Performing repair operations on the cleft lip and palate patients

The four-day 2019 "Operation Smile into Nanning" public welfare event was held in the Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital from June 20 to 23. Launched by Hangzhou Operation Smile Charity Hospital, an “Operation Smile” team of 80 medical volunteers and 76 social volunteers from all over the country screened more than 170 cleft lip and palate patients in Nanning, and performed free repair surgeries for 116 of them who met the relevant criteria. Most of the patients were children under the age of five, the youngest of which was only five months, while the oldest was thirty-seven years old. Many of them were left-behind children from poverty-stricken families. Timely surgery can not only reconstruct a child’s mouth, but also reendow him/her with a smile, and even restore a family.

All the volunteers taking the oath at the launching ceremony.

Cover Character: Liao Honghong, male, born in November 2018; from Laibin, Guangxi Province. Here is a picture after his cleft lip surgery.

On-site free clinic being strongly supported

On the morning of June 20, many parents, together with their children, arrived early and crowded the outpatient hall of Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital. Many of them came from mountainous areas hundreds of kilometers away, looking forward to having their children with cleft lip and palate treated. At the brief launching ceremony, representatives of the SSCLF Lu Jiaxian and Gao Wenying Special Fund donated 1 million yuan to the organizer’s “Operation Smile” poverty relief project for cleft lip and palate patients, and 3.27 million yuan to the “Operation Smile” training project for primary doctors on cleft lip and palate.

The day was mainly about screening, with all applicants fully registered and reviewed to determine whether they met the requirements of surgery. The Maternal and Child Health Hospital had specially opened a hall. The organizers have set up various links such as registration, vital sign measurement, pre-examination, blood test, photographing, admission, etc. Guided by volunteers, the children and their parents entered the screening hall in turn with valid certificates. Their defective faces and innocent eyes made everyone anxious and touched.

From June 21, eight operation tables in four rooms on the sixth floor were operated on at the same time and for three consecutive days. Each operating table is equipped with an operating doctor, one or two anesthesiologists and several nurses. With the duration from ninety minutes to two hours, each operation was carried out in an orderly manner. Outside the operating room, “smile wards" were set up by the Health Hospital for children to rest. Between the wards and the operating rooms, nurses were for the deployment while volunteers were in charge of transfer. The “Operation Smile” project with hundreds of previous free clinic experiences was as intense and orderly as ever.

Waiting in line to enter

The hall was crowded with people

Father carrying his child to seek medical advice

“Doctor, will my child be cured?”  

The 7-year-old girl was not brought for treatment until the volunteers found her 

Using mobile phones for lighting

The representative of SSCLF Lu Jiaxian and Gao Wenying Special Fund (on the right side) donated a check to Han Kai, the initiator of “Operation Smile”

Stay true to the mission for 28 years

When it comes to “Operation Smile", Dr. Han Kai should always be mentioned. Back to the early 1990s, Han Kai, receiving his Doctoral Degree abroad, gave up the high salary and advanced working environment there. Together with Dr. Lin Jing, he initiated the China “Operation Smile” project in Hangzhou, aiming at providing free treatment for cleft lip and palate children from poverty-stricken families with social assistance.

Cleft lip and palate, also known as "harelip", affects one in every 700 newborns in China. Due to defects in appearance and obstacles in pronunciation, children with cleft lip and palate often have serious psychological problems in their growth, and even a smile becomes a luxury for them. “Every child should have the right to smile as well as the dignity of life.”—holding tight such a faith, Han Kai led his team to embark on the long and arduous “journey for smile”.

As the “Operation Smile” gradually gained social recognition, various charitable organizations, medical institutions and volunteers also joined in the project. Since its first medical charity operation in China in November 1991, “Operation Smile” has organized 191 offline free clinics in more than 20 provinces and cities, providing free operations and related treatment for over 30,000 children patients with cleft lip and palate from poor families.

Han Kai infected everyone around him with his exquisite medical skills, noble personal charisma and strong spiritual strength. Today, the number of registered medical volunteers participating in “Operation Smile” has almost reached 500, with the total of volunteers all over the country amounting to tens of thousands. Han kai has devoted his best years to the charity cause of cleft lip and palate. In the past 28 years, he has performed nearly 5,000 surgeries. The guileless doctor, like a cordial uncle, has also won the honorary titles of “The Sixth National Moral Model” and “The Fifth Zhejiang Moral Model”.

