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Honduras

Experiencing the Patient Announcement in Honduras

Honduras

Experiencing the Patient Announcement in Honduras

By Kelly Raymond, Certified Child Life Specialist.

When I arrived in Honduras for the Operation Smile medical mission, veteran Operation Smile volunteer nurse Norrie Oelkers told me, “Honduras is the gold standard of Child Life. Just you wait …” Nothing could have prepared me for what I was about to experience.

Operation Smile Honduras is very well-established with a permanent cleft lip and cleft palate center in Tegucigalpa where local medical professionals offer surgeries and other essential care to patients year round. The organization truly values the work of Certified Child Life Specialists (CCLS), providing psychosocial support and procedural preparation for children who receive cleft lip and cleft palate surgeries during Operation Smile medical missions.

Operation Smile continues to strive toward enhancing not just surgical care but psychosocial care, as well, and to hold all work to the highest global standards of care. Operation Smile has created a role called Child and Family Advocate (CFA). CFA’s, like CCLS’s, provide psychosocial support and surgical preparation to patients and families during the medical missions in Honduras. CFA’s have a background in psychology, child development or other related field and experience working with children and families. CFA’s must complete a credentialing process including direct mentorship by a fully Certified Child Life Specialist (CCLS) before working independently on Operation Smile medical missions.

I had the privilege of traveling to Honduras for a medical mission in February to mentor and credential three local Honduran volunteers to become CFA’s.

Iris Velasquez, the lead Operation Smile CFA in Tegucigalpa, has carved out an amazing role and reputation for herself and the other CFA’s. Children and families adore her, professionals respect her, and her personality and charisma could even make grumpy cat smile. I affectionately call her “Mama Honduras”.

The CFA role with Operation Smile Honduras is slightly different than the CCLS’s on other Operation Smile medical missions around the world for a few reasons.

1. During medical assessments, CFA’s meet with each family to inform them about whether the doctors have deemed their child eligible for surgery.

2. CFA’s are responsible for making the patient announcement, letting all families know if their child is scheduled for surgery.

3. CFA’s accompany every child into the operating room.

When I look back on my trip to Honduras, I wanted to share my story of the patient announcement, as this is something that few Operation Smile volunteers get the opportunity to experience.

Since becoming a volunteer with Operation Smile, I’ve often heard of some Central and Latin American countries using psychologists to explain to families why they were or weren’t chosen for surgery. I always admired this and felt it was a compassionate way to deliver life-changing news. Many of these families travel for days only to find out their child isn’t getting surgery. It makes perfect sense to provide psychosocial support to families and answer their questions. You can imagine my astonishment when I found out that it’s actually the CFA’s, or CCLS’s role. Upon hearing this I was hit with a mixture of emotions. The only way to describe what I felt was ‘cautious excitement.’ There was going to be elation, grief, happiness, disappointment, and joy. I was ready.

Iris and I arrived at the hospital at 6:30 a.m. Saturday for the patient announcement. As we turned the corner to a large open courtyard we were greeted by more than 200 children and families anxiously awaiting news that could change their life. Some of these families were from Tegucigalpa, and some were from far away. One family had traveled for two days by foot, canoe, horse and bus.

We squeezed our way through the crowd and stood on a raised platform overlooking the sea of people with worried eyes and hopeful hearts. The air felt so heavy with emotion and worry, the tension was palpable. Iris jumped up on the ledge and immediately started entertaining the crowd to energize them.

The families loved her and she loved them right back. She told animated stories, jokes, and even got the crowd chanting “OPERACIÓN SONRISA!” Her enthusiasm and energy broke the tension and, for a brief moment, it felt like a celebration. When Iris was handed a pile of cards, the laughter died down and the air became heavy again.

Each card had a patient’s name on it, and one by one Iris started calling the names of patients scheduled for surgery. As names were called, people would raise their arm to identify themselves. The card would crowd surf its way through the sea of hands until it reached the excited and relieved recipient.

Some children had been turned away several times in the past, and were now finally receiving surgery.

Squished in beside me amongst the crowd was an 11-year-old boy I had met during medical screening the day before. As names were called, he and I occasionally played peek-a-boo or made funny faces at each other. His grandmother cheered as names were announced, saying things like “Oh I’m so glad they got picked! Good for them, I’m so happy for them!”

Slowly the crowd trickled away and only 10 families were left, including the boy I was interacting with. At that point Iris announced, “If you didn’t hear your name called, please come see me.” One by one, Iris met with families to explain why their name wasn’t chosen for surgery. This can be due to various reasons (too young, malnourishment, or simply too many patients).

I stood back and watched from a distance while Iris hugged the crying mothers, explaining to them why their child wasn’t chosen for surgery. Their tears and questions were met by comfort, reassurance, and even hope that one day their child would receive surgery. These were heartbreaking and intimate moments to witness.

Iris then met with my young friend and explained why he hadn’t been chosen for surgery. When I saw him again later, I told him I was so sorry to hear that he wasn’t getting surgery. In Spanish he replied, “Me too ... oh well, maybe one day I’ll get it done.” He then tapped my arm as if to say ‘You’re it!” and ran away, expecting me to chase him. We played a bit longer, and then he went to blow bubbles for the younger kids waiting in line for blood work.

This boy and his grandmother were understandably disappointed but not crest-fallen as I would have expected. His resilience moved me, and reminded me of the nature of the Honduran people. Despite their troubled history and past, they radiate strength, beauty and character, embrace the gift of today, and strive for a better tomorrow.

We often hear touching stories of children who have received surgery, but rarely hear about those who didn’t. Witnessing the patient announcement made me realize that those who don’t receive surgery are equally a part of the Operation Smile family. They are the reasons we keep coming back. They inspire us to keep doing the work that we do and remind us there is always work to be done.

A quote hangs on the wall of the Operation Smile Honduras clinic in Tegucigalpa. It reads, “Que la sonrisa de los ninos sea el motor que impulse nuestro corazon. May the smiles of children be the engine that moves your heart.”

Operation Smile Honduras is a glowing example of exemplary psychosocial support for the children and families, and the patient announcement is a testament to that. I’m grateful for having the opportunity to participate in the Operation Smile Honduras medical mission. I learned more than I could have imagined, and feel inspired for future missions.

Together, we are all part of the Operation Smile story. Take a moment to share with us why you're involved with Operation Smile. How your life has changed forever. It is, after all, your story and your commitment that helps make our work possible.

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