MisSiOn IN KenyaiFrom Lladró’s perspective, there is a double purpose for taking part in this mission. One is because I want to share with you and, as far as possible, I want to help you to live through my eyes and through my travel diary the highly satisfying experience of making life better for these youngsters as a way of thanking you for all the donations that many of you have made by purchasing Lladró sculptures. We also made this journey because it is our aim to open an Operation Smile Foundation in Spain to carry out future missions in Spanish-speaking countries; that is why my travelling companion on this occasion was USP España plastic surgeon José Ignacio García Ceballos whose task was to evaluate medical and organizational requirements.

For both reasons, I travelled to Kenya being aware of the important role we play there.

WEDNESDAY, OCTOBER 25TH

We arrived at Nairobi at 10 p.m. on Tuesday, October 24th, and spent the night there, since we had been warned that travelling to our fi nal destination during the night was highly dangerous. The city of Nairobi itself was totally deserted at that time.

Early the following morning, all the volunteers going to Nakuru gathered at a local hotel. Apart from our group, there were many other volunteers, since two other Operation Smile missions were being carried out in Kenya simultaneously: one at the National Hospital in Nairobi itself, with 43 volunteers, and another one in Kisumu, with other 43 volunteers.

The 57-member team going to the Nakuru mission left on several buses and, on the way, it was odd to see the diversity of people and nationalities inferred by their physical features and, above all, to feeling that we were strangers to one another at that moment, which naturally changed as days went by. One thing we did share: the desire to help.

It was a three-hour journey and, though most of it was uncomfortable due to the poor conditions of the road, it offered us the few opportunities we had to see some beautiful landscapes in Kenya, such as the Rift Valley, amazing because of its size and beauty. Besides, we could see the humble living conditions of these people. Natives waved at the bus convoy showing their welcoming nature, without even knowing the purpose of our visit.

Towards noon, we arrived at the city of Nakuru where we could appreciate how different it was from Nairobi: it was a much smaller, calmer and safer city, but still keeping the organised chaos common to all parts of Africa. On the way to the hotel, we crossed the main street, where trade is conducted and, once again, we could per-ceive the limited spending and purchasing opportunities. The only things that could be purchased there were basic products, that is, groceries and clothing, except for some local handicrafts for visitors and tourists.

After checking in at the hotel, we started the mission program with a preliminary meeting in which we were told how we were to be organised and were asked to introduce one another, telling where we were from and which our role was going to be. There were doc-tors, nurses, medicine students and more volunteers to meet all the needs of the mission. For me, practis-ing this exercise was one of the fi rst signs of profes-sionalism and wide experience of the Foundation and of how important it was for complete strangers to be able to form a strong team accordingly as soon as possible. Besides, it was very interesting to be able to put a face to the list of participants previously sent. To make things even easier, we were given an ID card that we would carry during the whole mission, with our name and the role we were to play.

Arrival at the Nakuru Hospital. Shortly after that, we made our fi rst visit to the Nakuru Provincial Hospital, where the mission was going to be carried out. Upon our arrival, we found an old hospital though in pretty good conditions; no doubt, it was the best option in many kilometres. Its struc-ture was made up of many small in-dependent cabins, where people were distributed according to their illnesses. All blocks were separated by gardens which, though not very well looked af-ter, contributed to making that place nicer and, to some extent, it was clear it had been an English colony some time ago. These gardens are now used to hang the patients’ clothes or as a waiting place.

“Towards noon, we arrived at the city of Nakuru.”

“All blocks were separated by gardens which contributed to making that place nicer.”

We were pretty lucky, because, in order to undertake the mission, a large block was emptied, which seemed to have been used to store bits and pieces before our arrival, and, judging by what we could see in the other blocks, they must have worked really hard to leave it the way we found it; one could even notice that it had just been painted. We had the basic and suffi cient things to carry out the fi rst part of the mission.

In that place, the following day, the examinations on the children that might be operated on would start. This task would take three full days and, even afterwards, once surgeries started, the staff would be pre-pared for more examinations if someone else showed up.