The three core members of “Operation Smile” (from left to right)—Gong Zhiping, Tang Limin and Han Kai were at the scene.

Dr. Han Kai (on the left) was performing an operation.

 A brave little boy

Ma Siwei, a speech training expert from the Stomatological Hospital of Xi’an Jiaotong University

“You are already 18 years old. Local anaesthesia will do.”

The medical volunteers in the trip to Nanning are professionals ranging from plastic surgery, pediatrics, orthodontics, orthognathics, otolaryngology, anesthesia to speech therapy, psychological rehabilitation and nursing, etc., including famous experts from Beijing, Shanghai, Hangzhou, Xi’an, Guangzhou, Jiangsu, Xinjiang and military hospitals.

Philanthropy helps to redeem the soul

Shi Lei (Plastic surgeon from Chinese Academy of Medical Sciences) was performing a surgery

I first learned about the public welfare activities of cleft lip and palate in 2000 at a launching ceremony in the Great Hall of the People. Back then, I was a graduate student in Peking University Third Hospital, and I took part in this activity with my tutor. After graduation, I went to work in the Cleft Lip and Palate Centre of Plastic Surgery Hospital, Chinese Academy of Medical Sciences. I have been engaging in the repair of cleft lip and palate, and have participated in public welfare activities organized by the Ministry of Civil Affairs, so I know more about cleft lip and palate. In July 2016, my senior fellow apprentice, Professor Xie Hongbin took me to the “Operation Smile” for the first time. It was in Yushu, Qinghai Province, and then I developed a close relationship with the “Operation Smile” team and participated in their activities almost every year.

Cleft lip and palate is a complex congenital malformation requiring a lengthy sequence of treatment procedures. For the patients, early surgery is quite essential. Successful early surgeries—for example, those performed at the age of three to six months, can change the children’s whole life. They can integrate into society as those children without deformity. Here is the significance of our doctor's surgery.

I’m a plastic surgeon, and doctors in our specialty often perform cleft lip and palate surgeries. We always perform more meticulously for we have higher requirements in appearance, so you see sometimes I need more time than others in performing the operation. Participating in the intense “Operation Smile” project every year is a little laborious for me, ha-ha!

This time I participated in the whole process of the “Operation Smile” in Nanning, including the screening link, and had more contact with the sick children and their parents. During the process, I heard many stories about vicissitudes of life. If you don’t take part in it personally, you will never believe that some people in our country are still living in such poverty and misery. I am quite emotional and I often can’t help shedding tears when I hear what happened to them …

Every time I participate in public welfare activities, I will think about one question—"What is the value of charity?” I think maybe we are not helping them, but redeeming our own souls. People doing public welfare must seriously consider this question, in which the value of philanthropy lies. If we feel that we superior than others and giving alms, we will lose the core of public welfare and deviate from the original mission, because the premise of public welfare is “respect”.

Examining the child

The conscientious and meticulous doctor

Cooperating with each other

Dare not slack, Leave some memories

Cheng Zhijun (anesthesiologist from Chongming branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University)

This is my second time to take part in “Operation Smile”; the last time was in Liupanshui, Guizhou Province, in April this year. I am also the first anesthesiologist from Shanghai who participate in the project—only surgeons from Shanghai engaging before.

It usually takes three to five days for an on-site free clinic like “Operation Smile”—many young doctors are not able to have such a long vacation. Fortunately I am greatly supported by my department, so what I need to coordinate is my family relations. My wife is a senior marketing manager, and she travels to host all kind of meetings every month. So during my two trips to “Operation Smile”, my under-two-year-old little daughter was taken on business by my wife. This time when I came back from Nanning, my daughter and wife also just returned from Yiwu. On seeing me, my daughter was so excited that she almost fell off the table… When my daughter grow older and can take care of herself, maybe I will take her to be a little volunteer for “Operation Smile”!

