Is there hope for older teens and young adults who have a cleft palate? On a recent medical mission to Nicaragua, I witnessed firsthand there is indeed hope for all patients.

Ramon, a 29-year-old professional engineer, underwent surgery to close his cleft palate for the first time in Juigalpa, Nicaragua. He traveled for nearly three hours from his town of Muelle de los Bueyes, hoping to receive surgery.

Ramon told us he had never had the opportunity or resources to journey to a medical mission site in Nicaragua before this trip.

As one of six children growing up in a relatively remote part of Nicaragua, his parents did not have the means to seek help for him earlier in life. It wasn’t until recently that his local hospital had contacted him to let him know that Operation Smile would be coming to Juigalpa, closer to his home, to conduct healthcare assessments and perform surgeries. As soon as they heard, Ramon and his girlfriend of six years, Yadira, hopped on a bus.

Dr. Peter Radell, a Swedish physician serving as Field Medical Director for the medical mission, requested Ramon undergo a full speech evaluation prior to consideration for surgery. At nearly 30 years old, could there be any improvement in speech with surgery?

As the team’s speech language pathologist, it was my job to meet with Ramon and conduct a full speech assessment. Ramon had significant nasality because of his cleft palate, but he had surprisingly not developed any compensatory bad speech habits that would require intensive speech therapy to correct. He was an excellent candidate for surgery and was able to receive the procedure that week.

Post-surgery, Ramon and his girlfriend were excited to return to their town to share the news. Ramon chose not to tell anyone in his family of his journey, wanting it to be a surprise.

Some might wonder: Why bother with such a surgery when he clearly had coped this long with a cleft palate? Yet for a motivated young man like Ramon, it has made all the difference. He confessed when he first met Yadira, he was shy to speak to her, worried she would not understand him. Though he worked hard in school and succeeded in his studies, he faced challenges in his workplace, as many have difficulty understanding his speech.

American surgeon Dr. John (Andy) Dean performed Ramon’s cleft palate surgery, careful to re-attach the muscles needed for soft palate function that would be essential for clear speech. Ramon now has a home program to practice specific speech exercises and dreams of further advancement in his career.

Oscar dreams of a better future in Nicaragua.  A 19-year-old student in his final year of high school, Oscar arrived in Juigalpa with his mother seeking surgery for his cleft palate. After travelling four hours by bus from the El Rama region, Oscar met with the Operation Smile medical team for his evaluation.

Oscar’s goal is to become a physician one day, but his primary goal today is to develop clearer speech. Oscar was another older patient who was an ideal candidate for surgery.

As the team’s speech language pathologist, I met with Oscar and his mother before and after surgery and, with the help of a volunteer Spanish translator, I laid out a series of speech activities and a practice schedule that could assist the highly motivated Oscar. Oscar’s mom was committed to work with her son every day after they returned home.

Patients typically do not stay in the hospital for long after surgery, but every spare minute I had, Oscar was there requesting “otra session de terepia del habla” (another speech therapy session). With his determination and his mother’s support, I’m sure he will enhance his speech skills quickly.

In my time volunteering with Operation Smile, I’ve seen cleft lip repairs in babies and toddlers provide dramatic before-and-after photos – we have all grown accustomed to seeing those photos of life-changing surgeries.

But there is hope for improved quality of life and a door to greater opportunities when Operation Smile volunteers take the time to treat our adult patients like Ramon and Oscar. Thanks to Operation Smile, these two young men have now so many more opportunities and dreams to chase.