Preliminary Medical Tests. Grace, a great local volunteer nurse, offered us an interesting and detailed explanation on how the examinations of children had been organised step by step in this temporary clinic. The process would start in the waiting room where children would wait to be called, accompanied by their families. Said waiting room was a porch located outside the block, where I would end up spending most of my time, though I still did not know it.

After being called, they would go into the block to be examined medically. In the fi rst stage, patients’ data would be collected and they would be assigned an ID number which they would keep until the process was complete, including the surgery. After that, they would be taken a series of photos from different angles to record their pathologies and how serious they were. Thus, they would obtain an accurate record –as far as possible– of each step which would then be used to compare the evolution visually after the surgery.

As of that moment, specialist doctors would examine their patients deeply following a stipulated order: paediatri-cians, anaesthetists, plastic surgeons, dentists, haematologists, speech thera-pists and, fi nally, another doctor would be in charge of verifying that the record was entirely in order, with the individu-al reports by the specialists in charge of the examinations.

For Operation Smile, safety is crucial at all times and only perfectly diagnosed cases make it into the operating the-atre, and absolute priority is given to cases of cleft lip and cleft palate. Oper-ations are always carried out using the techniques developed by Dr. William Magee, founder of the project. After-wards, following the same strict diag-nosis and safety criteria, other patholo-

gies are operated on, such as burns or tumour deformities since, logically, the intention is to see to the highest number of patients.

In addition, we had the option of diverting the more complex patients to the National Hospital in Nairobi to be operated on there, as they have more technical resources than in Nakuru.

THURSDAY, OCTOBER 26TH

Everything was ready to start. The provincial mass media had been announcing our arrival for several days invit-ing everyone who needed medical care. We were quite surprised to see the number of people who went there. The waiting room and the gardens around it were packed with people, most of them children accompanied by a family member, though some were sick adults.

I will never forget my fi rst moment of contact, nor the look on the faces of those children, some younger some older, as they looked at us as if they had just seen aliens, uncertain of what to expect of us. It was no less

“We were offered a detailed explanation on how the examinations of children had been organised step by step in this temporary clinic.”

striking to see the children who were down for surgery. I had never seen so many children with cleft lips and so many young patients with this kind of deformities and burns.

It was really sad to fi nd so many needs and, at the same time, it caught my attention that so many girls were wearing long bright colourful dresses on their casual clothing, like the princess costume our girls would wear for parties and games. The fi rst thing that came to my mind was that it was their way to welcome us, but I realised later on that it could be the way their parents found for their children to call our atten-tion to be liked and, in this way, be part of the selected group.

A Story for Daniel. Honestly, everything was extremely sad, but we were not there to feel sorry for them; we were there to give them con-

fi dence. And that was what I told myself over and over again as I fi nally managed to approach them in an attempt to break the ice. I recall ap-proaching a child with a cleft lip who had come with his mother and ask-ing his name. His mother told me his name was Daniel and was a year and four months old; then I asked Daniel if he would like me to tell him a story and he looked at me with wide open eyes as he smiled shyly and approv-ingly. His mother also smiled shyly and gave her permission so I opened my backpack and pulled out some-thing that I knew was to become a treasure to these little ones: four of my own children’s favourite stories; a child’s hopes and dreams go be-yond borders and languages. Indeed, Daniel loved them and they quickly aroused the other kids’ interest.

It was great to see how parents, chil-dren and I myself did not feel com-pletely strangers now and, for me, it was particularly touching to see I was somehow helping them by mak-ing their waiting hours happier and funnier.

The whole team made a great ef-fort for these people to feel really welcomed from the very fi rst day. On the one hand, we had the price-less help of local volunteers, whom, “Parents, children and I myself did not feel completely strangers.”

“We were quite surprised to see the number of people who went there.”

naturally, people felt more comfortable with since, in addition to being experts in their medical fi eld, they also helped to translate into their local language, Swahili. On the other hand, all foreign volunteers were highly experienced since many of them had participated in other missions of the Foundation previously. In fact, many came half-disguised or with toys that hid their medical instruments, stunts that would facilitate the examination on the little ones. Besides, the place was decorated with fl ags and balloons and the little ones received toys; it really seemed to be a birthday party rather than a medical appointment. Everything that would help to make the uncomfortable tests easier and more bearable for children was important.