Anesthesiologists, like goalkeepers on football fields, are the last line of defence to protect the lives of children during the operation. A slight slip can make the team lose all the previous work. Children with cleft lip and palate are often malnourished due to deformities of their mouths and faces, while anesthesia can easily affect breathing and endanger the patients’ life. The condition changes very quickly, leaving short time for anesthesiologists to deal with. Therefore, as long as I enter the operating room, I never dare to be slack or careless.

Speaking of participating in “Operation Smile”, from my own perspective, I am lucky enough to do what I want, having my wife and child healthy and happy. I would like to use what I have learned to do something other than supporting my family, thereby leaving some memories for myself and also my child. I am proud and willing to work with such a group of simple and kind people. I particularly admire those social volunteers who pay for their tickets and hotel fees, buy gifts for their children, and gather from all over the country to participate in this activity, which makes me feel the purity of public welfare. This time in Nanning, Dr. Pei told me a patient's story: the girl with cleft lip and palate had changed more than twenty foster families, and finally the son of her adoptive father’s brother (her cousin) brought her to seek medical treatment. The uneducated and taciturn girl suddenly said, “I love my brother...” This story struck me as never before: these children said nothing, but they actually understood everything. Every child deserves our wholehearted care and help!

Another surgery was completed

Giving the patient an anaesthetic

 All the operations must be photographed and archived

 The doctor was recording carefully、

If the medical team is the main force to treat those children, then the large number of social volunteers are the indispensable “green leaves” of “Operation Smile”. Although they need to cover the fee by themselves, there are still more and more people joining the project. Wherever “Operation Smile” holds the on-site free clinic, not only a large number of local volunteers enthusiastically participate in, but also many determined fans come from all over the country to join.

Pay for themselves to help along the way

Zheng Qiumei (a social volunteer from Xiamen)

Holding a child who had just been operated on

I learnt about “Operation Smile” from husband. I still remember seeing pictures of children with cleft lip and palate for the first time, making me totally shocked and distressed. I am also a mother, and I want to do something for them. The chairman of Taiwanese Wigg Bakery was quite supportive and allowed me to leave. My husband and I together signed up for the “Operation Smile” trip to Qujing, Yunnan in May this year. It was my second time to participate in the project, and it was held in Nanning this year. My husband and I are social volunteers. Therefore, our air tickets, accommodation and meals are all at our own expense.

It was in Qujing that I witnessed those children with cleft lip and palate who were not treated in time because of poverty, which was rather heartbreaking. Also, I met a lot of lovely partners. All of them were committed to their positions without any complaint. These, piling up together, touched me deeply. And as a participant of “Operation Smile”, the most fulfilling moment was to see those children carried out by the nurses from the operating room after surgery. That was when happiness filled my heart. I don’t know how to describe it—I was so happy at that time, because these children would no longer feel themselves inferior and can laugh happily in the future… As a member of the preoperative comfort group, I was mainly responsible for providing some comfort and support for children and their family members before operation. It might seem trivial, but my partners and I worked hard and enjoyed a lot.

After I got married, I settled down and began to work in Xiamen. Though my child was only six months old, I still signed up for this trip to Nanning, Guangxi, because Nanning is also my hometown. How can I be absent since so many volunteers coming from afar to devote their love to the children in my hometown? I took my mother to Xiamen to help take care of my child and came to Nanning by myself. In the future, I will always follow “Operation Smile” until I can no longer walk.

The girl’s melancholy eyes were heartbreaking

Taking the child’s temperature

Volunteers even paid for lunch themselves

Identify with the patients to nurture a loving heart

Annabeth, a Hangzhou girl in her second year of a boarding junior high school in America, was taken by her mother to volunteer during the summer vacation.

On the day of screening, Annabeth, a second-year junior high school student in a boarding school in America, served at the reception desk for registration and verification. The 13-year-old girl said that she returned to her hometown, Hangzhou to spend her summer vacation, and was taken by her public-spirited mother to Nanning. It was the first time that she participated in such activities. These children with cleft lip and palate, in her view, were pitiful and shocking. So many volunteers were obligated to help them, touching her deeply and rendering her willing to do her best to help in the future. She also said that she would chat with her classmates about her feelings after returning to school, hoping that more people would know about “Operation Smile”. The daughter was working at the reception desk while the mother was in the pick-up group. The mother, who previously worked as a university English teacher, said that just like her daughter, it was also her first time to participate in the “Operation Smile”. “Maybe as a child she cannot understand well, but I hope to sow the seeds of love in her heart, offering her a lens to see that there are many vulnerable groups in the world. We should try our best to lend them a helping hand.”

