Treating the Whole Patient: Psychologist Andrea Díaz

From the Field
Posted 4/5/2017

Editor's Note: As we celebrated World Health Day on April 7, 2017, one may think this year's theme of depression wouldn't have a connection to a cleft organization. However, Operation Smile believes in offering the most comprehensive care possible at our medical missions and care centers around the world; and after more than three decades of listening to the emotional hardships of our patients and their families, we knew the need for clinical psychologists was critical.

Due to the social stigma which often haunts cleft patients and their families – as well as the crushing effects of poverty many feel in their daily lives – depression is an ever-present health hazard. Psychologists like Andrea Díaz of Operation Smile's Gilberto Mariño Contreras Centro de Atención Integral in Bogotá, Colombia provide invaluable support for our patients and their families so that they can live healthier, more fulfilling lives both before and after receiving surgery from Operation Smile.

According to Díaz, children with cleft lip and cleft palate don't only experience mistreatment from their peers, but many must also deal with the disapproval of their parents, who may not believe their child is as capable as a child without a cleft condition. If a child shows symptoms of depression, cognitive treatment is offered with the goal of changing the patient's ideas about him or herself, as well as the patient's behavior. Supportive parents play a key role in this course of treatment. Diaz also helps parents of children with cleft cope with their anxiety and depression.

“To be able to help someone overcome their problem and avoid future health risks – I really do not have the words to describe the feelings that I have. To see them, little by little, coming out of their deep sadness and to see a future with more light, more happiness, more joy, and they come to understand that everyone has opportunities if they are ready to see what they can do," Díaz said. "The feelings that this gives me are very difficult to describe. The work I do here fulfills me both professionally and personally. I hope that I will be able to continue to help these families and their children.”

In celebration of World Health Day, we offer our humblest thanks to Díaz and every psychologist who helps us deliver world-class, patient-centered care.

Cleft surgery will heal a child’s open lip or open palate, but what happens after surgery? In many cases, children go home with a new smile, they go to school again, they’re accepted by their peers and they go on to live productive, successful lives, which may not have been possible without cleft surgery from Operation Smile medical volunteers.

At Gilberto Mariño Contreras Centro de Atención Integral, the year-round Operation Smile care center in Bogotá, Colombia, patients receive comprehensive care including dental work, speech therapy, nutrition, psychology, parental workshops, genetics studies, social works, audiology, orthodontics and more. The idea is that surgery provides immediate care, but all the other disciplines are necessary to treat the whole patient.

Caring for not only the whole patient, but the whole family is what drew psychologist Andrea Díaz to work at the center in Bogotá. Her passion for Operation Smile started when she was just a child herself – her mother was a volunteer and her father helped with fundraising efforts.

“The first time I saw kids from my own region, many who have so many difficulties, I was really moved,” Díaz said. “I saw the struggles those kids go through, not just with cleft lip or cleft palate, but everything else – bullied, teased and for some, their parents had a hard time accepting them – I knew I wanted to do something more."

Díaz continued to volunteer through her teens and throughout high school and university. She worked in every nonmedical aspect of the center, helping out wherever she could. Once she graduated university with a degree in psychology, she knew that she wanted to be involved with Operation Smile as a clinical psychologist.

“Psychological support is so important here from the very beginning, from when the mother is still pregnant and an ultrasound shows her baby has a cleft,” she said. “Working with these families from before their child is even born will help them accept their child. We tell them, ‘This is not your fault. This is a birth defect, it is not a curse, it is not karma.’ That takes time for the parents to understand.”

For those families who don’t know their child has a cleft until birth, the center offers parental support from the moment they bring their baby in. This psychological support is offered throughout the child’s teen years until they no longer need assistance.

Díaz recalled a teenage girl who returned to the clinic asking for a repair. She got surgery when she was very young and stopped coming to the clinic after some time. She returned because, now that she was in high school, the other teens were making fun of her very tiny, tiny scar. “You couldn’t notice it at all! It was a flawless surgery,” Díaz said. “So she came back for psychology. We helped her accept herself. To say, ‘Yes, I had a cleft lip, I got surgery, and that’s it.’ It’s very hard, especially for teen girls who want to be absolutely perfect to be satisfied with themselves.”

Through her work at the center, Díaz and the other psychologists, help families and children overcome social stigmas and build their confidence before and after surgery, continuing on for years if necessary.

“It’s not just the physical transformation that matters,” Díaz said. “It’s the entire healing process. The emotional transformation is just as important.”