Scenes of hope and healing in Antsirabe

From 25 April to 3 May, 86 medical volunteers from 13 countries, including Madagascar, South Africa, Malawi, Mozambique and Kenya, came together to provide cleft care to children and adults in Antsirabe, Madagascar.

Antsirabe is the capital of the Vakinankaratra region. Here, the landscape is very hilly without many main roads to connect rural communities to the bigger cities. Many patients live in remote areas. Some have to travel for days to reach their nearest medical facility.

This surgical programme was held at the Centre Hospitalier de Référence Régionale (CHRR), which is the biggest referral hospital for the region. The CHRR has been recently renovated by Operation Smile, in partnership with the UBS Optimus Foundation. The renovation was part of a Global Essential Surgery project which aims to address the root causes of why people struggle to access surgery.

Jose is Operation Smile’s Patient Coordinator. His responsibilities include organising surgical programmes and raising awareness about Operation Smile and cleft care. He also manages the pool of patient advocates who act as first point of contact for patients across the different regions.

Jose works closely with the patient advocates to tackle the biggest barriers to care. As most patients live in remote areas without roads or radio service, lack of information and distance to healthcare facilities are the main barriers they face.

The team also works together to fight misconceptions about hospitals and surgery. In Madagascar surgical procedures are rare and hospitals are often known having a lack of medical tools or life-saving equipment. So, it’s understandable that people are fearful.

Here people are afraid of surgery and they are afraid of hospital. So what’s the solution? Getting back to awareness, explaining them that the rumours they heard are not right. Working with the head of the village, who’s respected by everyone, to build trust. Education is also a big part to avoid those rumours, to avoid the fear. Patient advocates are also important. The can advocate. They can tell them ‘We’ve been there, there is no problem. They helped us’

Jose, Patient Coordinator

Operation Smile Madagascar has 16 patient advocates and patient ambassadors covering 23 regions across the country. It’s their job to find and register new patients. Many patient advocates are either former parents of an Operation Smile patient or community health workers employed by the government who then volunteer with us. This vital team reaches areas, shares vital information about cleft care and safe surgery, and challenges common misconceptions and superstition about cleft conditions and hospitals.

I show parents photos of my granddaughter Claudia, so they can see that she also had a cleft and now she is fine. I do my best to convince them that Operation Smile can provide surgery and this care is safe and free, they will cover all the expenses.

Dadafara, Patient Advocate and grandfather of a former Operation Smile patient

During the programme in Antsirabe, around 180 children, teenagers and adults came to receive a full medical evaluation. Our medical team in Antsirabe included medical and non-medical specialties, from surgeons, nurses, anaesthetists, paediatricians, dentists, orthodontists and child life specialists, to speech therapists, nutritionists, PIT photographers and medical records officers. This highly skilled local team, works together to provide the best care for our patients, in line with Operation Smile’s Global Medical Standards. This ensures every patient is treated the same, and receives the safe, high-quality care we’d all expect for our loved ones.

During surgery days, the OR medical team was extremely busy, impacting the lives of more than 110 patients, using three of the CHHR’s five recently renovated operating rooms (ORs).

One of the surgical tables was dedicated to training, where Prof. Romain Raherison, a leading local cleft surgeon, mentored Prof. John Alberto, a general surgeon participating in the Operation Smile training programme. Prof Romain was also part of that programme and is now passing on his skills to other colleagues.

Finally, at the patient village, our comprehensive care team worked hard to provide care to our patients, before and after their surgeries. in total, 55 patients received dental care and 36 had speech and language therapy.