Nurse Emily Silcox tells us what life is like on an Intensive Care Unit (ICU) at Great Ormond Street Hospital (GOSH) during a pandemic, before sharing why everyone has the right to a smile.
“I look after children who have had major surgeries within the cardiac ICU, and every day and every case is different”, says Emily. “Some children can get better very quickly, but there are some who come to us who sadly deteriorate quickly or are very unwell.”
The Covid-19 pandemic has impacted the way Emily and her colleagues at GOSH work. “Although we continued treating urgent cases, the trust had to change the way it worked to ensure our patients and their families were safe”, Emily explains. “For example, we had to limit the number of visitors, so only one parent allowed at their child’s bedside at a time. This was incredibly challenging for families, and we really had to support parents through it.”
“Now we wear masks for our full 12.5 hour shifts, which makes it really difficult to communicate with families”, Emily says. “It must be very scary for the children, they can’t see us smiling at them. I feel lucky that my time volunteering with Operation Smile, helping treat children with cleft conditions, helped prepare me for the pandemic. Hospitals are very different in countries where Operation Smile works, and this helped me face unforeseen situations and think on my feet.
Emily reveals that her parents have old schoolwork where she says she wants to be a nurse. Growing up, she spent her weekends at the local hospital with her father, who worked there. She studied nursing, followed by a diploma from the London School of Tropical Diseases. Two years later she started working at GOSH. She turned to volunteering as a way to combine her desire to travel with her work.
“In 2012 I volunteered with an NGO in Haiti”, says Emily. “It was quite frustrating, it felt like we were just putting a plaster on the problem. That’s why I love volunteering with Operation Smile. You can instantly see how a child has been helped, and nobody is left behind. Those who couldn’t have surgery this time around will be helped during the next mission, six months later. I’m hooked – I’ve been on five missions now, to Ethiopia, Burma, Ghana, Madagascar and Malawi.”
During a mission, medical volunteers like Emily see over 500 patients over two days. They are assessed to see if they are fit for surgery. “Some are too malnourished, or are ill so we can’t treat them. Operation Smile’s dieticians and medical experts in the country help them, to make sure they are fit enough to be treated next time.”
“We then carry out about 30 surgeries a day, operating on children and adults with cleft. It’s a 45-minute surgery and their lives are changed forever. It’s amazing.”
Memorable patients
Emily shares the stories of two patients she will never forget:
“Each mission there are always so many emotional encounters. Watching a parent see their child for the first time never gets old. Finally, these families’ lives have changed for the good.”
“We did a lot of adult surgeries in Malawi. I’ll never forget Flyness. She is a 79-year-old woman with a significant bilateral (on both sides) cleft. I could see the pain and despair in her eyes pre-op. After her treatment, I asked her what the first thing she would do now. She said ‘Finally be able to kiss my husband’, with a big smile! It was amazing to see that at 79 her life was just starting, with the opportunity to live with a new smile.”
Emily continues: “In Ghana I met a 15-year-old boy. He thought he was the only person in the world to have a cleft lip. He didn’t go to school, and was shunned by his community. He told me he was considering committing suicide. But being surrounded by other children made him realise he wasn’t alone. After his operation, he had a whole new lease of life.”
The right to smile
Every three minutes, a child is born with a cleft lip or cleft palate, and without surgery will struggle to eat, speak and socialise, many being shunned by their communities.
In the UK, cleft lip and cleft palates are operated on in the first three to six months of a child being born. However, in many countries medical resources are scarce, and when available the cost is prohibitive – in some countries the cost of an operation is a year’s salary.
Operation Smile carries out hundreds of medical missions throughout the year all over the world, with the long term vision of improving the local healthcare system in the area. In addition to mobilising highly accredited medical volunteers, Operation Smile provides training to local medical personnel and partners with hospitals, governments and ministries of health in order to ensure that safe surgery is a right for everyone in need.
Children with cleft lip or cleft palate can be considered untouchable and shunned by the community who see them as cursed. Some untreated teenagers even report considering suicide. This is why therapy, as well as raising awareness of cleft conditions, are of prime importance. Children with a cleft condition can be vulnerable to malnourishment as it can be difficult to feed properly, which is why nutritional support for both child and the wider family is key.
“I’ve missed going on a mission this year, but it’s really daunting to think what missions will be like post-Covid. I can’t help but think of the children waiting this year, who can’t have treatment,” Emily shares.
“Everyone has the right to smile. Operation Smile gives hope to families in areas of need.”
Best and worst:
Best part of an Operation Smile mission – Seeing the transformations and being able to work with so many people around the world. I come home a better person, a more humble person. My problems don’t feel like problems any more.
Worst part of an Operation Smile mission – Not being able to treat everyone and seeing effects cleft lips have on children, like malnourishment.
