World renowned doctors to perform 50 life-changing surgeries in Armenia this week
Cafesjian Family Foundation takes the lead in organizing Smile Network mission to Armenia
by Paul Chaderjian
Published: Tuesday October 07, 2008
Yerevan - Every morning, four-year-old Gayane cries and begs not to be taken to school. She covers her mouth so that people don't see her lips. But they do, and they often react.
Gayane was born with a cleft lip - a genetic defect also known as cheiloschisis. In Armenia, they still call it a "harelip," a pejorative other cultures and nations have already retired from their languages.
No matter what it's called or the age in which we live, people on the streets here often stare at Gayane. Kids at school don't want to be around her. Some classmates make snide remarks. Others tease and bully her. Some adults here think of the split in her lip as a curse or a sign that she is mentally disabled.
Unfortunately, Gayane's story is not unique; but this weekend, Gayane tortured life will change forever thanks to a team of volunteer specialists from the United States participating in the first Smile Project mission in Armenia.
More than a dozen doctors, nurses, and other specialists will be in Yerevan to examine 250 patients with either a cleft lip, a cleft palate, or both. Fifty of these patients will undergo surgery between Monday, October 6, and Friday, October 10.
"The two surgeons leading the team are both renowned cleft surgeons," said Madlene Minnasian, director of the Smile Project. "One is Dr. Les Mohler, and the second is Dr. Samir Mardini. They call him Magic Hands. We're very lucky to have world-renowned surgeons come to this mission."
by Paul Chaderjian
Published: Tuesday October 07, 2008
Yerevan - Every morning, four-year-old Gayane cries and begs not to be taken to school. She covers her mouth so that people don't see her lips. But they do, and they often react.
Gayane was born with a cleft lip - a genetic defect also known as cheiloschisis. In Armenia, they still call it a "harelip," a pejorative other cultures and nations have already retired from their languages.
No matter what it's called or the age in which we live, people on the streets here often stare at Gayane. Kids at school don't want to be around her. Some classmates make snide remarks. Others tease and bully her. Some adults here think of the split in her lip as a curse or a sign that she is mentally disabled.
Unfortunately, Gayane's story is not unique; but this weekend, Gayane tortured life will change forever thanks to a team of volunteer specialists from the United States participating in the first Smile Project mission in Armenia.
More than a dozen doctors, nurses, and other specialists will be in Yerevan to examine 250 patients with either a cleft lip, a cleft palate, or both. Fifty of these patients will undergo surgery between Monday, October 6, and Friday, October 10.
"The two surgeons leading the team are both renowned cleft surgeons," said Madlene Minnasian, director of the Smile Project. "One is Dr. Les Mohler, and the second is Dr. Samir Mardini. They call him Magic Hands. We're very lucky to have world-renowned surgeons come to this mission."
Project Smile
Project Smile was initiated by the Cafesjian Family Foundation, Hope for the City, and the Smile Network - which leads similar projects around the world. The three Minneapolis-based organizations have come together to address cleft-care needs in Armenia.
In addition, Project Smile will give the local medical community a chance to listen to world authorities on cleft care through lectures. Local physicians and nurses will also shadow the guests and learn by observing their American counterparts.
"Coming to Armenia are expert anesthesiologists, pediatricians, operating room nurses, ward nurses, medical recordkeepers, and a host of nonclinical volunteers," said Ms. Minassian. "It's a very good group of 19 volunteers, one of which is of Armenian heritage. He's second or third generation Armenian, Dr. Robert Chantigian, anesthesiologist."
Project Smile was initiated by the Cafesjian Family Foundation, Hope for the City, and the Smile Network - which leads similar projects around the world. The three Minneapolis-based organizations have come together to address cleft-care needs in Armenia.
In addition, Project Smile will give the local medical community a chance to listen to world authorities on cleft care through lectures. Local physicians and nurses will also shadow the guests and learn by observing their American counterparts.
"Coming to Armenia are expert anesthesiologists, pediatricians, operating room nurses, ward nurses, medical recordkeepers, and a host of nonclinical volunteers," said Ms. Minassian. "It's a very good group of 19 volunteers, one of which is of Armenian heritage. He's second or third generation Armenian, Dr. Robert Chantigian, anesthesiologist."
It's estimated that one in 700-1000 kids are born with a cleft lip or cleft palate, both considered the most common birth defects in the world. While there are no thorough statistics of how cleft lip and cleft palate have been successfully treated in Armenia, the need for surgical intervention became obvious when Cafesjian Family Foundation board member Megan Doyle came to Armenia for a fact-finding mission last November with Kim Valentini, the founder of the Smile Network.
