Welcome to the Congo

The hour drive from the airport to the hotel looked much like some of the other countries I've visited. There are cell phone ads everywhere, dirt roads lined with women selling fruits under umbrellas, shanty shack shops and vehicles sputting out pollution driving around. I wanted to take pictures, but not the first day since picture taking is illegal in Kinshasa (consequence is confiscation of camera or deleting photo and paying a fine). After arriving at our hotel, I immediately meet up with my fellow research staff of Operation Smile and prep for our research project. We are collecting genetic samples via saliva and administering questionnaires to see different genetic links and environmental exposures that may lead to cleft lip and palate. We collect saliva samples from mom, baby and dad if he is present and administer the survey to moms and dads. Cleft lip and palate occurs during a woman’s first trimester in pregnancy (first 3 months). We are hoping to collect about 75-100 families with cleft lip and palate and compare it to about 250 families that have babies without cleft lip and palate. Our plan is to survey for 2 days during the Operation Smile screening of potential candidates for surgery and then survey in the community for the next 5 days for unaffected families. At the end, we do not quite reach our original goal but realized the unrealistic expectation we set for ourselves and collect the most that we can. Our skilled translators are doctors and medical students that speak English, French and the local dialect called Lingala. As always, I am impressed by the linguistic knowledge of other countries as compared to my own where most only know English and are at times intolerant to the thought of learning another language must less mastering it to fluency.

I love being with the mission for the screening days. You meet so many families and people who have suffered with cleft lip and palate. Some new mothers have shame for delivering a baby with the birth defect while other people live into their late adulthood and a lifetime of ridicule with their deformity. Families traverse considerable distances for even the chance to be screened. Not all of our patients have cleft lip and palate, those with severe burns, keloids (huge bulging scar tissue), microtias (missing an ear) and other craniofacial anomalies also arrive. Operation Smile allows everyone to go through the screening process despite their unlikelihood of being a surgical candidate. I am always impressed at how organized and smoothly the missions run. A team of about 150 people where each person has a specific and important role, including high school students that perform health education, cohesively screen and prep patients for surgery in the span of about 7 days. Operation Smile relies heavily on locals to volunteer as translators, provide the team with sponsored dinners and lend a huge hand in planning logistics. The number rule on our missions is to be flexible. Anything can happen and usually something does like missing cargo and medical supplies, shortages on drugs, travel delays or in our mission, absence of the last banquet dinner that is typically formal filled with a celebration and thank you to our volunteers since our sponsor mixed up the date of the banquet.

The research component that I am a part of did not spend a ton of time with the rest of the mission especially during surgical days since we had to venture out to the local community for our control recruitment. Our research piece is a newer branch with the vision from co-director and founder Kathy Magee that we want to find the root of the cause of cleft lip and palate instead of just always providing surgeries. My position is currently a part-time consultant titled “Research Coordinator”. My main role will evolve heavily when I return from Africa in July to manage this research project called the International Family Study, targeted to find the genetic and epidemiological links of cleft lip and palate development in multiple developing countries around the world. Our pilot is in Kinshasa, DRC but we also have collected from Vietnam and Peru in the past.