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From the Field Colombia

A Historic Shipment is Saving Lives in Colombia

An Operation Smile Colombia volunteer explains the benefits of ready-to-use therapeutic food (RUTF) to a family living in the remote region of La Guajira, Colombia. A nutritive peanut paste, RUTF saves lives by providing crucial nutrition that helps children grow healthy enough to undergo surgery. Photo: Camilo Zapata.

Our promise of improving health and dignity during the COVID-19 pandemic endures. Once again, we’re providing surgery and in-person care while taking stringent measures to keep families safe. Hope is on the horizon. And we remain focused on what cleft care makes possible for children, helping them to better breathe, eat, speak and live with confidence. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

As the COVID-19 pandemic persists and the Delta variant of the coronavirus spreads, it’s estimated that 270 million people will grapple with life-threatening food shortages in 2021, according to the United Nations' World Food Program. 

This tragic figure represents a 55% increase of people facing food insecurity, up from an already staggering 150 million prior to the pandemic. And according to the U.N., many people living in several of the countries that Operation Smile serves are on the brink of famine.

This includes the La Guajira region of Colombia, one of the country’s most impoverished areas.

With resources already stretched by the mass displacement of Venezuelans due to socio-political crises that have lasted for years, La Guajira, which borders Venezuela, has also been hard hit by the effects of the pandemic and climate change. Indigenous and displaced communities are now being disproportionately affected by food shortages.

“Many indigenous people that live in this region produce crafts by hand, and the only income they used to make was selling these beautiful mochilas,” which are intricate woven handbags and packs, said Paula Franco, a now-former program coordinator of Operation Smile Colombia. “But they’ve been unable to sell them because everything was closed for many months.”

For families affected by cleft conditions in this region, this reality is further compounded by the health risks posed by untreated cleft lip and cleft palate, which can cause difficulties with breastfeeding, bottle-feeding and eating solid food. This increases the risk of malnutrition and other severe health consequences, even death, if children don't receive enough nutrition to qualify for life-saving surgery.

Operation Smile Colombia volunteer nutritionist Cindy Getial consults with a father about the nutritional status of his son, Enoc, during an August 2021 program in which ready-to-use therapeutic food was distributed to families living in La Guajira, Colombia, a remote region where food insecurity threatens the lives of patients living with untreated cleft conditions. Photo: Camilo Zapata.

With a decades-long presence in La Guajira, the Operation Smile Colombia team has been working closely with local health authorities and partner nonprofits in the region to monitor the needs of patients and their families throughout the pandemic. According to Paula, it became clear in late 2020 that these families were in urgent need of nutritional support.

In November, at Operation Smile Colombia’s first locally led surgical program since pandemic lockdowns, a heart-wrenching number of children arrived for their health evaluations either malnourished or undernourished.

A proven solution that Operation Smile has employed in countries where malnourishment threatens the lives of young patients is ready-to-use therapeutic food (RUTF).

A nutritive peanut paste, RUTF saves lives by providing crucial nutrition that helps children grow healthy enough to undergo surgery.

Patricia and her son, Wilmar, stand in their kitchen in La Guajira holding a package of ready-to-use therapeutic food. Photo: Camilo Zapata.

“When we learned about the possibility of using RUTF for patients suffering from malnutrition in Colombia, it seemed like an easy thing to solve – we have this RUTF product, so let’s send it to them so we can save lives,” said Melissa DiBona, Operation Smile’s associate vice president of legacy projects who spearheaded the organization’s RUTF program. “But then you learn that it’s not so easy.”

The import of medical supplies and equipment from the United States to Colombia is a complex and highly regulated bureaucratic process that can be painstakingly slow. And with adequate supplies and equipment available in-country, Operation Smile hasn’t shipped from the U.S. to Colombia since 2007.

Until now.

Members of the Operation Smile logistics team pose for a photo with the historic shipment of RUTF before its forwarding to Colombia in May 2021. Pictured are, from left: Joe Sanchez, pharmacy specialist; Chris Brewington, warehouse assistant; Jesse Hines, chief of logistics and facilities; Yolanda Weaver, logistics quality assurance coordinator; Candace Streit, director of logistics; Edd Basilio, warehouse specialist; and Jojo Ocampo, warehouse team lead. Operation Smile photo.

Led by Kathy Magee, Operation Smile’s co-founder and president, members of the RUTF and Colombia teams reached out to the office of the ambassador of Colombia to the U.S. in January to express the urgent need of this shipment – 99 cases of RUTF – to get to those patients as soon as possible.

Promptly, now-former ambassador Francisco Santos Calderón met with the Operation Smile team to discuss expediting the shipment of RUTF into the country. According to Melissa, Santos agreed that the needs of children suffering from cleft conditions and malnourishment are a dire emergency, and he promised to work with his colleagues across various government agencies to help Operation Smile get RUTF to the families and children in need.

While the process was still lengthy in comparison to other countries’, the shipment was prioritized, expedited and cleared Colombian customs within four months of meeting with Santos.

After further regulatory processing and product registration, the RUTF was finally distributed to families in the department of La Guajira in early August 2021.

Patricia is pictured with her six children Wilmar, Yolimar, Karen, Alejandra, Yoiner and Frainer. Photo: Camilo Zapata.

According to Candace Streit, Operation Smile’s director of logistics, the shipment ranks as one of the top accomplishments of her team of experts in the nuanced and complex world of international medical logistics and customs.

“No corners were cut, but it was helpful to have the support of the ambassador, which definitely sped up the process,” Candace said. “The collaboration between several departments, several teams and Operation Smile Colombia is what made it successful.”

Operation Smile Colombia’s nutritionist, Cindy Getial, joined the organization in May 2021 and delved into supporting the needs of families affected by cleft conditions and food scarcity in La Guajira. This also included packages of food that have been distributed throughout the pandemic.

“It became evident that they don’t have the tools needed (to ensure food security),” Cindy said. “By tools, I mean food and nutrition education. Families are unaware of healthy habits and physical tools both in their homes and in the region to be able to guarantee nourishment.”

Cindy added that while conditions in the area are tough, educating families about easily accessible, locally produced food makes nutritional improvements possible.

“I think the most important thing is the strategy we have to leave knowledge with the families for them to be their own managers in their effort to overcome the food insecurity situations they are going through,” she said.

While this life-saving shipment will help many children become healthy enough for their next chance at surgery, Melissa, Candace and Paula shared that they hope this achievement sets the stage for many more essential shipments of RUTF to reach patients and families as the need for improved food security mounts in Colombia.

“This was a perfect match for the need in this region, and it arrived at the perfect moment,” Paula said. “It’s so nice to see how after we opened a door that there are many opportunities – after we didn’t give up – and that this will really help the children.”

Help us to continue keeping our promise to patients living in places like La Guajira, Colombia, amid the COVID-19 pandemic. Your support today means we can help patients through these uncertain times and provide them with the care and surgery they deserve.

Photo: Camilo Zapata.

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