Syril...before and after pictures!

Susan, reading with Syril!  His smile lit up a room!  Below is his before and after picture.  Susan and I watched his lip surgery start to finish- beautiful new lip for a beautiful child!

Our last two days of visiting the ward!

We loved visiting the pediatric ward!  It was usually first thing in the morning or in the evening before heading back to our hotel.  Most children were a little apprehensive when we would show up- but  a few books, coloring pages/crayons and toys later...all smiles!

 Peek-a-boo!!

 Beautiful smile even before his surgery!

 This girl is 12 years old and has waited all her 12 years for surgery to correct her very severe cleft of the lip (and palate).  These are the most upsetting cases for me- that there is not a system in place in their country to meet the needs of these beautiful children (if not for missions); to go 12 years and to be so beautiful and bright...she deserves the smile of other 12 year olds in her community and school! I was not able to find out how her father heard of the mission team being in Dipolog, but usually it's because of the Rotary of Dipolog City getting the word out.  She was very shy (and I'm sure very scared!) but once we started playing MEMORY she was smiles and determined to win the game!  She read beautifully for Susan as her Papa sat and watched!  She had her surgery on Friday, after we left, so we did not get to see the after picture...I'll try and get a copy of it from someone on the team.  Her palate is also unrepaired so hopefully she'll return next year.

 Dr. Williams and nurses doing rounds on the ward...

 Most of the children do not bring books with them because I suspect they don't have any to bring!  Loved to watch them read (school instruction is primary in English and their dialect)!

 Aahhh...some sleep after her lip repair!  Usually parents are sleeping too since they tend to get the least amount of sleep!

 This is Syril- Susan and I watched Dr. Williams do his lip repair the night before!  Still a lot of swelling which will subside.  No smiling yet though!

 Gwen interpreting the home instructions following palate repair!

 This little trooper had his cleft palate repaired 2 days before, and still tried to muster a smile for the camera!  We hope to see him next year for speech follow up and possible speech therapy.

Gwen is a nurse at the hospital and speaks the dialect (and was our interpreter every day except the weekend). She transcribed very simple speech instruction for the children getting palate repairs on this mission for practice at home.  We instructed the parents to wait 3 weeks and then encourage some speech practice using BIG open vowels (to get that palate moving) and think about sounds that should go through their mouth and not the nose (like "p, b, and sh").  We hope to see them next year so we can check their speech and function of the palate after surgery.  Most children even in the USA still require some speech therapy following a palate repair.

 Dr. Geoff Williams making rounds and checking on all the patients in the ward!

 Games and book, games and books...that was the fun of the ward!

 Waiting her turn for surgery!

Parents too, love the books!! They almost always started to read the books to them as soon as they were given.  We distributed books on screening day and again when they were in the pediatric ward waiting for their surgery (or immediately after.)  We had enough books to leave some on the ward for the few children still arriving Friday night for Saturday's clinic and gave a few to Gwen to use in the Emergency Room (where Gwen works when not our interpreter!)

Witnessing the gift of a new smile...

Susan and I watched Syril get a new smile today at the skilled and compassionate hands of Dr. Geoff Williams!  It was a 3 1/2 hour surgery to repair his incomplete bilateral cleft lip!  It was the first time I have watched a complete surgery!  After all these years of working with children with cleft lip and palate, I was mesmerized by the process!  For those of you who know me well (my family) you know I tend to be somewhat of a lightweight when it comes to "fainting" easily (family trait)...but this was no problem!  Susan and I hope to be able to watch a cleft palate surgery tomorrow before heading out Friday morning! 

Dr. William's...taking his time to give this little guy the best repair possible. If you read about Dr. Williams on the International Children's Surgical Foundation website (icsfoundation.org) you'll understand why this surgery took 3 1/2 hours!  Dr. Williams believes in the same quality of care that children in the US would have access to...so there is NO rushing through the process.  And the results show! 

Theresa...no fainting involved!

Susan- who had promised to hold Theresa up through the incision part of the surgery... but her support was not needed! Susan had previously observed a surgery (laryngectomy) so she was a pro...

We both took advantage sitting on the stools occasionally, but spent most of the time looking over Dr. William's shoulder to watch the entire surgery!

