Healing More Than a Smile
For 22 years, a cleft lip shaped Joseph’s life. Born with the condition, he had grown used to isolation. “I always feel alone because people don’t want to be around me,” he admitted.
Over time, his world grew smaller, and fear took hold. In 2016, his aunt heard that patients with conditions like Joseph’s could receive free surgery on board Mercy Ships’ hospital ship, the Africa Mercy, in Madagascar. She urged him to go, but the thought of people staring at him was unbearable. What if they laughed? What if they turned away? Joseph stayed home, withdrawing further from a world he felt had already pushed him aside.
He dreamed of change but resigned himself to solitude: “We don’t have surgeons in our village; besides, I cannot afford the surgery.”
Eight years later, weary of being defined by his condition, he was ready to seek help. When Mercy Ships returned to Madagascar in 2024, he found the courage to act.
He traveled 12 hours to the port city of Toamasina, where the Africa Mercy was docked. As he neared the end of the exhausting journey, his loneliness felt heavier than ever. “If I had friends, I wouldn’t have walked alone,” he said.
Joseph was among the many adults cleared to receive cleft lip repair surgery on board. Volunteer lead surgeon Dr David Chong immediately noticed the toll the condition had taken on Joseph’s confidence.
“I’ve seen so many older patients now… they tend to avoid eye contact and often seem unsure of themselves,” he observed. “Joseph is an example of a young man emotionally scarred by his cleft.”
A cascade of knowledge
In Madagascar, 80% of the population lives below the poverty line, which limits access to healthcare. Delayed treatments result in poor health outcomes and specialised medical professionals are scarce, leaving conditions like Joseph’s untreated for years.
In contrast, in many high-income countries, cleft lip is often repaired with surgery within the first few months of a baby’s life. These routine procedures usually include follow-up care like speech therapy, orthodontics, and additional surgeries if needed. Access to high-quality healthcare, advanced medical technology, and multidisciplinary care teams make cleft lip treatment highly effective.
As an expert in cleft lip and palate repair surgery, Dr Chong believes that part of the solution to improving cleft care access for patients like Joseph is ensuring the nation’s medical workforce is equipped with training and mentorship.
Joseph’s surgical team included local health professionals onboard to receive specialised training and mentorship as part of a collaboration between Mercy Ships’ surgical training programme and a partner charity, Operation Smile. Among them were Malagasy surgeons, anaesthetists, nurses, speech therapists, and a dentist.
Joseph’s case did not surprise Malagasy pediatric surgeon and professor Romain Raherison, who had performed several cleft lip repair surgeries on older patients in Madagascar. “We don’t have enough Malagasy surgeons who really master cleft lip and palate surgery,” he explained.
A future unfolding
It took a week after surgery for Joseph’s stitches to be removed and within days of recovery, he’d already begun to feel a positive shift.
Dr Chong found witnessing Joseph’s transformation profoundly moving.
“The biggest sense for me is that it’s like a relief. He can think to himself, ‘All that stuff I’ve carried for so long, I can actually let that go.’ And I think it doesn’t mean his life will be perfect by any stretch, but it’s one less load, one less burden to carry.”
Before surgery, Joseph spoke of the dreams that had slipped away. “When I was younger, I wanted to study and become a politician, but I was not able to do it because of the cleft lip.”
As he looked into the mirror seeing his new smile for the first time after surgery, a sense of restored hope came over him. His aspirations were simple yet profound: “I want to become handsome after the surgery, and I also want to make friends.”
For the first time in years, Joseph saw a different future – one filled with limitless potential.
Joseph’s journey is just one of many stories of transformation made possible through access to safe surgical care. But there are countless others like him still in need of hope and healing. Whether you give, go, or pray, your involvement can change many more lives.