National, International, Armenia, and Community News and Opinion

14 The Armenian Reporter | October 4, 2008
Armenia
World renowned doctors to perform 50 lifechanging
surgeries in Armenia this week
Cafesjian Family
Foundation
takes the lead in
organizing Smile
Network mission to
Armenia
by Paul Chaderjian in
Yerevan
YEREVAN – Every morning, fouryear-old
Gayane cries and begs not
to be taken to school. She covers
her mouth so that people don’t see
her lips. But they do, and they often
react.
Gayane was born with a cleft lip
– a genetic defect also known as
cheiloschisis. In Armenia, they still
call it a “harelip,” a pejorative other
cultures and nations have already
retired from their languages.
No matter what it’s called or the
age in which we live, people on the
streets here often stare at Gayane.
Kids at school don’t want to be
around her. Some classmates make
snide remarks. Others tease and
bully her. Some adults here think
of the split in her lip as a curse or a
sign that she is mentally disabled.
Unfortunately, Gayane’s story is
not unique; but this weekend, Gayane
tortured life will change forever
thanks to a team of volunteer specialists
from the United States participating
in the first Smile Project
mission in Armenia.
More than a dozen doctors, nurses,
and other specialists will be in
Yerevan to examine 250 patients
with either a cleft lip, a cleft palate,
or both. Fifty of these patients will
undergo surgery between Monday,
October 6, and Friday, October 10.
“The two surgeons leading the
team are both renowned cleft surgeons,”
said Madlene Minnasian,
director of the Smile Project. “One
is Dr. Les Mohler, and the second
is Dr. Samir Mardini. They call
him Magic Hands. We’re very lucky
to have world-renowned surgeons
come to this mission.”
Project Smile
Project Smile was initiated by the
Cafesjian Family Foundation, Hope
for the City, and the Smile Network
– which leads similar projects
around the world. The three Minneapolis-based
organizations have
come together to address cleft-care
needs in Armenia.
In addition, Project Smile will
give the local medical community
a chance to listen to world authorities
on cleft care through lectures.
Local physicians and nurses will
also shadow the guests and learn by
observing their American counterparts.
Dr. Les Mohler. Photo: Andrew Tonn.
“Coming to Armenia are expert
anesthesiologists, pediatricians,
operating room nurses, ward
nurses, medical recordkeepers, and
a host of nonclinical volunteers,”
said Ms. Minassian. “It’s a very
good group of 19 volunteers, one
of which is of Armenian heritage.
He’s second or third generation Armenian,
Dr. Robert Chantigian,
anesthesiologist.”
It’s estimated that one in 700–
1000 kids are born with a cleft lip
or cleft palate, both considered
the most common birth defects in
the world. While there are no thorough
statistics of how cleft lip and
cleft palate have been successfully
treated in Armenia, the need for
surgical intervention became obvious
when Cafesjian Family Foundation
board member Megan Doyle
came to Armenia for a fact-finding
mission last November with Kim
Valentini, the founder of the
Smile Network.
“The Smile Network has been operating
all over the world for many
years,” said Ms. Minassian. “They
reach out to the international community,
and if they find a need for
cleft care in any country, they begin
their work. Through the generosity
and coordination of Hope
for the City and its founder Megan
Doyle, we were able to meet Kim
Valentini, who is founder of the
Smile Network. It was wonderful
to host Megan and Kim in Armenia.
The passion and love they have for
children all over the world is inspirational
and exemplary.”
Megan and Dennis Doyle established
Hope for the City eight years
ago to help fight poverty, hunger,
and disease around the world by
utilizing corporate surplus. The
couple’s organization has brought
more than $40 million in medical
equipment, supplies, and medication
to Armenia over the past few
years and was instrumental in
bringing the Smile Network to Armenia.
“Mrs. Doyle came to oversee and
visit her projects in Armenia, and
she brought Mrs. Valentini with
her,” said Ms. Minassian. “The visit
helped determine that there was a
need for cleft care in Armenia, even
though we have experienced, competent,
very professional maxillofacial
surgeons here. The problem
was in the ability for the patient
to pay for the care and access to
surgery.”
The government of the Republic
of Armenia tells the Armenian
Reporter that it offers a $700 stipend
for children under seven in
need of reconstructive cleft-lip or
cleft-palate surgeries, which are estimated
to cost around $2,000 in
Armenia and upwards of $10,000
if performed in the United States.
One local surgeon says that the
government subsidy does not cover
costs for surgery, and the families
are asked to pay the difference.
Preparing for the
mission
During Mrs. Doyle’s and Mrs. Valentini’s
trip to Armenia last November,
the Smile Project was able
to secure the support of Armenia’s
Ministry of Health.
“We met with many different institutions
in order to do a search
to find a partner,” said Ms. Minassian,
“and we found our partner in
Dr. Les Mohler. Photo: Marc Ascher.
the Arabkir Medical Center, which
is run by Dr. Ara Babloyan. It’s
a privately owned and the largest
pediatrics hospital in Armenia. Dr.
Babloyan is a very capable, brilliant
person.”
The Smile Project also partnered
with the Health ministry’s Mother
and Child Department, which was
able to tap into public records and
its regional polyclinics and provide
a list of hundreds of children born
with cleft conditions since 1988.
“The lists were pretty extensive,
and we tried to target younger children
that we thought would have
not been operated on,” said Ms.
Minassian. “The lists did not indicate
whether these children had
had surgery. We just had statistics
of the birth defects.”
