Zack Yohan Guarino with his mother Bernadette and father Ruel before his surgery. Image Credit: Abdul Rahman/Gulf News

Abu Dhabi: Zack Yohen is nearly two years old and a bundle of energy. But his parents are still waiting to hear his first real words.

Fortunately, this could soon become a reality when Yohen undergoes corrective surgery for his cleft palate, which has so far stood in the way of his speech.

“Our son was born with clefts in his lip as well as in his palate. A life-changing surgery last year corrected his lip, and we are now eagerly waiting for another procedure to repair the cleft palate he still has,” Bernadette Guarino, 37, Yohen’s mother from the Philippines, told Gulf News before the surgery.

Yohen is one of 12 patients who received corrective surgery in the capital over the weekend as part of the second UAE mission by Operation Smile UAE.

Like the international charity, its local arm, which was set up in 2011, organises fund-raising missions in order to provide free corrective surgeries to children in countries like India, the Philippines, Pakistan, Yemen and Somalia.

Last year, it held its first UAE mission, hosted at Cleveland Clinic Abu Dhabi, and 12 patients aged between 11 months and 11 years underwent surgery. There was also a 32-year-old patient who received surgery.

Second UAE mission

This year, a total of 32 patients were screened. The 12 who have been selected include 10 children, aged nine months old and older, as well as two adult patients.

“We do not end up operating on everyone we screen, because some of the children are too young or may not be physically well enough for surgery,” explained Morag Cromey-Hawke, executive director of Operation Smile UAE.

Internationally, about one in every 750 children is born with a cleft condition. These deformities are also known to be more common in certain countries like the Philippines, India, China, as well as nations in South America.

The defects mean that children often fail to thrive because they cannot get enough nutrition.

They are also prone to developing infections and speech concerns, and to suffering from low confidence levels due to social stigma about their appearance, Cromey-Hawke explained.

Corrective surgeries

The corrective surgeries that children with cleft conditions require are often too expensive for families.

In the UAE, for instance, one such procedure can cost between Dh10,000 and Dh70,000.

“This is where Operation Smile comes in,” Cromey-Hawke said. To date, the charity has provided more than 240,000 free surgeries to children around the world.

This year’s UAE mission is once again being hosted at the Cleveland Clinic Abu Dhabi. It is seeing the participation of more than 200 volunteers from the hospital, as well as 24 other local medical volunteers.

In addition, 14 international volunteers, such as plastic surgeons, speech and language therapists and nurses, are also part of the team. The surgeries were conducted on Friday and Saturday.

Hopeful parents

Guarino is excited about her son’s follow-up surgery.

“We have three daughters, but Zack is our youngest and our only son. It will be a relief to know that he can live a normal life.

"Perhaps the hardest thing for us to witness was when other children noticed that Zack was different, and asked their parents about him. Now, with the cleft lip corrected, we want him to also develop the ability to speak,” she said.

Like Zack, Jared Angelo, aged a year and 11 months and also from the Philippines, will also underwent surgery to correct his cleft palate.

He was also one of the children whose cleft lip was corrected in Operation Smile UAE’s mission last year.

“Prenatal scans at 24 weeks gestation showed us that our firstborn would have a cleft lip, and a friend referred us to this magnanimous charity. Initially, we had to learn how to feed him using special bottles.

"Since last year’s surgery though, Jared is doing well. He still has some difficulty breathing, as well as difficulty producing speech. Hopefully, this will change after the cleft palate surgery,” said April Joy, 30, a logistics executive who lives in Dubai.

Fadi Hikmat, 32, and his wife, 28-year-old Rasha Shamoon, were another set of hopeful parents at the screening.

Their 17-month-old daughter, Edele Alqaselya, has a cleft palate that needs to be repaired, and they had been flown in all the way from Arbil in Iraq for the screenings.

“Our daughter was born with multiple congenital deformities, including club foot and a heart condition that prevented her from getting enough oxygenated blood. As a result, she had to undergo open-heart surgery as an 11-month-old,” Hikmat explained.

Cromey-Hawke explained that Operation Smile UAE would work to facilitate the corrective surgery for little Edele, but at a later date.

“She has recently had heart surgery, and we would like to operate on her at a mission conducted in a hospital that is specialised in paediatric care. We will continue to keep in touch with the family until then,” Cromey-Hawke said.


Cleft lips and palates

Cleft lips and palates are common orofacial birth defects. The affected baby is born with an opening in the lip or the palate (roof of the mouth). The conditions often lead to nutritional defects, frequent infections and difficulties with speech, as well as a loss of confidence among patients.

A cleft lip can be surgically repaired in the hospital after a child is six months of age. If the cleft lip is wide, special procedures like lip adhesion or a moulding plate device might help bring the parts of the lip closer together before the lip is fully repaired.

A cleft palate can usually be corrected after children turn a year old. Plastic surgeons connect the muscles of the soft palate and rearrange the tissues to close the cleft. This surgery requires general anaesthesia and a short hospital stay for recovery.

Some children may go on to need follow-up surgeries and dental treatment as they grow, or may require speech therapy.