Madagascar. Finding out that Rindra and Lanto could have the cleft surgery they needed, for free, was a dream come true for the family. Unlike here in the UK, health services aren’t free in many parts of the world, and the costs of treatment – or even travelling to reach medical facilities – are out of reach for most families.  

Rolland walked for four hours to the nearest hospital to register Lanto and Rindra for the next surgical programme. Thankfully, Operation Smile provides free transport for families travelling to surgical programmes, and Rolland was given details of when and where to catch the bus for the forthcoming surgical programme. 

When Rolland and his children arrived at the hospital, they were surprised to see so many other families in the same situation. It was a comfort for them to know that they weren’t alone. After a thorough medical evaluation by Operation Smile medical volunteers, Lanto was found to be fit enough for surgery, and later got the brand new smile her parents had dreamed of for her.  

Photo – Henitsoa Rafalia

Operation Smile is wonderful, and we are very thankful that they are here. We hope that they will be in Madagascar for a long time!

Rolland, Lanto and Rindra’s Father 

Too sick for surgery 

But, for Lanto’s younger brother Rindra, the journey to his new smile would take a little longer. During his health checks, medical volunteers found that he was underweight due to problems feeding, which sadly, is often the case for children with cleft conditions. He was also suffering from a respiratory infection, which meant he wouldn’t be healthy enough for an operation.  

Children born with cleft conditions often face major challenges with feeding and getting the vital nourishment they need in their first few months of life. This can lead to malnutrition, developmental delays, and sometimes even death.  

Thankfully, Rindra was referred to Operation Smile’s nutrition programme, which will provide ongoing support for the family through workshops, advice and nutrition supplements.   

Photo – Margherita Mirabella

Life-saving nutritional support 

Nutritional support is a vital part of the comprehensive care we provide to patients and their families. Years ago, before Operation Smile’s nutrition programmes were developed, Charlotte Steppling was involved in patient recruitment in Madagascar. Charlotte saw firsthand the devastating impact of malnutrition. She recalls, “We were turning away patients suffering from malnutrition. I was waiting for these kids to show up at the next surgical programme, but they just weren’t coming back. They were dying, and it broke my heart. What If we had come into contact with them earlier?”  

Today Operation Smile nutrition programmes are active in 24 countries, including the one in Madagascar that’s currently supporting Rindra and his family.  

We need to reach these patients as early as possible. Whenever a patient is born with a cleft, they should know that Operation Smile exists.

Charlotte Steppling, Director of Global Medical Education, Comprehensive Care 

Thanks to the efforts of our nutrition team, Rinda is getting stronger by the day, and should soon be strong enough to get life-changing surgery and a brand-new smile like his big sister.  

Photo – Henitsoa Rafalia

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