"The Smile Network has been operating all over the world for many years," said Ms. Minassian. "They reach out to the international community, and if they find a need for cleft care in any country, they begin their work. Through the generosity and coordination of Hope for the City and its founder Megan Doyle, we were able to meet Kim Valentini, who is founder of the Smile Network. It was wonderful to host Megan and Kim in Armenia. The passion and love they have for children all over the world is inspirational and exemplary."
Megan and Dennis Doyle established Hope for the City eight years ago to help fight poverty, hunger, and disease around the world by utilizing corporate surplus. The couple's organization has brought more than $40 million in medical equipment, supplies, and medication to Armenia over the past few years and was instrumental in bringing the Smile Network to Armenia.
"Mrs. Doyle came to oversee and visit her projects in Armenia, and she brought Mrs. Valentini with her," said Ms. Minassian. "The visit helped determine that there was a need for cleft care in Armenia, even though we have experienced, competent, very professional maxillo-facial surgeons here. The problem was in the ability for the patient to pay for the care and access to surgery."
The government of the Republic of Armenia tells the Armenian Reporter that it offers a $700 stipend for children under seven in need of reconstructive cleft-lip or cleft-palate surgeries, which are estimated to cost around $2,000 in Armenia and upwards of $10,000 if performed in the United States. One local surgeon says that the government subsidy does not cover costs for surgery, and the families are asked to pay the difference.
"The Smile Network has been operating all over the world for many years," said Ms. Minassian. "They reach out to the international community, and if they find a need for cleft care in any country, they begin their work. Through the generosity and coordination of Hope for the City and its founder Megan Doyle, we were able to meet Kim Valentini, who is founder of the Smile Network. It was wonderful to host Megan and Kim in Armenia. The passion and love they have for children all over the world is inspirational and exemplary."
Megan and Dennis Doyle established Hope for the City eight years ago to help fight poverty, hunger, and disease around the world by utilizing corporate surplus. The couple's organization has brought more than $40 million in medical equipment, supplies, and medication to Armenia over the past few years and was instrumental in bringing the Smile Network to Armenia.
"Mrs. Doyle came to oversee and visit her projects in Armenia, and she brought Mrs. Valentini with her," said Ms. Minassian. "The visit helped determine that there was a need for cleft care in Armenia, even though we have experienced, competent, very professional maxillo-facial surgeons here. The problem was in the ability for the patient to pay for the care and access to surgery."
The government of the Republic of Armenia tells the Armenian Reporter that it offers a $700 stipend for children under seven in need of reconstructive cleft-lip or cleft-palate surgeries, which are estimated to cost around $2,000 in Armenia and upwards of $10,000 if performed in the United States. One local surgeon says that the government subsidy does not cover costs for surgery, and the families are asked to pay the difference.
Preparing for the mission
During Mrs. Doyle's and Mrs. Valentini's trip to Armenia last November, the Smile Project was able to secure the support of Armenia's Ministry of Health.
"We met with many different institutions in order to do a search to find a partner," said Ms. Minassian, "and we found our partner in the Arabkir Medical Center, which is run by Dr. Ara Babloyan. It's a privately owned and the largest pediatrics hospital in Armenia. Dr. Babloyan is a very capable, brilliant person."
The Smile Project also partnered with the Health ministry's Mother and Child Department, which was able to tap into public records and its regional polyclinics and provide a list of hundreds of children born with cleft conditions since 1988.
"The lists were pretty extensive, and we tried to target younger children that we thought would have not been operated on," said Ms. Minassian. "The lists did not indicate whether these children had had surgery. We just had statistics of the birth defects."
While compiling lists of prospective patients, the Smile Project also engaged local media to reach out to families in Yerevan and throughout the republic. The media campaign resulted in hundreds of calls from parents with children who needed cleft care as well as adults, well into their 40s, who had had a series of unsuccessful cleft procedures.
"We have so much support that it is surprising," said Erik Grigoryan, project manager for the Smile Project. "Armenians are usually less volunteerism-oriented, and it was a surprise for me to get the type of feedback we have been receiving. For example, we went to the hotels and asked for discounts and said these doctors are coming to Yerevan to perform free surgeries. We received 25-30 percent discounts plus car service from Hotel Meg."
Another big surprise for Mr. Grigoryan has been the number of calls he has been receiving from people who want to volunteer next week. He has enlisted psychologists, speech therapists, translators, and those who wants to drive patients and their parents to and from the screenings and surgeries.
"One woman called and wanted to cook for the patients and the other volunteers," said Mr. Grigoryan.
One of the other businesses heavily involved with getting the word out was Cascade Insurance, which took the initiative to print and distribute posters to all local and regional hospitals, clinics, and dental offices informing the public about the Smile Project.
