The Surgery He Always Deserved

Patient Stories

The Surgery He Always Deserved

High in the mountains of western Honduras, Rudis Casteñeda walked alone up a winding, dirt and gravel path.

The humidity hung heavy in the air as step after exhausting step through this rugged terrain brought him slowly closer to his destination – the home of Marco, a 54-year-old man living with a cleft lip and cleft palate.

To that point, very few people had ever made the long walk to visit Marco, who lived his life as an outcast due to his cleft condition.

Rudis had no way of knowing if Marco would be home or not, and yet he pressed onward. After all, he had life-changing news to deliver to Marco if he was there to receive it.

On this day, Marco happened to be home.

There were no odd jobs around for him to work for the meager payment of food. Since he was 12 years old, this was Marco’s daily struggle. Through the course of the next 42 years, he never had the opportunity to earn income beyond the next meal for himself and his mother.

And after she died seven years ago, Marco was left without a single loved one or friend.

That was until Rudis knocked on his door.

Rudis is a volunteer with the Acompañando Sonrisas – “Accompanying Smiles” – patient recruitment and advocacy program, which enlisted seven people with personal connections to cleft to find potential patients and bring them to Operation Smile Honduras’ care. The program was critical to finding the last remaining adults and children in Honduras living with unrepaired cleft conditions like Marco, who live in the hardest-to-reach, most impoverished places in the country. Thanks to the tireless efforts of the Acompañantes, the only Hondurans living with cleft are either babies or toddlers who can be scheduled for safe, effective and timely surgery through Operation Smile.

In honor of his selfless service, Rudis is now known as Don Rudis, as use of the honorific Don conveys respect for that person.

After hearing about Marco from people in a nearby village, Don Rudis walked four hours from his home to Marco’s to tell him that there were people that wanted to help. He could finally receive surgery and it would be completely free of charge.

After Don Rudis’ daughter received cleft surgery from Operation Smile at 3 months old, Operation Smile Honduras asked the farmer if he would volunteer his free time to search the country's mountainous western region for people like Marco who would never be able to access safe surgery on their own. Feeling a debt of gratitude toward Operation Smile for his daughter’s surgery, Don Rudis agreed to become an Acompañante.

Photo: Rohanna Mertens.
Rudis Casteñeda comforts a patient and parent while volunteering as an Acompañante in Operation Smile Honduras' Acompañando Sonrisas patient recruitment and advocacy program. Photo: Rohanna Mertens.

Marco long knew that surgery could repair his cleft condition, but he never knew how to go about receiving treatment. Even if he had, he never had the money to pay for transportation to the nearest hospital – let alone the cost of the surgery itself.

For decades, he was forced to live with the cruel daily reminders of his cleft, which came in the form of painful bullying and social isolation. Even his father abandoned Marco and his mother after he was born.

The jeers and loneliness were so painful to endure, but Marco dug deep to find the strength to ignore people’s abuses against him.

It didn’t take long for Don Rudis to convince Marco to come with him to seek help from Operation Smile.

The next medical mission was coming to the capital city of Tegucigalpa in two weeks, and Don Rudis told Marco that he was welcome to stay at his home with his family until then. Don Rudis would also be able to provide some farming work for Marco so that he would be able to pay for the six-hour bus ride to Tegucigalpa. Operation Smile Honduras would reimburse Marco’s travel expenses upon his arrival to the mission site.

Without hesitation, Marco said, “I am going.”

So began the four-hour return trek back to Don Rudis’ home.

Along the way, the possibility of receiving cleft surgery inspired Marco as he had never been before. Since he began working to support himself and his mother at 12, Marco had chewed and smoked tobacco. On that long walk, he decided to give up those unhealthy habits after 42 years of use.

Two weeks later, Marco and Don Rudis departed for Tegucigalpa. It was the first time Marco had ever been to a big city.

When they arrived to the medical mission site at Hospital General San Felipe, Marco was shocked to see so many other people who were born with the same condition. Throughout his stay at the patient shelter and the screening process, his excitement to receive surgery continued to build.

Photo: Carlos Rueda.
Marco engages in therapeutic play with child life specialist Kelly Raymond at the February 2017 Operation Smile medical mission to Tegucigalpa, Honduras. Photo: Carlos Rueda.

Finally, after living a lifetime of anguish, Marco was selected to receive surgery during the medical mission.

When his name was called, the surgery that seemed impossible to attain was only hours away from becoming reality.

¡Macanudo!” Marco said, meaning “wonderful.” 

Photo: Carlos Rueda.
Marco walks to the operating room with Bolivian anesthesiologist Dr. Marco Corrales. Photo: Carlos Rueda.
Child life specialist Kelly Raymond of Canada comforts Marco before he goes under anesthesia for cleft lip surgery. Photo: Carlos Rueda.

Calmly, Marco walked into the pre-operative room to receive anesthesia. Once under, the team led by surgeons Pernille Lindholm of Sweden and Honduras’ own Oscar Rodriguez performed his life-changing cleft lip surgery.

Photo: Carlos Rueda.
Operation Smile volunteer surgeons Drs. Pernille Lindholm of Sweden and Oscar Rodriguez of Honduras perform Marco's cleft lip surgery. Photo: Carlos Rueda.
Marco sees his new smile for the first time. Photo: Carlos Rueda.

When Marco woke from anesthesia, a medical volunteer handed him a mirror so he could see his new smile for the first time. He gazed at his repaired lip with amazement before giving the “thumbs up” sign.

At last, the surgery he always deserved brought five decades of his needless suffering to an end.

Photo: Carlos Rueda.
Marco, moments after seeing his new smile. Photo: Carlos Rueda.

Editor's Note: In the 20-year history of Operation Smile Honduras, our medical volunteers have delivered free cleft surgery to more than 4,500 patients. However for most of this time, all too many patients born with cleft conditions were not able to get surgery when they were babies, which is the ideal age range for the best results.  

In 2014, there were about 1,000 cleft cases remaining in the country and many of those potential patients were adults, teens and children. Together with Operation Smile Honduras, we made a commitment to find them and end their needless suffering by making sure they receive the safe and effective surgery they deserve. 

Supported by medical missions and the ongoing care provided at Operation Smile Honduras’ care center, a strategy was put into motion to identify and recruit potential patients, many of them among the poorest and hardest-to-reach in the country.  

We’re proud to report that the effort was successful. 

Now, the remaining patients in Honduras who need surgery are nearly all babies and toddlers. For the first time in the country’s history, Operation Smile has made sure that cleft surgery in Honduras is truly SET: safe, effective and timely

On May 11, 2017, Operation Smile Co-Founder and CEO Dr. Bill Magee made the historic announcement alongside the President and First Lady of Honduras. 

Though we’ve reached this historic milestone, our work is far from done.  

In this series, we share the stories of how Operation Smile Honduras was able to find and provide surgery for the final patients of the country’s backlog of cleft cases.