Speech Therapy- week 2!

This little guy, John Cedrick, joined me for speech therapy last year!  He was very quiet! He used more speech this year- although still quiet! He made good progress in only a few sessions!  We'll see him back next year!

MISCELLANEOUS SPEECH THERAPY PICTURES!

SPEECH THERAPY CONTINUES THIS WEEK.  MANY OF THE CHILDREN FROM LAST WEEK COULD ONLY STAY FOR ONE WEEK BECAUSE OF SCHOOL, TRANSPORTATION ISSUES AND PARENT SCHEDULES.  WE HAVE 5 CONTINUING PATIENTS FOR THIS WEEK FROM DIPOLOG. THE 5 GIRLS FROM THE ISLAND OF NEGROS CONTINUE TWICE A DAY WITH BOTH INDIVIDUAL AND GROUP SPEECH THERAPY.

This is Allen Rey who had his palate repaired by Dr. Williams last year!  He joined us for 6 sessions through today (Tuesday the 24th).  He need to get back because his mother didn't want him to miss examinations at school! School is very important and most children will get excused because the school knows how much the children need speech therapy! We wouldn't want Allen Rey to miss his exams!  His speech improved, but like the 2 children below, he made need additional palate surgery to improve his speech.

 Cesar has been to 4 speech therapy sessions, with 3 to go!  They live quite a distance away, but his mother found someone to stay with in Dipolog so he could get therapy all this week!  He is such a hard worker!  His palate was repaired by Dr. Williams last July.  He has made some nice progress but may need additional surgery to improve his speech.  We hope to see him back for speech next year!

Ma'am Susan Stempel, as the children call her, at work with Ariel.  We use alot of manipulatives (like a colorful pegboard) to encourage imitation of sounds and make therapy more fun.  For the most part, the ABC's, numbers and colors are spoken in English.  I have mastered animal names and a few other words; Susan has mastered more of the native dialect although the inflection is so hard to match.  We tend to say the words as we would in our language and the parents will try and repeat the words numerous times- usually with no improvement on my part!

This is Ariel who joined us for 4 session of speech therapy to date...he is scheduled for 2 more!  He will hopefully come back next year and may be considered for a second surgery on his palate to improve his speech!  This rarely happens with mission trips because you often need a trial of speech therapy first to determine if additional surgery is needed!  Since Dr. Williams does follow-up in all the cities he goes to, this is possible for his patiens since adding speech therapy to the process!  Ariel will likely get a revision of his lip since it was poorly repaired initially (not by ICSF) and he is teased at school about it.  I look forward to seeing Ariel next year and making a plan to further improve his speech!

THE PEDIATRIC WARD!

WE LOVE TO VISIT THE WARD AND READ, DISTRIBUTE TOYS, PLAY GAMES AND TAKE PICTURES!

Surgery over!  Now home with his family! ... and liked his new book!

Post lip repair!  He went home this morning!  With swelling down and suture out... looked amazing and was ready to go home with a new smile. 

This is Alice Clare who was scheduled for her palate repair on Tuesday, but it had to be cancelled because of fever!  She was ALL PERSONALITY, and yes, she is posing for the camera with her hand on her hip!  She is on the wait list for October; otherwise she'll have surgery next July. There were so many children at screening day (60!) that Dr. Williams scheduled 40 for these 2 weeks of surgery and scheduled the other 20 for an add-on mission in October!  He wants the parents who attend the screening to know their child will get surgery and not have to hope to possibly find another mission to come through Dipolog at some later date!  Alice Clare will be back!

And, yes, she did have a cleft lip repair last year by Dr. Williams!  Almost undetectable!  He is known for taking his time and never rushing a surgery so the results are as good as possible.  Alice Clare and all the children are worth the time it takes- wouldn't you agree?

Please note, these are the beds available in the pediatric ward (no mattresses). The parents can bring mats to place on the bed, although most bring blankets only...especially if they have to travel long distances!  Usually the whole family (Mom, Dad, grandma, siblings...) are staying in the bed together or on the floor on mats. Grandma in 'Visaya' (the local dialect) is 'LOLA'...many Lola's join the family or sometimes bring the child themselves if the parents work.

