When we as workers run up against those stretches where 12-hour days are the norm, the ending is a welcome feeling. Tarrytown, N.Y.'s Dr. Michael Koch can count on a two-week period like that every year but leaving these long days behind is actually the hardest part. "If you could stay longer, you would," he says of his annual trip to a developing country with an organization called Smile Train.
A cleft lip is a congenital deformity that leaves millions of children around the world disfigured with no access to augmentative surgery. "You can't smile," says Dr. Koch. "That's why theycall it Smile Train." And bringing lifelong changes to as many children as possible is its mission.
The condition occurs because lip tissue that normally fuses together remains separated. Medically, it can cause severe feeding problems for infants, and if the pallet is cleft, speech can be affected. In turn, he says, "If your speech is impaired your development will be delayed."
Of course, it's hard to overlook the impact that appearance will have on the rest of these children's lives. "How other children respond to them can be a very significant social development issue," he says.
It's probably safe to say that's an understatement, but connecting to this organization 13 years ago in a first mission to the Philippines fit rather nicely within Dr. Koch's specialty as a plastic and reconstructive surgeon. "The wonderful thing about plastic surgery is it's a very portable specialty," he says. "That's to say, we can do most of the surgeries with instrumentation that I can pack in a suitcase."
On the other hand, the trick for the larger organization is finding a local hospital thatis capable of providing two or three operating rooms -- giving access to hundreds of patients. After the word is let out to the community and Smile Train arrives, he says, "We really do take over the hospital."
Dr. Koch describes the onslaught of hope in sheer numbers as dramatic. At the same time, the days are long and hard for "Healing the Children" -- the local chapter of Smile Train professionals that the Scottish born doctor travels with. Nonetheless, he says, "It doesn't feel like work because the team spirit is so strong and enthusiastic -- it just feels good to do it."
Averaging about $250 per operation and many times done in less than 45 minutes, there's still a cold reality to the effort. "You know when 600 children turn up, you're not going to be able to help all of them," he says.
Fortunately, solace can be taken in Smile Train's educational component, which teaches local doctors to manage the patients once the train has left.
Otherwise, he's not beneath reaching out to the community for financial support to this longtime nonprofit, but he couldn't help being touched by the initiative his patients undertook before his last trip. Collecting more than 400 Beanie Babies for the children, he says, "That was very gratifying to see."