Moses’ Journey to Surgery

Malnutrition contributes to the deaths of 3.1 million children less than 5 years old annually. Operation Smile patients born with cleft conditions are especially vulnerable.

Due to difficulty eating caused by the cleft condition, patients can confront significant health problems or even death if they don’t receive timely intervention. Improving access to nutritional support and educating families on the importance of hygiene are crucial, which is why Operation Smile has established nutrition programs in 24 countries around the world, including Madagascar, India, Guatemala and Ghana.

During an Operation Smile Ghana surgical program, Moses arrived in dire need of nutritional support. Moses and his mom, Aba, met with volunteer nutritionist Dede Kwadjo, who would later turn out to be an integral part of Moses’ cleft care journey toward surgery.

The rate of Ghanaian children experiencing growth delays and being moderately to severely undernourished stands at a staggering 19 percent.

“Challenges people in Ghana are facing: no access to nutritious foods, foods are too expensive,” Dede said.

With an increased risk and probability of complications during surgery, many hopeful families who arrive with their children to Operation Smile programs leave disappointed after medical volunteers determined that their child was too malnourished to safely undergo surgery.

Working closely with our local teams, we design country-specific curriculums with the goals of increasing the capacity of nutrition volunteers and creating educational opportunities for families to learn which foods and treatments are available to them. To help the overwhelming number of children suffering in the country, Operation Smile Ghana’s nutrition program is conducted year-round in five regions across the country. The program offers ongoing educational support and monthly intervention assessments to track patients’ development.

“We train our mothers to use what they have to create nutritious food for their children. We ask what they have available: fish, beans, banana. Then, we work with them to create a practical solution, teaching them how to help their child,” Dede said.

For Aba, the personalized education and counseling she received from Dede throughout the nutrition program motivated her to stay consistent and to never give up hope that her son would receive his new smile one day.

Despite her son’s recurring respiratory infections and low weight, Aba remained committed to the program and became more optimistic as she began to see positive changes in Moses’ health. Dede concluded that Moses’ appetite was good and that he had no other underlying health conditions to prevent weight gain. Aba was asked to bring Moses to a nutrition program clinic where medical professionals could determine if he had reached a proper health status to undergo surgery during an upcoming program taking place later that year.

“To receive surgery, you need to be at a healthy nutritional status. At Operation Smile, we have very high standards around who is cleared for surgery,” said Operation Smile Director of Nonsurgical Programs Charlotte Steppling.

“All of our patients are candidates, but being cleared for surgery is a very different topic. You have a lot of parents who are feeding them whatever they can, whether that’s watered-down rice water, condensed milk mixed with water or some type of porridge or stew.”

Today, thousands of families are receiving education focusing on nutrition and healthy foods that are available, affordable and accessible in their communities. 

Additionally, families and patients around the world are provided instruction and awareness around water, sanitation and hygiene, which is a very important part of ensuring healthy habits.

Patients’ lives are being saved through timely intervention and access to formula, cereal mixes and nutrient-rich supplements like peanut-based ready-to-use therapeutic food (RUTF).

For Dede, the individual education and empowerment consultations she offers to families are just as important as the care she delivers to the children.

In 2022, more than 4,000 children like Moses received nutritional care from Operation Smile.

When asked if she had a message for the volunteers who helped her son become strong and healthy enough for cleft surgery, Aba said, “Thank you.”