A BEAUTIFUL NEW FACE - 2012
It is almost a year since I returned from Malawi.
On Saturday October 27, 2012, while on vacation in California, I attended the screening of the documentary "Beautiful Faces" at the Ojai Valley Film Festival, 2 hours north of Los Angeles. "Beautiful Faces" profiles the life and work of esteemed cranio-facial surgeon Dr. Fernando Ortiz-Monasterio of Mexico City.The film revelaed that many thousand lives have been changed by the intricate skills used by Dr. Monasterio and his team to re-arrange malaligned tissues and bones in the head and face. A neuroscientist was quoted as saying that human beings are not wired to accept those with odd and unusual appearances, and that many of the untreated live marginalized lives - physically disabled and often hidden away.
And, I thought of little disfigured Magadalena whom I met purely by chance (or was it), last December in Malawi.
I agree with Deepak Chopra's definition of "coincidences". "Coincidences are not accidents but signals from the universe which can guide us toward our true destiny".
On Saturday October 28, I received an email and photo from Dr. J. Mbeya of St. Gabriel's Hospital in Namitete, Malawi to inform me that 6 year old Magadalena M. from Waliranji village had successfully undergone surgical repair of her severe cleft lip at the Queen Elizabeth Central Hospital in Blantyre, the biggest referral government hospital in the country.
Imagine my profound joy and sense of achievement!
I had waited so long for this news.
Last December I spent the month at St. Gabriel's Hospital, Namitete, Malawi, working as a volunteer R.N. Just 2 days before the end of my time there, I took part in a day long antenatal clinic held in a rural village - Waliranji - in Chipondwe region. The area consists of very small tracts of land farmed by families who live in very basic brick dwellings. The level of poverty is high and hunger is commonplace especially when maize supplies run low. Infrequent mobile clinics are often the only way families receive health care. As we packed up our truck (World Vision donated!) at day's end, to head back to the hospital, a group of children gathered round, excited to see a white nurse "muzungu". In the crowd, I noticed one shy little girl with an obvious untreated cleft lip. No-one seemed to know who she was, or why her deformity was untreated, but suggested that I give her my one and only cloth doll as a sign of "specialness". I snapped a photo of her and our team headed back to St. Gabriel's.
Something about the little girl had really touched my heart though and I silently vowed to do everything I could to arrange treatment for her. But, was it possible? Trying to co-ordinate care would prove a daunting challenge, but I was determined to succeed! I soon became aware that an invisible force seemed to guide me all the way.
Something about the little girl had really touched my heart though and I silently vowed to do everything I could to arrange treatment for her. But, was it possible? Trying to co-ordinate care would prove a daunting challenge, but I was determined to succeed! I soon became aware that an invisible force seemed to guide me all the way.
The day before returning to Canada, I showed the picture of the little girl to the only general surgeon and acting director at St. Gabriel's. He indicated that repair of the cleft lip could be done in Blantyre at Queen Elizabeth hospital, however he was too busy to offer more information. I exchanged email addresses with an HIV Quick Response technician (with the unusual but not uncommon name of "Gift") who had been with me at the antenatal clinic, told him I'd be in touch, and left for home.
Once back in Canada, the search began.
Who was the child? What was her name? Why was she untreated? Most children with cleft lip are operated on by age 3 months. The cause of cleft lip/palate is not clear however there is strong evidence to suggest that folic acid deficiency is a predisposing factor. Even though the prevalence is lower in Africa, I was pleased to discover that the antenatal team was now supplying vitamin supplements to all pregnant women in outreach clinics.
But, back to the little girl in Waliranji. How could she be assessed? How could the parents or guardians travel for assessment to St. Gabriel's? Would the family even want surgical repair? I had come to learn that there were tribal superstitions and customs that I didn't understand. Was I interfering? I decided to continue to search and coordinate treatment until I was told not to.
The emails with Gift began in January, 2012. Gift was busy, upgrading his health studies in another part of the country, had no computer and travel was difficult. Weeks passed. I began to wonder if it was really possible to assist the child. By March, Gift had visited the little girl's village and learned that her name was Magadalena M., age 6 years, the youngest of 5 children, in primary school, father a farmer and mother stays at home. The parents had indicated interest in surgery for their child.
Next step; who would accompany the family for initial assessment and referral? Gift agreed to accompany them but then I received word that they had arrived at St. Gabriel's and been turned away for some unknown reason.
I was not sure what to suggest next.