Three Days of Examinations. During three full days in a row, medical examinations were carried out. I had the opportunity of accompanying several children through this process, including the fi rst one I met, Daniel. Thanks to him, it is easier to put a face and a name to this account. Although, of course, for us, all the kids deserved the same attention and the opportunity to improve their lives and, thank God, this was going to be the case for most of them. I say “for most of them” because, unfortunately, not every person could be operated on. As incomprehensible as it may sound, currently, it is not possible to perform surgeries on people who have, for example, the fever, let alone more serious pathologies such as infections.

If patients had the fever, the operation was postponed a couple of days to see if they improved. However, in other cases, such as children with malaria, they did not have the option since it would be too risky to perform the surgery as they might not come through the operation. Doubtless, this was the cruellest part of the project; it was really hard to tell these people they would not be operated on, but it would have been extremely irre-sponsible for us to risk their lives in the operating theatre, although we really wanted to help them.

SATURDAY, OCTOBER 28TH

On Saturday afternoon, the list of the fi rst 30 people scheduled for operation the following Monday was posted; then the names of the other persons to be operated on the following days would be known. There we were, families and volunteers. It was a very intense moment, engulfed in silence. Nurse Grace told the names of those chosen, one by one. I was really pleased to hear the name of many of the children I had met, including lit-tle Daniel. At the same time, I was surprised to see that, when people heard the name of their family members, they would not scream happily or show any sign of satisfaction, despite their desire to be part of that list. Later I understood that it also entailed the risk of an operation and that was not easy for anyone.

In any case, for us, it was a happy day because we had enough cases to consider the call successful and now we only had to wait until Monday to begin the operations. That night, the whole team was honoured with an offi cial dinner, unquestionably, a nice way of soothing the nerves of the past days.

SUNDAY, OCTOBER 29TH

Sunday was our free day and we were taken to a photography safari to the Nakuru Lake Natural Park. We had the opportunity to enjoy a beautiful landscape, and also to get to know one another better, particularly thanks to the game we all participated in, a requirement that must be met by every volunteer in all Operation Smile missions.

The 57 members of the team sat in a circle and we all had to repeat the name of the others by heart. It was not easy, but honestly, it was funny and necessary so that we all formed a team. From that moment onwards, the work and the coexistence were much nicer since we could all address one another by our names, no matter how diffi cult they were to pronounce.

MONDAY, OCTOBER 30TH

At last, the longed-for Monday morning arrived; for many volunteers it was the fi rst day of the mission since operations began that day.

We had to take full advantage of each and every day ahead, and it seemed we were going to, as we arrived at the hospital at 7 a.m. and the day was scheduled to be completed at 7 p.m.

Dr. García Ceballos and I were also waiting for the beginning of the operations eagerly and, in our case, with the additional incentive of living it fully, as intensely as possible, since the following day we would set out for Spain, after having spent a week in the mission. That is why we wanted to participate in as many activities as we could during a day and a half. It was enough time, taking into account that 30 people were going to be operated per day, each operation lasting an average of 40 minutes.

This stage of the mission was also scheduled strictly, beginning with a fi nal preoperative medical examination to ensure that the conditions of each patient were still optimal, with no dangerous infection or fever. Otherwise, the operation could be postponed a few days.

While the patients were waiting to be operated on, the children were taught about the medical instruments using toy reproductions of those devices they would later see in the operating theatre so they could be, in a way, familiarised with them and would not be afraid.

To perform the operations, we had two operating theatres –each one equipped with two operation tables– and seven foreign and local plastic surgeons. Teams of two surgeons per table were organised, which will allow for two simultaneous operations per operating theatre, thus taking full advantage of the facilities. By working in pairs, the operation would be speeded up; they could take turns so that no surgeon would suffer from exhaus-tion during the 12 hours of daily operations. After the surgery, patients would go to the recovery room and, later on, they would be hospitalised and then discharged.

