Manchester-Dubai. Dubai-Mumbai. Mumbai-Aurangabad.
After three flights, multiple security checks and almost 24 hours of travelling, we arrive in Aurangabad early Saturday morning to be greeted by a customary Indian reception from our hosts.
A welcome breakfast at the hotel, a couple of hours rest and the team head off to Hedgewar hospital who are hosting the Northern Cleft Foundation with the help of Sewa UK and SEWA Mumbai for the next eight days.
Work starts with pre-op assessments so operations can begin tomorrow. People have heard about the arrival of the team via newspaper adverts, community health clinics and leaflets and many have travelled long distances to have their children seen.
One of the children in clinic had a cleft lip repaired last year and has returned for his palate to be repaired this time. Amazing result from his previous surgery – hard to believe he ever had a cleft lip!
Great to have arrived and have the “camp” underway … there is much to be done.
Alarm goes at 6am. Breakfast at 6.30am and on the bus to the hospital by 7.15am for a full day of operating today which starts shortly after we arrive. Ten corrective surgeries in three theatres to be performed mainly on children with cleft palates.
This time the NCF are a team of thirty six people – surgeons, anaesthetists, nurses, support workers and, for the first time, a trio of speech therapists – who are making an immediate impact.
They are able to advise parents on how best to help their children who have nasal speech as a result of cleft deformities. They are also cascading their skills to local speech therapists who will provide ongoing support after the NCF have left.
This input will make a huge difference as children with cleft defects can have multiple associated problems that need addressing to give them the best future possible.
Special day today! A young man having a cleft palate repair was the 1000th patient to be operated on by the charity.
This is an amazing achievement for a team that has been coming out to India for the last thirteen years and has grown from a few people to so many on this current trip. That’s 1000 operations on children and adults who would otherwise have struggled to access care.
It is striking how far people travel to consult with the NCF. Parents have described travelling 100 km on a motor bike for their child to be seen and then travelling that distance back a couple of days later with a child who has just had an operation. Life is much harder here with none of the social support that it is easy to take for granted at home.
The “camp” is in full swing. Twelve more operations planned for today. It is nice to see more children who have had cleft lip repairs last year who have returned to have their palate repair on this occasion.
The main problems that parents mention is that their child’s speech is affected and has a nasal quality so they may be difficult for other people to understand and that liquids come back through the nose when they are drinking.
Corrective surgery will help speech development, which can then be improved further by speech therapy and it will cure the nasal regurgitation. Many of these children are underweight due to malnourishment and recurrent infections in part due to their cleft problems. The majority of them are much smaller than children of a corresponding age in England.
The ward is now full of pre and post op patients – the chatter of families and the sound of crying babies is loud. Louise and Mandy, NCF nurses, hold the fort admirably, juggling temperature checks, wound care, encouraging fluids and advising parents on how to manage once they are home.
Families sit cross legged on the beds patting their children to soothe them and making hammocks out of shawls tied to the bed rails in which they swing their babies to sleep.
A routine of early starts and late finishes for the team means there is hardly any time to get a feel for Aurangabad, all we see is from the bus windows as it takes us to the hospital each morning.
We pass the same group of school children on their daily commute – pristine blue and white uniforms standing out on the dusty roads. Rickshaws and motor cycles weave about, jostling for space and avoiding the bullocks ambling forward against the flow of traffic. Seemingly oblivious to potential dangers women sit helmet-less, side saddle on the back of the bikes, holding one child on their laps, whilst another sits at the front of the bike steadied by their father driving,
The journey to the hospital takes about half an hour. A large banner across the gates advertises the work of the NCF. The charity has access to three operating theatres and a ward which are used exclusively for cleft patients during these eight days.
The facilities are very good; it is remarkable how smoothly the whole operation runs as everyone has a dedicated role – the huge expertise within the team is very evident.
The “recovery” area has been “shared” and comprises a waiting area for children going to theatre, an area for the speech therapists to work and an area for pre-op assessments.
There is a steady flow of information between all departments and an incredibly calm atmosphere which must be very reassuring to the parents.
The “recovery” area is re-configured again as part of it is transformed into a seating area for delegates coming to the first NCF Masterclass in Cleft Surgery being run by consultant surgeons and anaesthetists from the team.
It starts tomorrow – Professor Gosla Reddy, cleft surgeon from Hyderabad will also be lecturing on Sunday. Video equipment links theatres to screens in the lecture area so that attendees will be able to watch operations in real time. The staff of Hedgewar Hospital have done a great job organising all this.
Operations continue as before. A young man called Ganesh is seen in pre op clinic – he has a severe bilateral cleft lip. His parents are accompanied by the headmaster from the local village school – he is the one who has advised them of the Northern Cleft Foundation’s work and encouraged them to bring Ganesh to the hospital.
It is hard to know how Ganesh feels – he is thirteen years old – an awkward age when teenagers are very conscious of their appearance… it is impossible to imagine just how difficult this must be for him.
It is also wonderful to think that something can be done to help. He is shown a before and after photo of someone who has had corrective surgery… it is worth more than a thousand words.
The Masterclass is underway. Indian doctors listen to lectures and watch operations in progress, as everything else continues as before.
The father of an eighteen year old boy, who has had his palate operated on, arrives to present Dr George Teturswamy with a box of Indian sweets to share out amongst the team. He is thrilled that his son has been able to access corrective surgery and hopes it will give his son the confidence that he has been lacking.
Up on the wards it is as busy as ever. All those people who donated bubbles, balloons and colouring books would be thrilled to see them in use. Bubbles prove a great distraction and are used to keep little ones enthralled whilst waiting for theatre, having their wounds cleaned or just to cheer them up. The older children spend hours colouring in.
Clothes that have been donated are shared out. It is often difficult to know which babies are boys and which girls. They all have a mass of black hair and liquid brown eyes; little boys can be dressed in pink and little girls in blue and both can have their ears pierced so the usual clues are absent.
The penultimate day sees the last pre-op session. Nearly everyone who has attended for surgery has had an operation. Just a few babies were too small and poorly nourished to be operated on, so their parents were given feeding advice and will be seen again next year.
Many of the children who have had operations have been discharged as most of them are kept in for just two days post operatively. Often parents have had to stop work and therefore stop earning to bring their children to the hospital. Occasionally grandparents bring the children in as their parents cannot afford to lose a day’s wages cutting sugar cane or working on the farms. Loss of earnings means lack of food on the table.
A local philanthropist, Mr. Khinwsara, provides all the food for the families during their stay. They are given coupons for their travel expenses which they redeem on the ward.
The final day of operating. 83 operations in 8 days. 83 lives changed this week.
Today finishes earlier than usual – many of the team have had twelve to fourteen hour days at the hospital during the week. The team head back to the hotel on the bus in daylight – a change from the usual trip after dark and a chance to catch one more glimpse of Aurangabad hustle and bustle.
There will be a final ward round tomorrow morning and then the NCF will head back to Mumbai to fly home, with talk no doubt turning to the next trip to Nagpur in January 2015.