After 30 hours of non-stop traveling, we arrived late at night in Kampala, the capital of Uganda. The drive from the airport is eerie, as the city is in total darkness. Electricity is sporadic. Luckily our “hotel” has a generator and mosquito nets.
We wake up early and go to a partner clinic. Our host, Dr. Andrew Hodges, is a young, British plastic surgeon who recently moved back to Uganda from Britain with his wife Sara, also a doctor and anesthesiologist, and three young children.
The Hodges have been helping poor children in Uganda for almost 15 years. They once spent 8 months traveling all across Uganda, operating on poor children with clefts. When there was no electricity, they would use spare headlights attached to a car battery.
You may wonder why a successful plastic surgeon who could easily earn hundreds of thousands of dollars a year in England would choose to take a 95% pay cut and move his family to Uganda. (Ugandan doctors are doing anything they can to leave.)
The Hodges are a special breed indeed. Seven years ago they helped a newborn Ugandan girl abandoned days after birth. They not only fixed her cleft – they adopted her.
Smile Train is lucky to have the Hodges on board. Uganda is lucky to have them, too. There are only 3 or 4 plastic surgeons in the entire country.
We saw many clefts as well as more serious problems.A 3-year-old boy with elephantitis who needed his leg amputated.
An 8-month-old that weighed 7 pounds. (My 18-month-old son weighed 20 pounds at 8 months old.)
A baby boy with both legs amputated above the knee.
It seemed like the kids with clefts were the only ones with any hope of some kind of a happy ending.
There was a workshop where they were stripping old bicycles to make parts for home-made wheel chairs. And a table with a big pile of little black plastic prosthetic legs. Very sad.
Working at this clinic, we met a diverse group of modern-day, good Samaritans including doctors, nurses, social workers, college kids and volunteers who had come from all over the world. Under very difficult circumstances, these brave souls were doing the best they could helping children nobody else really cares about.
The next day we left at sunrise in a tiny 4-seater Cessna. We flew up the Nile to Northern Uganda to a village called Kumi. This area is much poorer than Kampala and struggling with a broad range of misfortunes and tragedies.
A local insurgent group called The Lord’s Resistance Army has been murdering government soldiers and peasants for years. They’re “known” for cutting lips off of informants. They’ve abducted 20,000+ 10-14 year-old girls to supply “wives” for their rebel leaders and resulting babies for their cause. There are cattle rustlers armed with AK-47s. Highway bandits. Waves of refugees fleeing Sudan. An AIDS epidemic. Severe droughts. And a long list of diseases and health problems that are responsible for an average life expectancy in Uganda of just 42 years. Western Europe once had a life expectancy of 42. But that was back in 1805.
Kumi hospital is an old, broken-down missionary hospital. It has no running water. Limited electricity. And no surgeon because “no surgeon in his right mind would ever agree to live in such a place as Kumi.” That’s a direct quote from the head of the hospital who is a living saint and also a Martin Luther King look-alike.
I interviewed him in front of his “Hall of Hope” where they begin every day with a prayer service. I was amazed at his upbeat, enthusiastic, positive attitude. When I looked around, all I saw was suffering and hopelessness. But he kept telling me how things were looking up. He was grateful that The Smile Train could send him a surgeon every couple of months. The surgeons we send not only help children with clefts but with other problems too, such as burns, tumors, amputations, etc.
Flying in Smile Train surgeons to very poor, remote places like Kumi is really the only way to help many of these children. Travel to a big city such as Kampala is not really an option. They are too poor and afraid to even think of making the long, dangerous trip to the city.
Dr. Hodges told us of many heart-breaking conversations with parents of children with major health problems, begging them to go to Kampala to get life-saving treatment. They rarely do. Most quietly go back to their small villages and watch their children die.
In the afternoon we set off to visit patient homes. In a rickety, 20-year-old Range Rover, we drove many miles down bumpy dirt roads. Looking out the window, it felt like we were traveling back in time.
There were no other cars or trucks, everyone was walking or on bicycles.
In field after field, we saw hundreds of people “working,” hacking at the dirt with simple garden backhoes and scattering seeds by hand.
There were no oxen, donkeys or horses. No plows. No livestock. No tractors. No irrigation. It was as if the agricultural and industrial revolutions had never happened.
We watched in shock and sympathy as hundreds, thousands of these people bent their backs and hacked away at the dirt with their crooked backhoes, desperately trying to claw a living out of the dirt. No wonder they’re all starving to death. Our pilgrims in Plymouth, Mass, almost 400 years ago, must have had better farming equipment and resources.
We stopped to meet a 10-year old Smile Train patient. She and her family were waiting to greet us. The girl’s name is Ajok. Every baby born with a cleft in Uganda is given that name. It means “cursed by God.”
Ajok was a very quiet, polite girl who did her best to try and smile for us. Her cleft surgery went well – but she still is very much “cursed by God.”
Just look at her mother’s face. She is 35 years old. Her face tells the story of life in Uganda much better than my words ever could. This woman has seven young children and her husband died of AIDS six months ago.
They now have no income, live in a thatched hut and sleep on a mud floor. They light a fire every night to fill the hut with smoke to keep the mosquitoes away. That works fine until 3 in the morning when the fire dies out and the mosquitoes come pouring in.
Every 30 seconds, a child in Africa dies of malaria. That’s more than 1,000,000 children dying a year – almost five times the death toll of the Tsunami. There is no way to stop a tsunami, but mosquito nets impregnated with insect repellant reduce the risk of malaria by close to 70%. They cost only $4 each, but for this poor woman they might as well cost $400. For years, the U.N., rock stars, and all kinds of politicians have been talking about how these mosquito nets could save millions of lives. They keep talking while millions of children keep dying.
Before my trip, a Smile Train surgeon told me not to bother. He said Africa has so many problems that are so much bigger than clefts, that we shouldn’t waste our time or money. It is true, there are many bigger health problems than clefts such as AIDS, malaria, tuberculosis, etc.
And, hundreds of billions of dollars in aid and research are pouring into Africa to solve these problems. But not one dollar of that aid is doing anything to help the hundreds of thousands of children who are suffering with clefts in Africa. In Africa, nobody cares about kids with clefts.
That’s a shame because the cleft surgeries we witnessed are some of the rare successes that seem to be happening in Uganda these days. There may well be bigger problems than clefts, but I don’t know if there are any bigger successes than transforming the face of a child in 45 minutes and giving them a second chance at life. Cleft surgery is a medical miracle happening in a place where miracles are far and few in between.
After seeing how difficult life is for these children and their families, it motivated me even more to find a way to help them and at least give them a fighting chance.
No one knows how Ajok’s life will turn out now that she has had her cleft surgery. But I do know how it would have turned out if she hadn’t. She would never be able to go to school and her life would be one long nightmare. At least today she has hope and a future that has been given back to her.
We are currently working with several major partners to expand our free cleft treatment and training programs throughout Africa. We have a major cleft surgeon training initiative and newly expanded treatment programs planned for Ethiopia, Nigeria, Tanzania, Rwanda and Uganda.
Africa is just one part of the world where we are using your support to bring new smiles and new lives to children who would otherwise never be helped. The Smile Train is now helping children in 56 of the world’s poorest countries and this year we’ll provide more than 35,000 free cleft surgeries.
Each one is a little miracle that we deliver to places where miracles are in very short supply.