"When people call to register for the screenings," said Yvetta Ghazaryan, project coordinator, "they cannot believe that this medical attention is possible in Armenia. Many patients and their families have been waiting for this mission with a lot of hope and they trust us. They know that with the help of our mission, the children will begin a new life. They will also gain the invaluable gift of a new smile.
During Mrs. Doyle's and Mrs. Valentini's trip to Armenia last November, the Smile Project was able to secure the support of Armenia's Ministry of Health.
"We met with many different institutions in order to do a search to find a partner," said Ms. Minassian, "and we found our partner in the Arabkir Medical Center, which is run by Dr. Ara Babloyan. It's a privately owned and the largest pediatrics hospital in Armenia. Dr. Babloyan is a very capable, brilliant person."
The Smile Project also partnered with the Health ministry's Mother and Child Department, which was able to tap into public records and its regional polyclinics and provide a list of hundreds of children born with cleft conditions since 1988.
"The lists were pretty extensive, and we tried to target younger children that we thought would have not been operated on," said Ms. Minassian. "The lists did not indicate whether these children had had surgery. We just had statistics of the birth defects."
While compiling lists of prospective patients, the Smile Project also engaged local media to reach out to families in Yerevan and throughout the republic. The media campaign resulted in hundreds of calls from parents with children who needed cleft care as well as adults, well into their 40s, who had had a series of unsuccessful cleft procedures.
"We have so much support that it is surprising," said Erik Grigoryan, project manager for the Smile Project. "Armenians are usually less volunteerism-oriented, and it was a surprise for me to get the type of feedback we have been receiving. For example, we went to the hotels and asked for discounts and said these doctors are coming to Yerevan to perform free surgeries. We received 25-30 percent discounts plus car service from Hotel Meg."
Another big surprise for Mr. Grigoryan has been the number of calls he has been receiving from people who want to volunteer next week. He has enlisted psychologists, speech therapists, translators, and those who wants to drive patients and their parents to and from the screenings and surgeries.
"One woman called and wanted to cook for the patients and the other volunteers," said Mr. Grigoryan.
One of the other businesses heavily involved with getting the word out was Cascade Insurance, which took the initiative to print and distribute posters to all local and regional hospitals, clinics, and dental offices informing the public about the Smile Project.
"When people call to register for the screenings," said Yvetta Ghazaryan, project coordinator, "they cannot believe that this medical attention is possible in Armenia. Many patients and their families have been waiting for this mission with a lot of hope and they trust us. They know that with the help of our mission, the children will begin a new life. They will also gain the invaluable gift of a new smile.
Preparing for this mission
With the health ministries of the Republic of Armenia and the Republic of Nagorno-Karabakh, the Arabkir Medical Center, and the Cafesjian Family Foundation teamed up to organize the first Smile Project mission, the Fund for Armenian Relief (FAR), and the Hand in Hand nongovernmental organization in Karabakh also joined the project.
"FAR is taking care of transportation costs and food and lodging for our patients, so the 50 who are chosen for surgery will then get their transportation compensated for and will get their nutrition," said Ms. Minassian. "They will bring food to the children who are in post-operation care, and they will also pay for the lodging of one relative if they are from out of town."
Helping locate patients with cleft care needs in the Republic of Nagorno-Karabakh was the Hand in Hand organization, which is a partnership of several Canadian-Armenian medical associations. Hand in Hand provides free dental care through mobile clinics and several stationary clinics all over Karabakh. Since cleft children have major dental care needs, Hand in Hand was able to let cleft children's parents know about the Smile Project mission.
"They've been instrumental as our Karabakh partners." said Ms. Minassian.
With the health ministries of the Republic of Armenia and the Republic of Nagorno-Karabakh, the Arabkir Medical Center, and the Cafesjian Family Foundation teamed up to organize the first Smile Project mission, the Fund for Armenian Relief (FAR), and the Hand in Hand nongovernmental organization in Karabakh also joined the project.
"FAR is taking care of transportation costs and food and lodging for our patients, so the 50 who are chosen for surgery will then get their transportation compensated for and will get their nutrition," said Ms. Minassian. "They will bring food to the children who are in post-operation care, and they will also pay for the lodging of one relative if they are from out of town."
Helping locate patients with cleft care needs in the Republic of Nagorno-Karabakh was the Hand in Hand organization, which is a partnership of several Canadian-Armenian medical associations. Hand in Hand provides free dental care through mobile clinics and several stationary clinics all over Karabakh. Since cleft children have major dental care needs, Hand in Hand was able to let cleft children's parents know about the Smile Project mission.
"They've been instrumental as our Karabakh partners." said Ms. Minassian.
First week of October
After screening exams on Saturday and Sunday, October 4 and 5, the visiting medical specialists will meet and discuss each of the cases. The team will see 17 patients an hour and 250 patients over the weekend.