The ward is pink and bright- although fans only...so very hot! Susan and I are very spoiled in our "therapy room" in the hospital- we have air conditioning.  The parent's would never utter a word of complaint!  Never!

John Michael, Monday night, the night before his surgery! He had his surgery today and was drinking water from a syringe when we visited tonight.  His mother told us she heard about the mission on the radio and was "truly blessed by God" to have this surgery for him. He had a cleft of the palate only and his speech was very effected.  We plan to have him return next summer for speech therapy!

JOHN MICHAEL AND RICA (ABOVE) WERE BOTH THRILLED TO GET THE WORLD ATLAS FOR THEIR BOOK!  WE POINTED OUT AND MARKED WHERE THEY LIVED AND WHERE WE LIVED!  WHEN THEY WEREN'T READING THE BOOKS, WE WOULD CATCH THEIR PARENTS OR OLDER BROTHERS AND SISTERS READING THE BOOK!  THE BOOKS WERE DONATED BY FAMILIES AT MY OFFICE AND FROM MY SISTER MARY!  SUSAN BOUGHT MANY BOOKS WITH HER (THAT MEANT SHE HAD TO TRANSPORT THEM IN HER LUGGAGE THROUGH CHINA- WHERE SHE WAS FOR 2 WEEKS PRIOR TO THE MISSION) AND THESE WERE DISTRIBUTED ON SCREENING DAY AND SOME USED FOR SPEECH THERAPY! 

RICA (THE LITTLE GIRL ABOVE) WOULD NOT SMILE OR GIVE US EYE CONTACT WHEN WE VISITED HER THE NIGHT BEFORE HER PALATE SURGERY.  ALTHOUGH IT'S ALMOST IMPOSSIBLE TO TELL SHE HAD A REPAIRED CLEFT LIP IN THE PICTURE...I'M SURE SHE REMEMBERS THAT SURGERY AND WASN'T HAPPY TO BE BACK FOR HER PALATE REPAIR.  WE PLAYED "MEMORY" WITH HER, GAVE HER THE BOOK AND STICKERS, AND SHE WAS ALL SMILES!  BY THE TIME WE LEFT, SHE WAS PLAYING MEMORY WITH JOHN MICHAEL (TWO PICTURES ABOVE) AND THEY WERE LAUGHING AND SMILING!
TODAY I SAW HER IN THE WAITING AREA TO BE TAKEN TO SURGERY AND SHE WAVED AND SMILED AT ME!  WHAT A TREAT TO HAVE MADE HER FEEL A LITTLE BETTER

This is Bernie!  Some of you may have seen pictures of Bernie last year.  He was scheduled for surgery but started to run a fever and had to be rescheduled for this year! His sister (who's picture I can't find) also had a cleft lip repair last week!  AND, BERNIE got his lip repair!  It was a tough surgery with the position of his permanent teeth and the protrusion of his upper gum line.  But as he was last year (I immediately remembered Bernie) he was happy and outgoing before the surgery.  And, in spite of clearly being in some pain, he was very stoic and never cried when we were on the floor after his surgery!  WHAT A LOT FOR Bernie and Birly's PARENTS TO GO THROUGH EMOTIONALLY TO HAVE TO TAKE CARE OF TWO OF THEIR CHILDREN 2 DAYS APART FOR LIP SURGERY! They were always polite and appreciative and their children were so sweet and friendly!  Bernie still needs a palate repair so perhaps I'll get pictures of his lip when the swelling goes down and is well healed- next year!

This is Renovem who had his cleft palate repaired on this mission (previously had a cleft lip repair!)  He and his mom read this book 4 times in a row in the time we were visiting the ward!  He knew all his letters and numbers and is 4 years old!!  Can't wait to see him next year for speech therapy!  The plan is to have the children who have their palate repaired come back for speech therapy the next year!

These two decided to have a little book group!  Susan and I are in a book club together!!  Maybe that rubbed off!

The little guy in the red shirt ended up running a fever and had to be rescheduled for October or next July!

MORE SOON NOW THAT I HAVE AN ADAPTER TO KEEP MY LAPTOP CHARGED WHILE THE INTERNET GOES IN AND OUT!