Lioia sat with her 1-year-old daughter, Katherine, in her arms, waiting silently for surgery in the child life room. Nervously bouncing her knee, Lioia kept a smile on her face, though her eyes spoke otherwise.

As soon as Katherine's attention and cheer turned to a wind-up dancing chicken toy, Lioia allowed the tears to stream down her face, wiping them away with her palm. This is Lioia’s third child born with a cleft condition.

Rocio, a Honduran psychologist with Operation Smile in Honduras, squatted down next to Lioia.

“There’s nothing to worry about. She will have the best care. Don’t worry,” she consoled in Spanish, smiling and giving Lioia a reassuring hold on the shoulder.

Lioia and her husband, Jorge, brought their twins to this medical mission in Tegucigalpa, Honduras. Their son, Donari, has a unilateral cleft lip, and their daughter has a bilateral cleft lip and palate. Donari was already out of surgery and reunited with his favorite green soccer ball by the time his sister was getting ready for surgery.

Rocio guided Lioia and other waiting parents in the child life room through a step-by-step binder with photos explaining the surgical process. Her presentation ended with several pages of photos showing successful surgery outcomes and elated children.

The child life area is a place where volunteers engage in play therapy with patients before they are accompanied to the operating room. While the children are occupied, medical volunteers help explain to parents exactly what their child is about to go through.

Although Lioia listened intently, she already knew the process. Jorge and Lioia have a 7-year-old son who received surgery on his cleft lip at 8 months old from Operation Smile. Even as she’s been through the process before, nothing can quell a mother’s worry, she said.

“I’m happy, excited, but nervous,” she said through a translator. “I know she will be OK, but I’m still scared for her.”

Lioia said her oldest son is doing great and he hardly has a scar from surgery.

“When Katherine and Donari were born, I was scared but not as scared as I was with my older boy,” Lioia said. “This time we knew what to do. We had hope. We knew that Operation Smile could help us again.”

The family walked for two hours and took a bus for four hours to make it to the Operation Smile medical mission, the same journey they completed six years earlier for their son. Lioia said she would go any distance to get help for her kids.

“There is a solution for my children. Operation Smile gives the solution. We don’t have money to go to a private clinic for help,” she said. “I feel very happy for Operation Smile. Thank you, thank you for helping all my children.”