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Patient Story Madagascar

In Madagascar, mother becomes an advocate for Operation Smile

Patient Story Madagascar

In Madagascar, mother becomes an advocate for Operation Smile

Joyce is a happy and cheerful 15-month-old girl, running around the medical evaluation area, seemingly very comfortable with what was happening around her. It turns out this is her second time going through this process with Operation Smile.

Her mother, Nina, speaks English very well, since she has worked as a maid for an American family in Madagascar and is now a teacher. Nina has brought her whole family with her to the medical mission. She and her husband, Tiana, have four children – three sons (Johan,12  Daniel, 10 and Alex, 5) and their baby girl, Joyce.

“It was a shock to me when I first saw her. It looked like something was missing in her face. I cried and was very upset. I was afraid people would treat her badly," recalls Nina. "I heard stories about a man with cleft who wanted to get married but had to give away a cow to the girl’s family before they could accept him."

Someone told her about Operation Smile and she wrote an email and got a reply that they could come to the mission in Tamatave for medical screening, which determines if a child is healthy enough to receive surgery safely. They hoped Joyce would be selected for the free surgery, and she was. Joyce got her lip repair a year ago during the medical mission.

“Afterwards, when I first saw her – I didn’t recognize her! She looked so different! I even had to check her clothes to make sure this was my daughter. I needed a few days to get used to her new face,” Nina explained.

The surgeon who did the operation was the Swedish volunteer Petra Peterson, who is so excited to see Joyce and Nina here again.

“I really tried to sit down with Nina after surgery to explain how important it is for her daughter’s speech development to repair the palate as soon as possible. And she listened – here they are and it is a perfect time to fix Joyce’s palate!” Peterson said.

Joyce and her family live in Antsirabe, a city four hours by car, south of the capital Antananarivo. Antsirabe is situated in the mountains in a volcanic area where the prevalence of cleft is much higher than in other parts of the country.

I don’t know if the radiation can explain my daughter’s cleft. People kept on asking me what I had done, if I had eaten something during my pregnancy. I felt I was blamed and felt a lot of guilt.

- Nina

She remembers the advice she got when her daughter was born.

“They told me to never stop showing my daughter how much I love her. Whatever people around her do to her – I will show her love so she can get plenty of self-esteem to tackle the difficulties. But I also told my three sons to protect her, to be her bodyguard. And they love her so much,” Nina said.

Now, Nina’s only worry is how her own daughter will feel when she becomes a teenager.

“Today young people, especially girls, are so critical towards themselves and the way they look,” Nina said.

Nina also worries that a future fiancée to her daughter will be skeptical and think about the genetic risks. 

Could they have afforded a surgery for their daughter if it was not for free?

“No, but we would have done everything possible to make it happen. We would have taken a loan or sold things in our house to afford to pay for surgery,” she said.

After their daughter’s first surgery Nina has become an advocate for Operation Smile. Every time she sees a child with a cleft condition she talks with the parents, explains about Operation Smiles missions, gives them advice on how to get there and what will happen.

“I have told six families about this mission. But only one came here. They don’t have the money for transportation and they are too afraid since it is so far away."

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