Pairs of parents and children were among the team of social volunteers who participated in the “Operation Smile”. A young man from Hangzhou has participated in “Operation Smile” with his father since elementary school. Now he has gone to the United States for college education, and still insists on volunteering when he returns home for summer vacation. Mr. Chen, an entrepreneur from Foshan, Guangdong Province, is a big fan of Han Kai and also an accompanier of “Operation Smile” each year. He said that although he was not a specialist in medical field, he could do some chores instead. At the very least, he could invite front-line medical staff to have a meal to express gratitude. On the first day of screening, the entrepreneur, wearing a volunteer T-shirt, worked at the reception desk enthusiastically, helping to direct the ways and holding the children.

Volunteers escorted the child out of the smile ward to the operating room

Mr. Chen, an entrepreneur, was taking care of the child

The day of the operation was just the patient’s second birthday. Volunteers bought cakes to celebrate the baby’s birthday in the ward.

The volunteer was shooting the unforgettable moment

Social assistance will always be kept in mind

Li Jianhua (father of the cleft lip and palate child)

A photo of the family after operation

After the operation, the daughter and her mother huddled in the bed and fell asleep. Her father, Li Jianhua, a farmer from the northern foot of the Shiwan Mountain in southwestern Guangxi, sat on a chair in the corridor and chatted with the author. This dark-skinned Yao man was very cheerful, though his Mandarin with the accent of Yao dialect made people have to guess what he was talking about. He said that he was a peasant in Shangsi County, Guangxi. He had four daughters, the eldest of which was seven years old, and the youngest—the one with cleft lip and palate, was only 11 months old. They lived on farming and mainly grew sugarcane, with an annual income of several thousands. He said he didn't migrate for work because his parents had passed away; his wife had four children to bring up and had to farm, which was too overwhelming. “She’s Vietnamese. She has no land in China and no household registration.” To prove that he wasn’t lying, he even returned to the ward to bring the account book.

Li Jianhua is a low-income household. He said he was grateful to the government—the house that his family were living in was built with government-aided 50,000 yuan and another borrowed 30,000. This time he was also notified by the local government of “Operation Smile”, which gave his daughter this opportunity to get treated. Li Jianhua grew up in a poverty-stricken family and dropped out of primary school in the first grade. Now the eldest daughter had reached the school age, and he said that no matter how poor the family was, he would send her to school… This time, the couple came out with their little daughter for treatment. Then who was taking care of the three children in the family? Li Jianhua said that he had cooked meals for the children in advance, and they would eat whatever there was when hungry. “The organizers helped a lot; they arranged my daughter to be operated first, so that we can return home tomorrow. Nanning is more than one hundred kilometers from Shangsi County, and we have to change buses to go back…” The father’s heart seemed to have flown home.

The little boy was just operated on

On seeing the operated child, the old man smiled with relief

Related links

The children with cleft lips and palates waiting to be cured

Cleft lip and cleft palate, also known as orofacial cleft, is a group of facial conditions that includes cleft lip (CL), cleft palate (CP), and both together (CLP). It is a congenital birth defect. Except a few hereditary factors, most of them are resulted from the mother’s medical history of viral infection, drug poisoning, hypoxia, nutrition deficiency, chemical poisoning, radiation and other illnesses in the early pregnancy. Sometimes the mother’s emotional stress during pregnancy may also lead to the occurrence of cleft lip and palate. According to statistics, there are at least two million cleft lip and palate patients in China. Cleft lip and palate has a great impact on life, but it can be treated and cured. At present, in poverty-stricken areas, due to information blockade and backward concepts, the newly-born cleft lip and palate patients are often the most impoverished and incompetent groups, and also those who need poverty alleviation and assistance most. Timely and reliable repair surgery can not only relieve patients' pain, but also change their whole lives.

The parents were full of hope

The surgeries have made remarkable changes  Taken by Dong Zhenhua

（From SSCLF's Quarterly "Change" thirteenth issue in June 2019)