Meet 5-month-old Tiavina. He was one of the many patients brought by patient advocate Fidelis during a 2018 Operation Smile Madagascar surgical program in Antsirabe. Photo: Rohanna Mertens.

Having already raised four children, Denise and her husband, Cyril, never could’ve anticipated what happened on the day their fifth child was born. 

Their son Tiavina was born with a cleft condition. 

The couple felt uncertain about what this would mean for Tiavina’s future. It just so happened that Denise’s midwife, who was present for Tiavina’s birth, was knowledgeable about cleft conditions, and she reassured the family that their son’s cleft lip could be repaired through surgery. Since breastfeeding is often a major challenge, she also provided Denise with techniques on how to feed Tiavina, helping to ensure he was properly nourished. 

The support the midwife provided Tiavina’s family was invaluable, as infants born with cleft conditions have nine times the risk of dying within the first year of life due to health challenges associated with malnutrition, sickness and infection.

While the nutritional support and knowledge of a solution were comforting, it didn’t entirely alleviate their fears. They knew they didn’t have any supplemental income to afford the cost of Tiavina’s surgery. Each day, Denise stayed home with the children while Cyril worked as a subsistence farmer, making only enough to support his family of seven. 

But a few months after Tiavina was born, Denise was visited by a man named Fidelis, who would ultimately be the person to change everything. 

Fidelis’ son was born with a cleft condition. But Fidelis wasn’t simply a fellow parent of a child with a cleft lip. He was a patient advocate, determined to find parents like himself and raise awareness about the organization that had made life-changing surgery possible for his son. 

Fidelis poses with his wife, Bao, and their son, Tsilavina, who received surgery for his cleft lip in 2017 from Operation Smile. Photo: Rohanna Mertens.

Inspired by his family’s experience, Fidelis made it his personal mission to help more families by introducing them to Operation Smile Madagascar, building their trust and personally escorting them to surgical program sites so that their children can receive free and safe surgical care. 

He explained to Denise and Cyril that Operation Smile helps families around the world just like theirs and provides patients like Tiavina with free reconstructive cleft surgery and ongoing care. He encouraged the family to take Tiavina to Operation Smile’s surgical program in Antsirabe that was taking place in a few months.

The realization that a life-changing surgery was now possible for their son gave Denise and Cyril a deepening hope and determination to face any obstacle standing in their way of Tiavina’s new smile, including traveling 10 hours by bus to reach the program site in Antsirabe. After stepping off the bus, Denise found herself surrounded by families whose love for their children had also inspired them to leave their communities and travel from all over the country to reach Operation Smile Madagascar.

As she gazed at the families and patients arriving at the program, Denise didn’t even realize that many of them were brought by Fidelis. 

This included 24-year-old Herve.

Herve lived with an untreated cleft lip for 24 years before learning about Operation Smile Madagascar from Fidelis. Photo: Rohanna Mertens.

If someone had told Herve two years prior that he’d be married, free of the burdens of his cleft condition, he may not have believed it. But now, after receiving life-changing surgery from Operation Smile, Herve’s life has been irrevocably changed for the better. 

When Herve was born, his family was given no explanation about his cleft condition. Many in his community had never seen anyone with a cleft lip before. The lack of access to information about the potential causes of cleft conditions resulted in Herve being ostracized and bullied by his peers throughout his childhood. 

Herve wasn’t aware that a solution existed, let alone that it could be provided to him for free by a team of highly trained medical volunteers.

Life continued to become more difficult for Herve as he got older. He eventually got married, but unable to move past the reality being married to someone with an untreated cleft condition, Herve’s wife eventually left him. 

Cemented to the hope that he would one day find someone who loved him unconditionally, Herve threw himself into his job, working long hours farming rice and cassava fields. The person who remained by his side through these challenging years was his good friend Christine. She was there for him as he dealt with his separation from his wife and coped with the isolation that one with a cleft condition often faces. Over the months, Herve grew to love his friend.

Christine was even by his side on the monumental day when Herve met Fidelis.

As a patient advocate, Fidelis shares his story to all who will listen as he travels to remote communities across Madagascar. By detailing the transformation of his own son’s smile and the free surgical care his family received from volunteers, Fidelis hopes his efforts will one day lead to Operation Smile Madagascar treating every patient living with a cleft condition in the country. 

While there are many children who still need surgery, Fidelis knows that his efforts made an extraordinary impact on the lives of two families during a surgical program in 2018.

For Herve, he discovered a new self-confidence after surgery and found the courage to tell Christine he loved her. He couldn’t contain his smile when she said she loved him too. 

For Denise and Cyril, the impact of Fidelis’ involvement gave their son a brighter future. A future filled with health, happiness and opportunity.   

“I am very happy,” Denise said. “I will tell others about Operation Smile.”

Herve and Tiavina weren’t the first two patients who were connected to Operation Smile Madagascar through Fidelis’ selfless devotion as a patient advocate. And they won’t be the last. 

When asked about his motivation to volunteer, Fidelis said, “I know that I have my own problems to take care of, but I have to leave them behind. It is the duty of people who are healthy to help people who are sick.”

Patient advocate Fidelis shakes the hand of 52-year-old Alfred. For many of the patients he connects to Operation Smile Madagascar, Fidelis travels to their local communities after they receive cleft surgery to reconnect and ensure they continue to heal and thrive after leaving our surgical programs. Photo: Rohanna Mertens.

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