"Fifty-five of the patients are under seven and are awaiting their first surgeries," said Ms. Ghazaryan, the project coordinator. "Other patients are as old as 43, who need additional operations. There's one patient who has had 11 surgeries already and had complications, infections, and sometimes the palate cracks were not closed properly."
Ms. Ghazaryan says patients are coming from all over the Republic of Armenia, from Karabakh, as well as Javakh in Georgia. Those patients who live in Yerevan or are a short distance away have already been prescreened by Dr. Harach Arshakyan, a plastic surgeon from the Arabkir Medical Center. Dr. Arshakyan has been organizing the clinical aspect of this first mission, and he has already seen 150 patients who will be examined by the team from the Smile Network.
Dr. Arshakyan tells the Armenian Reporter that cleft issues arise in the first three months of a pregnancy, and he tries to advocate that in addition to genetic factors, malnutrition and low folic acids may also be factors in children being born with cleft palates and lips. He said he sees a great need for the local medical community to develop cleft care services and deal with the current need.
"The patients already screened by Dr. Arshakyan will meet our visiting pediatricians and with our cleft surgeons and nurses," said Ms. Minassian. "Vital statistics will be taken, and we will make sure that the child is healthy, that the child doesn't have any conditions or issues that would lead to complications or inability to operate."
After the initial examinations, the team will meet Sunday afternoon, prioritize the 250 patients and schedule surgeries for the top 50 patients.
"The highest priority is for children that have problems with nutrition," said Ms. Minassian. "Children who have not had an operation before will also be a high priority. With a condition like cleft palate, there are difficulties in eating, so if you're trying to feed with a bottle, and the child is very young, they can't suckle. And most of these children end up being fed through a feeding tube. Also, drinking from a cup, even drinking from a bottle can result from the milk coming out of the nose."
After the screenings, the Smile Project team will schedule 10 daily surgeries for five days. Two different surgical teams will operate in two separate operating rooms, and surgeries may take between 40 minutes to two hours.
"Two hundred cleft care patients will not have the opportunity to be treated," said Ms. Minassian, "Instead of being turned away, we're organizing a spring mission; but we're going to need funds to do that. The funds for this week's mission are covered, but we're going to have to share in the Smile Network's costs for a follow-up mission."
After screening exams on Saturday and Sunday, October 4 and 5, the visiting medical specialists will meet and discuss each of the cases. The team will see 17 patients an hour and 250 patients over the weekend.
"Fifty-five of the patients are under seven and are awaiting their first surgeries," said Ms. Ghazaryan, the project coordinator. "Other patients are as old as 43, who need additional operations. There's one patient who has had 11 surgeries already and had complications, infections, and sometimes the palate cracks were not closed properly."
Ms. Ghazaryan says patients are coming from all over the Republic of Armenia, from Karabakh, as well as Javakh in Georgia. Those patients who live in Yerevan or are a short distance away have already been prescreened by Dr. Harach Arshakyan, a plastic surgeon from the Arabkir Medical Center. Dr. Arshakyan has been organizing the clinical aspect of this first mission, and he has already seen 150 patients who will be examined by the team from the Smile Network.
Dr. Arshakyan tells the Armenian Reporter that cleft issues arise in the first three months of a pregnancy, and he tries to advocate that in addition to genetic factors, malnutrition and low folic acids may also be factors in children being born with cleft palates and lips. He said he sees a great need for the local medical community to develop cleft care services and deal with the current need.
"The patients already screened by Dr. Arshakyan will meet our visiting pediatricians and with our cleft surgeons and nurses," said Ms. Minassian. "Vital statistics will be taken, and we will make sure that the child is healthy, that the child doesn't have any conditions or issues that would lead to complications or inability to operate."
After the initial examinations, the team will meet Sunday afternoon, prioritize the 250 patients and schedule surgeries for the top 50 patients.
"The highest priority is for children that have problems with nutrition," said Ms. Minassian. "Children who have not had an operation before will also be a high priority. With a condition like cleft palate, there are difficulties in eating, so if you're trying to feed with a bottle, and the child is very young, they can't suckle. And most of these children end up being fed through a feeding tube. Also, drinking from a cup, even drinking from a bottle can result from the milk coming out of the nose."
After the screenings, the Smile Project team will schedule 10 daily surgeries for five days. Two different surgical teams will operate in two separate operating rooms, and surgeries may take between 40 minutes to two hours.
"Two hundred cleft care patients will not have the opportunity to be treated," said Ms. Minassian, "Instead of being turned away, we're organizing a spring mission; but we're going to need funds to do that. The funds for this week's mission are covered, but we're going to have to share in the Smile Network's costs for a follow-up mission."