Exceptional Opportunity to Witness an Operation. Once the theory was explained, it had to be put into practice and I was going to have the chance of living it fi rst-hand, since I was offered the opportunity of accom-panying Daniel during the whole process as he was one of the fi rst cleft lip cases of the day. Honestly, I was a bit inhibited by what witnessing the operation would mean, but I could not miss this exceptional opportu-nity and decided to do it, thinking that Daniel would feel less lonely or scared in that strange place.

As soon as we arrived at the hos-pital, each of us occupied our po-sitions. José García Ceballos went directly to the operating theatre to assist the fi rst operations, an im-portant part of his stay there, and I went to check out the fi nal preoper-ative examination. There they were, Daniel and his mother, and thank God, all the examinations were go-ing well, including his, so I walked them to the waiting area. The chil-dren hanged out there playing with the surgical toys mentioned before,

“The children were taught about the medical instruments using toy reproductions of those devices they would later see in the operating theatre.”“The children were taught about the medical instruments using toy “The children were taught about the medical instruments using toy

but the little ones, including Daniel, would not stop crying because they were hungry since that morning they had not eaten anything due to the operation. It was almost impossible to calm them down, although Daniel ended up falling asleep in his mother’s arms.

At last, we were told the operation was about to begin. I put on my operating theatre clothes and went for Daniel. His mother placed him in my arms as he slept and, after promising her everything would go well and would be over in less than an hour, I took him into the operating theatre. About Rosemay, his mother, I can only say that she was a woman with incredible determination and unusual calmness.

“Now Daniel’s cleft lip would be operated on.”

Now Daniel’s cleft lip would be operated on. Once inside, I was surprised to see how many people were there; I could not recognise some of them at the beginning for the masks there were wearing. Next to the surgeons, there were the anaesthetists, the nurses and a group of students who would not miss a thing. Someone told me where I should place Daniel and several people put electrodes on him to check his vital signs. He woke up crying but the anaesthesia mask was placed on him right away and, because he was crying, he inhaled the gas faster and fell asleep soundly immediately. At that moment, I was startled when I realised what a tiny part of the operating table’s total space Daniel took up. I took his little hand to make him feel better and, despite my efforts, I was unable to hold back my tears.

The plastic surgeon who would perform the operation was the highly experienced surgeon Roberto Peneda from Honduras who would explain every step to me, in my own language. Roberto was assisted by the Ca-nadian plastic surgeon Arthur Rideout. The operation was very interesting and I could see the whole process closely, appreciating Roberto’s skilled and meticulous work. I saw for myself that the Foundation only draws on top-class surgeons.

Daniel’s Waking Up. As the operation followed its course, we all knew it was going to be a great success. It was amazing to see Daniel’s little face without a blemish and I was fi lled with great happiness. After congratu-lating the surgeon for the results, I took Daniel to the recovery room, where I felt sad to hear the other children crying. It is particularly traumatic for them to wake up after an operation because they feel the pain and are confused and scared. We left Daniel on his bed and we tuck him in with blankets until he woke up.

“Now Daniel’s cleft lip would be operated on.”

I could not help it and jumped protocol (no news should be given to parents until children leave the recovery room). I ran outside to tell Daniel’s mother, at least, that all had gone well and that her child was now even more beautiful than before. She smiled and thanked me but I knew she would not calm down until she saw him. In a few minutes, Daniel started crying and, when he was stable, I was authorised to take him to Rosemay’s arms, whose face lightened in a few seconds, an image I will never forget. She did not cry, but was fi lled with happiness. I was fortunate to be able to share that moment with them, an exceptional experience.

The three of us went to the block where the hospitalised patient’s rooms were, a section of which was dedicated to the patients of the mission. There, there were other children who had undergone surgery. We found a bed for Daniel and, after making sure he was fi ne, it seemed ap-propriate to leave them alone. I also felt the great need to know how all the other kids whom I had spent intimate moments with were doing. I went from hospital bed to hospital bed to see each one for myself and, little by lit-tle, more arrived. It was incredible to see how well all the operations had gone – even if their fatigue was there for all to see. I just felt happier and happier. I spent what was left of the day coming and going from the operating theatre to the patient’s block being there for the parents and their children while waiting to be called and after the operation. Now I had plenty of powerful argu-

ments to calm them down, as I could tell them, from fi rst-hand experience, about the positive results of the operations already performed; thus I could build up their trust and calm down their nerves. It was an intense and satisfying day.