On April 11 I received an email from Gift: "The family is inquiring about how to get surgery. Now even the child's friends fear her the way she looks and she even fail to go to school". Several more fruitless emails followed. I finally decided to get the email address of the surgeon I had initially spoken to, even though I understood how busy he was, and appeal to him for advice on an assessment and referral for Magadalena. Much to my sursprise, Dr. Mbeya responded with interest, and by July an assessment and referral and consultation was completed. Dr. Eric Borgstein, a paediatric surgeon from Queen Elizabeth Central Hospital in Blantyre would operate sometime in the fall. However, Magadalena's family would require financial assistance in order to travel the long distance to Blantyre, rent lodgings, buy food, and be able to return for a 6 month follow-up. Nothing is easy in Malawi and poverty determines life's pathways. This seemed to be the reason that Magadalena had never received surgical repair years earlier! The family simply had no money to arrange for sustenance and travel.
Dr. Mbeya and I consulted over several emails and established a very reasonable budget. A few hundred dollars was sent.
By early October, I received word that the family was preparing for the trip to Blantyre. Real excitement!
On October 23, Dr. Mbeya notified me that Magadalena would be operated on within the week.
Then came the October 31 email, and before and after photos. Dr. Mbeya's email read "Magadalena is home now. She is happy."
Gift also emailed: " the family sends you thanks"
Seeing the "after" photo was probably the greatest gift that I have ever received in my life.
Once back in Canada, the search began.
Who was the child? What was her name? Why was she untreated? Most children with cleft lip are operated on by age 3 months. The cause of cleft lip/palate is not clear however there is strong evidence to suggest that folic acid deficiency is a predisposing factor. Even though the prevalence is lower in Africa, I was pleased to discover that the antenatal team was now supplying vitamin supplements to all pregnant women in outreach clinics.
But, back to the little girl in Waliranji. How could she be assessed? How could the parents or guardians travel for assessment to St. Gabriel's? Would the family even want surgical repair? I had come to learn that there were tribal superstitions and customs that I didn't understand. Was I interfering? I decided to continue to search and coordinate treatment until I was told not to.
The emails with Gift began in January, 2012. Gift was busy, upgrading his health studies in another part of the country, had no computer and travel was difficult. Weeks passed. I began to wonder if it was really possible to assist the child. By March, Gift had visited the little girl's village and learned that her name was Magadalena M., age 6 years, the youngest of 5 children, in primary school, father a farmer and mother stays at home. The parents had indicated interest in surgery for their child.
Next step; who would accompany the family for initial assessment and referral? Gift agreed to accompany them but then I received word that they had arrived at St. Gabriel's and been turned away for some unknown reason.
I was not sure what to suggest next.
On April 11 I received an email from Gift: "The family is inquiring about how to get surgery. Now even the child's friends fear her the way she looks and she even fail to go to school". Several more fruitless emails followed. I finally decided to get the email address of the surgeon I had initially spoken to, even though I understood how busy he was, and appeal to him for advice on an assessment and referral for Magadalena. Much to my sursprise, Dr. Mbeya responded with interest, and by July an assessment and referral and consultation was completed. Dr. Eric Borgstein, a paediatric surgeon from Queen Elizabeth Central Hospital in Blantyre would operate sometime in the fall. However, Magadalena's family would require financial assistance in order to travel the long distance to Blantyre, rent lodgings, buy food, and be able to return for a 6 month follow-up. Nothing is easy in Malawi and poverty determines life's pathways. This seemed to be the reason that Magadalena had never received surgical repair years earlier! The family simply had no money to arrange for sustenance and travel.
Dr. Mbeya and I consulted over several emails and established a very reasonable budget. A few hundred dollars was sent.
By early October, I received word that the family was preparing for the trip to Blantyre. Real excitement!
On October 23, Dr. Mbeya notified me that Magadalena would be operated on within the week.
Then came the October 31 email, and before and after photos. Dr. Mbeya's email read "Magadalena is home now. She is happy."
Gift also emailed: " the family sends you thanks"
Seeing the "after" photo was probably the greatest gift that I have ever received in my life.
This story is an addendum to my month of volunteer nursing that did not end when I left. It's a story of a very long but ultimately successful attempt at navigating the Malawian medical and social system from far away Canada and never losing sight of the goal - a beautiful new face for a little 6 year old girl. I started my blog with a sense of "do it now" urgency and discovered that much can be accomplished from wherever we are. I have learned alot about myself - perseverance and determination being at the forefront, that an invisible force of spiritual grace is part of me, and that my interest in helping others will always continue.