Mission Trip Puts A Smile In Nurse’s Heart

By Nancy K. Crevier

For Sandy Hook resident Jenn Placanica it was a change that affected two weeks out of her life. For the children she helped, it was a lifetime.

Ms Placanica, the mother of three young children and a nurse in the pediatric emergency unit of Yale-New Haven Hospital, traveled to Antananarivo, Madagascar, this October with Operation Smile, an organization that provides free surgery to repair cleft lips and palates and other facial deformities for children around the world. Teams of medical and community volunteers provide the equipment and expertise that restores not only physical well-being, but mental well-being, to children who might not otherwise have access to or capability to pay for medical services.

“The abuse of the medical care system here is disheartening at times,” said Ms Placanica, “so I wanted to go somewhere where I could help make an immediate difference in someone’s life. I wanted to go and walk the walk of those less fortunate than we are, and feel what they feel, and to smell the smells in another culture. I wanted to fully experience what it is like to lack the basics.”

She had heard about Operation Smile from a colleague who has taken part in more than 20 missions with the organization, and felt that this collaboration of surgeons, nurses, dentists, child life specialists, and speech therapists would fulfill her desire to help. “That was the big draw to this organization, that it is such a team effort, with everyone looking at the patient as a whole,” she said.

The application process was more time-consuming than she expected. It was not until June, four months after she first applied, that she was credentialed as having the necessary critical care experience and could apply to a mission. The missions for Operation Smile fill up quickly, though, and several times she was turned down. “One of the goals of Operation Smile is to help the country being served to become self-sufficient in care of these types of surgeries, so Operation Smile chapters in certain areas are more and more staffed by local volunteers, which is really a good thing,” she explained, but limiting to volunteers such as herself. By the time she applied to the Madagascar mission in September, Ms Placanica was feeling frustrated.

Then things suddenly took a turn. “I applied on a Saturday. On Monday I got a call asking if I could fill in for a nurse who couldn’t go, and I had only 24 hours to decide,” she said. With the support of her nursing manager at Yale-New Haven and her friends, she was able to find coverage for several shifts to which she had already been assigned. “My husband had to ask for two weeks off to take care of our kids, and if he couldn’t get it, then I didn’t see how I could go,” said Ms Placanica. Fortunately, the Wilton Police Department, where her husband, Peter Trahan, is a detective was supportive, and in just one day, she was lined up to go.

Learn As You Go

She left from JFK airport in New York City on October 21 to join the mission, three weeks after she accepted. All of her training was done online prior to her departure. It was not until she landed in Johannesburg, South Africa, the first leg of her trip, that she met other Operation Smile participants, some of whom were experienced Operation Smile volunteers, and others who were new. “Operation Smile is very organized, but it is a lot of learn as you go. I didn’t know what to expect when I arrived,” she said.

With just two years of high school French, the main language spoken in Antananarivo, the capitol city of Madagascar, she relied on university students to translate. The local Lions Club greeted the mission volunteers with a welcome dinner the first night, and provided each with a cellphone to use during the two-week stay.

Work began immediately the next morning to screen the hundreds of children, many of whom had traveled with their families on foot from distant villages. Ms Placanica was assigned to a position in the postoperative room

“The hospital was very primitive and severely understaffed. They provided the surgical rooms and the postoperative rooms, but Operation Smile brings all of the equipment and drugs and surgical materials, even bandages and gauze. In the post-op and pre-op, we had only Tylenol, Motrin, and juice to give. There weren’t enough mattresses, and families brought their own food. The babies there don’t have diapers usually, so we had one diaper per child we could give out postoperatively. In two and a half days,” she said, “we screened 256 kids to see if they were eligible, and did 176 surgeries over the course of four and a half days. It was amazing. Operation Smile is life-changing. You can help change a child’s life in areas as basic as eating, drinking, and speaking. It’s an enormous change in just 24 hours. No matter the language, you can sense the need.”

Not all children who arrive at the screening are accepted. An underlying illness or damage that has gone untreated for too long can make a patient not a good candidate. “For some, it was their second or third try at getting screened, and they still were not accepted,” said Ms Placanica. But the gentle and soft-spoken people were uncomplaining when rejected, for the most part. “The difference I saw between the people at the Operation Smile clinic and at Yale-New Haven was that in this third-world country the ‘have nots’ are still very happy, and very entrenched in the traditions of their own villages. But from the perspective of a mother, I could see that they want their children to be as healthy and well educated as I want for my children. The basic human desires are there, even with limited resources available,” she said. Facial disfigurement, generally the result of poor prenatal nutrition, can lead to being ostracized in some of the villages, so parents are eager to have defects fixed when possible.

Overwhelming Emotions

The surgery creates overwhelming emotions when parents see the improvement, said Ms Placanica, and using the “Smile Bag” pocket mirror each child receives after surgery, children cannot believe the positive change in appearance. “We had a mother come up to us, tears streaming down her face, to thank us for surgery done by Operation Smile — years earlier. Her daughter can speak properly, is beautiful now, and has completed university schooling. Fixing a child’s lips and palates can create a better situation physically, socially, and mentally,” said Ms Placanica.

In her position in the Yale-New Haven emergency clinic, Ms Placanica has observed that American “have nots” are extremely aware of what they do not have, and there are not always the tools to help those people learn to help themselves, or a willingness to go the extra mile. “Certainly people in America are appreciative, but we see a lot less graciousness in patients here than I did in Madagascar,” she said.

She has carried home with her lessons for her own three children, Tess, 8, Kyle, 6, and Audrey, 4. Tess had helped her put together little goodie bags of toiletries and small toys to be given out by the child life specialist, and Kyle donated several of his Matchbox cars for her to give away, as they helped her prepare for her trip, she said. “Audrey didn’t really understand, but she understood that there were sick babies in Madagascar I could help, just like I do here,” said Ms Placanica.

“I want my children to never be afraid to do things because of the fear of the unknown. To know that if something is unpleasant, it’s okay. This experience has engraved in me how fortunate we are here, and I can’t wait to do it again,” Ms Placanica said. “I couldn’t have done it without the amazing support group of friends, family, and colleagues who understood that desire of mine as a nurse, and as a mother, to live that experience.”

She has been asked to go on the first Operation Smile mission to Rwanda in March. “I’m considering it, but we’ll have to see how it plays out,” she said.

Operation Smile accepts not only medical personnel as volunteers on the missions, but lay people and teenagers, as well. To find out more about volunteering with Operation Smile, visit operationsmile.org.