However, on the other hand, José and I felt somehow sad because our time in Kenya was almost over and we would leave the following day…

TUESDAY, OCTOBER 31TH

On Tuesday morning, we made our last visit to the hospital. We both hoped to have enough time to say good-bye to everyone and I did not want to leave without spending some time with the children before I had to say good-bye for ever. Likewise, I wanted to get some addresses to receive news from them from time to time. Besides, that morning I had been offered the chance to watch another operation: a palatal fi stula case, which, along with cleft lip, is Operation Smile’s main speciality.

So fi rst I went to the block were the operated children were to see how they had spent the night and it was incredible to see how different the place looked compared to the previous day. It was a lovely Halloween morn-ing and the radiant sunshine streamed through the worn windows of the hospital wards. The nurses and some volunteers had decorated the room accordingly. The situation was nothing like that on Monday: the children were happy and almost none was crying; many even played on their beds and this seemed to be the best sign that they were recovering favourably. The parents - still tired for having taken care of their children during the night - were fi lled with happiness to see their children as vital as usual. Everything reminded me of a heart-warming Christmas family gathering and I felt happy and fortunate to be the person representing Lladró, the one with the privilege of living these moments.

That reminded me, satisfactorily, of the values that have made Lladró unique and of the commitment to the underprivileged of all those working there. At that moment, the most important thing for me was to see that the children felt well and that their parents were happy.

“I realised that there was a job to be done and I quickly pulled myself together.”

After some touching minutes –which seemed seconds– I was told the other operation was about to begin and had to go to the operating theatre. This operation was much more complicated than Daniel’s. They had to close a hole located at the bottom of the palate, which prevents children from speaking correctly. It was a diffi cult process as the entire palate had to be detached by levering it with a spatula, after cutting the perimeter with a scalpel, to place the muscles that help to articulate speech in the right position. Then the hole and the palate edge were sewn with stitches. When the operation was over and after congratulating the surgeon, I said good-bye to the volunteers that were working in the operating theatre trying not to interrupt their work. With them and the rest of the team, the farewell was just a “see you soon” because we all hoped to participate in new missions of the Foundation and –why not– to see one another in some part of the world.

I went to see the child’s parent to tell them everything had gone well and walked them to the block where their child was. All those moments with all of them were really sad, though the saddest one was when I said good-bye to the little ones. I sensed that Daniel, despite being little more than a baby, was aware that I was about to leave because he threw himself into my arms as soon as he caught sight of me. This was one of the most special displays of affection I received in Kenya. I asked Daniel’s mother for her address and did the same for many other children. This way, I felt less sad because I knew I could hear from them.

Before I left, I gave Daniel one of my story books –the one that had been most popular among the little ones– which was, indeed, the fi rst story I told him upon my arrival. I gave the other story books to the volunteer nurses so that the other children could see them during the week and, with a simple but deep “bye all”, I left.

After saying good-bye to the last volunteers, José and I left for Nairobi to visit the Operation Smile mission being carried out simultaneously at the city hospital, where the more complex patients who could not be seen to in Nakuru were operated on. It seemed to be a completely different world, since it was a huge hospital, nothing like Nakuru’s, with a capacity to perform operations on many more children.

Heartfelt Appreciation. A friend once told me that when you go to a place like this, you think that you are going to be of help –and I am sure that we have been able to lend a hand– but it is also true that you take away with you much more than what you gave. Indeed, it has been incredible for us to witness fi rst-hand the efforts that the Operation Smile volunteers carry out daily so selfl essly. The whole trip meant an experience that was exceptional, in that it was different from our daily life, intense, in the full commitment of all the volunteers, and satisfying, in the good we did.

Thank you all.

“We all hoped to participate in new missions of the Foundation and - why not - to see one another in some part of the world.”

“A friend once told me that when you go to a place like this, you think that you are going to be of help but it is also true that you take away with you much more than what you gave.”