While compiling lists of prospective
patients, the Smile Project also
engaged local media to reach out to
families in Yerevan and throughout
the republic. The media campaign
resulted in hundreds of calls from
parents with children who needed
cleft care as well as adults, well into
their 40s, who had had a series of
unsuccessful cleft procedures.
“We have so much support that it
is surprising,” said Erik Grigoryan,
project manager for the Smile
Project. “Armenians are usually less
volunteerism-oriented, and it was
a surprise for me to get the type
of feedback we have been receiving.
For example, we went to the hotels
and asked for discounts and said
these doctors are coming to Yerevan
to perform free surgeries. We
received 25–30 percent discounts
plus car service from Hotel Meg.”
Another big surprise for Mr.
Grigoryan has been the number
of calls he has been receiving from
people who want to volunteer next
week. He has enlisted psychologists,
speech therapists, translators, and
those who wants to drive patients
and their parents to and from the
screenings and surgeries.
“One woman called and wanted to
cook for the patients and the other
volunteers,” said Mr. Grigoryan.
One of the other businesses
heavily involved with getting the
word out was Cascade Insurance,
which took the initiative to print
and distribute posters to all local
and regional hospitals, clinics, and
dental offices informing the public
about the Smile Project.
“When people call to register
for the screenings,” said Yvetta
Ghazaryan, project coordinator,
“they cannot believe that
this medical attention is possible
in Armenia. Many patients and
their families have been waiting
for this mission with a lot of hope
and they trust us. They know that
with the help of our mission, the
children will begin a new life. They
will also gain the invaluable gift of
a new smile.
Preparing for this
mission
With the health ministries of the
Republic of Armenia and the Republic
of Nagorno-Karabakh, the
Arabkir Medical Center, and the Cafesjian
Family Foundation teamed
up to organize the first Smile Project
mission, the Fund for Armenian
Relief (FAR), and the Hand in Hand
nongovernmental organization in
Karabakh also joined the project.
“FAR is taking care of transportation
costs and food and lodging for
our patients, so the 50 who are chosen
for surgery will then get their
transportation compensated for
and will get their nutrition,” said
Ms. Minassian. “They will bring
food to the children who are in
post-operation care, and they will
also pay for the lodging of one relative
if they are from out of town.”
Helping locate patients with
cleft care needs in the Republic of
Nagorno-Karabakh was the Hand
in Hand organization, which is a
partnership of several Canadian-
Armenian medical associations.
Hand in Hand provides free dental
care through mobile clinics and
several stationary clinics all over
Karabakh. Since cleft children have
major dental care needs, Hand in
Hand was able to let cleft children’s
parents know about the Smile Project
mission.
“They’ve been instrumental as
our Karabakh partners.” said Ms.
Minassian.
First week of October
After screening exams on Saturday
and Sunday, October 4 and
5, the visiting medical specialists
will meet and discuss each of the
cases. The team will see 17 patients
an hour and 250 patients over the
weekend.
“Fifty-five of the patients are under
seven and are awaiting their
first surgeries,” said Ms. Ghazaryan,
the project coordinator. “Other patients
are as old as 43, who need
additional operations. There’s one
patient who has had 11 surgeries
already and had complications, infections,
and sometimes the palate
cracks were not closed properly.”
Ms. Ghazaryan says patients are
coming from all over the Republic
of Armenia, from Karabakh, as
well as Javakh in Georgia. Those
patients who live in Yerevan or are
a short distance away have already
been prescreened by Dr. Harach
Arshakyan, a plastic surgeon
from the Arabkir Medical Center.
Dr. Arshakyan has been organizing
the clinical aspect of this first mission,
and he has already seen 150
patients who will be examined by
the team from the Smile Network.
Dr. Arshakyan tells the Armenian
Reporter that cleft issues arise in
the first three months of a pregnancy,
and he tries to advocate that
in addition to genetic factors, malnutrition
and low folic acids may
also be factors in children being
born with cleft palates and lips. He
said he sees a great need for the local
medical community to develop
cleft care services and deal with the
current need.
“The patients already screened
by Dr. Arshakyan will meet our
visiting pediatricians and with our
cleft surgeons and nurses,” said Ms.
Minassian. “Vital statistics will be
taken, and we will make sure that
the child is healthy, that the child
doesn’t have any conditions or issues
that would lead to complications
or inability to operate.”
After the initial examinations,
the team will meet Sunday afternoon,
prioritize the 250 patients
and schedule surgeries for the top
50 patients.
“The highest priority is for children
that have problems with
nutrition,” said Ms. Minassian.
“Children who have not had an operation
before will also be a high
priority. With a condition like cleft
palate, there are difficulties in eating,
so if you’re trying to feed with
a bottle, and the child is very young,
they can’t suckle. And most of these
children end up being fed through
a feeding tube. Also, drinking from
a cup, even drinking from a bottle
can result from the milk coming
out of the nose.”
After the screenings, the Smile
Project team will schedule 10 daily
surgeries for five days. Two different
surgical teams will operate in
two separate operating rooms, and
surgeries may take between 40
minutes to two hours.
“Two hundred cleft care patients
will not have the opportunity to be
treated,” said Ms. Minassian, “Instead
of being turned away, we’re
organizing a spring mission; but
we’re going to need funds to do that.
The funds for this week’s mission
are covered, but we’re going to have
to share in the Smile Network’s
costs for a follow-up mission.” f
connect:
madleneminassian@gmail.com
(818) 434 1725
+374 99 00 25 30