Smiles in Gabon - Humanitarian Mission Providing Cleft Lip and Palate Surgery in Libreville

Project location: GABON, Libreville
Project start date: December 2011 - Project end date: March 2012
Project number: 2011-40


Cleft lip and palate are birth defects that develop while the baby is developing in the mother's uterus. During the 6th to 10th week of pregnancy, the bones and tissues of the baby's upper jaw, nose, and mouth normally come together (fuse) to form the roof of the mouth and the upper lip. If the tissue in the developing mouth and palate do not link together, the baby could be born with these defects.
The severity of this deformity varies for every child and currently its real cause is unknown. Cleft lip and palate can not be prevented; most researchers believe clefts are due to a combination of genetic and environmental factors.
The most common problems related to these birth abnormalities are: misaligned teeth, change in nose shape, failure to gain weight, feeding problems (flow of milk through nasal passages during feeding), recurrent ear infections, speech and language difficulties and dental problems.
Clefting occurs most often in Asians, Latinos and Native Americans and least often in people of African descent.
The treatment for these abnormalities includes surgery. For this purpose Smile Train Italia plans and carries out surgical mission in order to provide free surgical treatment for babies with cleft lip and palate giving them a whole new world of happiness.
Gabon, country in central Africa, though it has seen a tremendous growth in recent years thanks to the wealth of raw materials (hydrocarbons) it shows an economic situation and short-term perspectives widely vulnerable to exogenous nature of economic disruptions given the strong country's sense of dependency on exports of raw materials. This means that most of the proceeds of that growth remain in the hands of multinational companies and only the mild balance is really destined to the Government of Gabon. In addition, in the country there is a strong inequality in the income's distribution within the population and there are social indicators and a level of endemic poverty, which place the country well below the world rankings based on simple statistical averages of indicators of wealth individual. The consequence of this is the lack of essential services, from education to health, with negative effects especially for the weakest groups of society.
In this country the cleft lip and palate (CLP) is a widespread disease, thousands of children are waiting to be operated, but the local health structures and local physicians are unable to meet these needs. It is in fact a condition that affects with higher incidence children born in countries with lower levels of socio-economic development and lack of essential services to the person.

The need to intervene with surgical missions in Gabon has emerged thanks to the efforts of the local Ministry of Health that has responded to the availability of our association by sending an official request for assistance which was followed by a visit performed by two volunteers of Smile Train Italy that have concluded in June 2011 a mission of assessment.
During this first assessment mission the volunteers visited the Central Hospital of Libreville, a structure in which there is only minimal equipment to carry out the mission, which will be implemented with the purchase of new instruments, which will then be donated to the hospital. In the hospital medicines, medical equipment and disposables tools are partially missing.
The hospital, with the exception of any further requests from the local Ministry of Health, will host the surgical missions to Smile Train Italy. The physicians of the hospital will work with our volunteers, especially they will manage the information campaign for patients' families so that they can be informed about the possibility of bringing their children with cleft lip and palate, outcomes of burns and others malformations in the hospital for the medical examination for the following surgery.
The surgical mission will take place in February 2012 and it will last approximately 10 days.

The team of Smile Train Italia will be composed by about12 volunteers divided into the following medical fields: plastic and/or maxillofacial surgery, anaesthesiology, paediatrics, and nurse and logistics coordinator.

The phases of the surgical mission are the following:

1. Patient Screening: The first two days are devoted to the medical visits of little patients who go to the hospital. The communication about the carrying out of the surgical mission is managed by the hospital of Libreville by means of collaborations with television, printing and advertising hoardings in order to spread the news of the doctors' arrival. So a real information campaign will be started.
This phase allows doctors to evaluate the severity of diseases which affects babies and children. Priority is given to younger babies; while all those babies who show other diseases, that are not compatible with the surgery, are excluded.
During the screening's phase is also established the timing of surgeries.

2. Surgery: During each surgical mission, doctors operate on average 40-60 children.

3. Post-Operative Course: Physicians care for patients in the days after the surgery making sure that there are not post-operative complications and leaving appropriate medical means to local doctors.

The surgical mission will include also training courses for doctors and nurse personnel of the hospital of Libreville. The training programs will be performed by means of video (CD, DVD) and paper tutorials (surgery book, medical guide and etc...).
This mission will start the realization of an ongoing project in Gabon, because one of the main goals of our Association is to realize humanitarian actions repeated over time, allowing the local population to live a real growth and not to benefit only from a prompt and not continuous form of help/support.

The primary outcome of this humanitarian project, which received a grant from the Nando Peretti Foundation, in Gabon will include free surgical operations for at least 40 children born with cleft lip and/or palate.
The secondary outcome foreseen by this project will be to provide technical support and training courses addressed to physicians and nursing staff of the local hospital in order to give them the professional skills for the treatment of facial malformations necessary to work independently.



Smile Train Italia is a non-profit organization formed by physicians-volunteers that provide free their professional skills in the carrying out humanitarian surgical missions helping poor babies and children affected by facial malformations (cleft lip and palate - CLP, burns and war traumas).
Cleft lip and palate represents the major disorder for the developing countries where there are many children suffering with un-repaired clefts. These malformations lead to frequent feeding problems and speech impairments, representing the main social interaction threats (social isolation and pain, work difficulties, etc...).
In many local cultures the birth of a baby with this kind of abnormality is considered a misfortune. For example, in Uganda the baby born with a cleft lip and palate is named "Ajok" which means literally "cursed by God". Nobody knows how many newborn babies with facial malformation are killed or abandoned after their birth. In some poor countries, the average birth of the babies with cleft lip and palate is about 1 in 400 births.
Smile Train Italia organizes and carries out humanitarian mission of plastic and reconstructive surgery in the underdeveloped countries of Africa, Asia and Latin America, where the incidence of these pathologies is extremely high.
The physicians-volunteers of Smile Train Italia include plastic and maxillo-facial surgeons, anesthesiologists, pediatricians, dental surgeons, nurses and logistics coordinators.
Smile Train Italia has several years of experience in this medical field, and thanks to the work and devotion of volunteers it carries out many surgical missions in the following countries: Afghanistan, Pakistan, Iraq, Tanzania, Mozambique, Democratic Republic of the Congo, Ivory Coast, Uganda, Georgia, Yemen, Ethiopia, Armenia, Indonesia and Bangladesh.
Besides, Smile Train Italia moved to Italy many babies and children with serious facial malformations, children that during the mission could not be operated for the lack of suitable surgical tools and materials.
Surgical humanitarian missions represent the "hearth" of activity of Smile Train Italia.
A surgical mission lasts about 12 days and during each mission the physicians-volunteers are able to operate about 40/60 patients. From 2007, the Italian volunteers of Smile Train Italia performed n° 34 surgical missions operating miles of children.
Furthermore, during the mission the physicians-volunteers of Smile Train Italia perform practical and theoretical training courses addressed to local physicians and health nursing personnel.
Periodically, Smile Train Italia organizes and carries out International courses and conferences in Italy in the field of surgical treatment for cleft and palate deformities.

Smile Train Italia ONLUS
think global, act local
you are here: Home  > Projects:  Charity or Africa  (or Both)  > 2011-40  > Project Description