Bui Van Nguyen, 6, from Tay Ninh Province, at My Thien Hospital in Ho Chi Minh City on August 7 after free surgery to fix a cleft palate.

Thousands of poor Vietnamese children born with cleft lips and palates can grin and speak clearly thanks to dedicated Vietnamese and foreign surgeons and the sponsorship of Operation Smile.

“My classmates were scared when they saw my face and shunned me because of my seriously cleft lip and palate,” 40-year-old Huong remembers as tears course down her face.

“I couldn’t stand it and quit school after finishing the fourth grade, yet nobody realizes I only got that far in my formal schooling. It’s because I often read books and newspapers.”

“I saw people going to the temples. I wanted to go too but did not dare,” says Huong, who has worked on the family farm since leaving school.

Her parents were well aware of their daughter’s ordeal but were too poor to afford surgery at a major hospital.

In 1985, when she was 16 years old, they took her to the local hospital instead, but the medical techniques there were not advanced enough to improve her facial appearance significantly.

A ray of sunshine broke through the clouds last month when she saw a television program that showed Dr. Lam Hoai Phuong, director of the National Hospital of Odonto-Stomatology in Ho Chi Minh City, operating for free on children with cleft palates.

Huong applied for and got a cheap government loan for poor people so that Dr. Phuong could fix her face.

The good doctor operated on Huong at the hospital’s My Thien branch in District 11 on August 5. The fee was VND15 million (US$842.45), but Dr. Phuong knocked VND5 million ($280.82) of the bill because of Huong’s obvious poverty.

“This operation is my last hope. It’s taken everything I’ve got,” says Huong.

“This is me. Other women of my age are teachers and such. Many live happily with their husbands and children, while I am still alone after forty years.”

Still, Huong is pleased with the surgery and reckons it has reduced her deformity to a seventh or even an eighth of what it was.

She’s back home in Nghe An Province looking after her 80-year-old mother, but now she has the problem of repaying the VND10 million ($561.64) loan as the little money she makes from the farm is barely enough to support the two of them, let alone service a debt.

Better luck

Huong had the operation at the same time as about 100 children with cleft lips and palates in Dong Nai and Tay Ninh provinces got free surgery at the same hospital under a charity program sponsored by Operation Smile Vietnam.

The month-long program, for which the Military Telecom Corporation (Viettel) donated VND1.5 billion ($82,000), benefited more than 300 children in six southeastern provinces.

It’s a far cry from Huong’s childhood, when little could be done for Vietnamese children in her situation.

One of the latest beneficiaries of Operation Smile is ten-year-old

Duong Dinh Bao Ngoc from Tay Ninh Province, who had plastic surgery at My Thien Hospital to complete a job that began with a free operation on her cleft palate at the city’s Cho Ray Hospital when she was 18 months old.

Her mother, 44-year-old Nguyen Ngoc Yen, remembers the first time she saw her newborn baby and how she felt so pained she couldn’t cry. Her biggest fear was that her daughter would never marry.

When she saw how Ngoc looked almost normal after that first operation, “I felt as happy as though someone had given me gold,” says Yen, who must work every day like her husband.

Little Ngoc had to take a lot of medicine before, but not any more. And there’s a good chance her lisp will disappear.

“Whenever my classmates teased me about my cleft lip, I wanted to beat them. Now I want to be a singer,” Ngoc says clearly.

Bui Van Nguyen, the six-year-old son of forty-something Pham Thi May, also from Tay Ninh, has just had his first operation to correct a cleft lip and deformed jaw.

May, who sells lottery tickets for a living, says her husband has such a seriously cleft palate that no-one can bear to look at him. Even she finds it hard.

One day when May was out selling lottery tickets, a local government employee told her about the free surgery and suggested she apply for her son.

“A winning lottery ticket is nothing compared to free surgery that can get rid of my son’s deformity and let him eat normally,” says May.

“His classmates often tease my boy about his cleft lip and don’t let him play with them,” May says, and repeats a lament she has often heard from him: “How could you bear me with a cleft lip? On that day, you should not have given birth to me. Why did you bear me?”

Most parents whose children have the free surgery are poor and must work all day every day to get by.

Ly Chi Thanh, 39, comes from the Mekong Delta province of Soc Trang and works on a coffee plantation in Dong Nai Province. Her five-year-old daughter, Ly Thi Ngoc Dung, has just had free surgery courtesy of Operation Smile Vietnam for the second time.

“Without the charity program, poor people like us could not afford it,” Thanh says.

Surgery alone is not enough

To obtain the best results, children being treated for cleft lip, cleft palate or both need to be supervised by a team of maxillofacial doctors, plastic surgeons, clinical psychologists and speech therapists from birth to the age of 18, says volunteer surgeon Tran Cong Chanh, who has been involved with Operation Smile and the National Hospital of OdontoStomatology in HCMC since 1989.

Trouble is, Vietnam does not yet have such a team. “It’s only doctors at the moment. It’s not enough,” says Dr. Chanh.

One important role for the psychologists would be to explain to the parents that their child’s deformity is an accident of nature and is not caused by evil spirits or such, as is widely believed. They could reassure the parents that all will be well.

They could also explain the common need for more than one operation to correct a cleft palate, perhaps two or three or even four, so that parents don’t have unrealistic expectations that the first operation will make their child perfect in every way.

“Many parents are not told what they should know beforehand and think their child will speak normally after just one operation. Forget it,” says Dr. Chanh.

In Vietnam, a child with a cleft palate undergoes surgery only when it is at least 18 months old, giving it plenty of time to develop a lisp.

That’s why a speech therapist is needed for at least a year after surgery, Chanh explains, and mentions that Operation Smile Vietnam has just recruited two speech therapists to help the hundreds of children who have had the operation.

About 3,000 babies are born in Vietnam with cleft lip and/or cleft palate each year, according to US-based Operation Smile. Among the country’s children, 15,000 with the affliction have not had the surgery.

Since it started up in 1989, Operation Smile Vietnam has helped more than 12,000 Vietnamese children and young adults with cleft lips and palates through local and international surgical missions.

Reported by Van Khoa