Creating Smiles, Improving Lives

#SmileSanSalvador – Day 3 – June 13, 2016

(Story by Hannah Reed and Photography by Ellie Falcao)


The five o’clock alarm this morning was a bit shocking, nonetheless I’m so thankful for the mug of strong coffee at breakfast I was able to gulp down. At 6am sharp the first half of our group loads the bus and drives to the hospital. It’s hard to not be in awe when we drive through the city each day. Have I mentioned yet that the city of San Salvador rests in a valley surrounded by volcanoes on all sides? The views are breathtaking!

We arrive at the hospital. The medical team goes upstairs to prep for triage and surgery, the rest of us find ourselves in the waiting room with the parents and children that are scheduled for surgery today. I feel so much joy as I catch eyes with little Lester, one of the babies that was evaluated yesterday. I prayed that he would make it on the list for surgery on his cleft palate this week. On his left sits four-year-old Nathaly in her Minnie Mouse bow and matching shirt. She sees our team photographer and my roommate Ellie, and immediately gets a huge smile on her face; and of course she did, we all grin when we see Ellie—she’s one of our team’s favorites! After talking to little Nathaly and her parents, we go and meet an older boy named Javier who is standing in the hallway with his mother. This will be his fifth surgery completed by Austin Smiles; they first operated on him at 6 months old. How incredible to know that our organization has essentially impacted his entire life for the last 14 years! His mother, Claudia, speaks close to perfect English, and she is a single mom and flight attendant. I ask her how she was feeling about surgery today, and she tells me “honestly, I am used to it, but I am also so grateful my son can be here today.” Mary Jane, our team leader- who has been an active Austin Smiles volunteer for over 20 years- happened to go on her first mission trip to El Salvador 14 years ago and remembers Javier when he had his first surgery as a baby!

A few nurses are making their way down the stairs to the waiting room and asking for the family’s orange tickets, which verify they are scheduled for Monday surgery- the Austin Smile’s version of a golden ticket! Next, Mary Jane and Dr. Barnes come down the stairs and motion for the parents and first three children scheduled for surgery to come upstairs for triage. As I follow these first patients and their parents upstairs into a white tiled room, we see that the triage room is in full motion. Dr. Barnes then motions for Lester and his mother to enter the room so that he and Jenny, one of our RN’s, can check his vitals and temperature. Next in line is Mateo, an adorable 8 month old brought in by his grandmother. It breaks my heart to hear Lester and Mateo’s cries as they are dressed in their teal green smocks and surgical bonnets. They are really hungry since they haven’t been able to eat since 9pm last night. As much as I dislike the sound of their cries, I keep going back to my most recent conversation with Dr. Barnes. We were standing there in the midst of the chaos in the hallway on triage day, and yet he was so calm. He has been on about 30 trips with Austin Smiles and he was teary eyed as he told me that despite the amount of trips he’s experienced, he still gets emotional thinking that 1 short hour of his life can impact a child’s life forever.

Lester has been cleared with Dr. Barnes in Triage, and is now following Dr. Cinclair down a narrow hallway several feet away from the operating room. I can feel the anticipation in the air as camera flashes are going off to capture the moment, and the nurses and doctors are eagerly waiting outside the operating room, ready to get surgery started. Baby Lester is being called in, and as Dr. Cinclair comes and reaches for him gently from his young, solemn-faced mother, both mother and son start to cry uncontrollably. As quickly as she starts to cry, Ellie and a few sweet Salvadorean women were just as fast to reach out to embrace and comfort her. Despite the tears in our eyes, each person in the room can surely feel an overshadowing force of love; the love of a mother for her child, the love of the surgeon as he took the child in for surgery, the love of strangers as they rushed to comfort the crying mother, and even the love of generous people all around the world that made this very moment possible.

I walk past the row of mothers waiting for their children that were just wheeled in for surgery and into the PACU room (Post Anesthesia Care Unit). The team of RN’s are prepping the room for their first patients. You can tell they are itching to get to work! We have seven PACU nurses: Morgan Gillen, Lori Dominguez, Paul Gonzalez, Tanya Gomez, Gayle Truax, Angie Englert and Maureen Sloan. Right next to the PACU, there are two sets of double doors to access the operating units. In the first room I put on a blue hairnet, blue shoe covers and a white mask. No one can enter the OR without wearing all three. I peek through the glass window on the door to see two beds- Lester on one side and Mateo on the other- and a total of sixteen surgeons, nurses, scrub techs, and volunteers all wearing some blend of bright blue and green scrubs. I force myself to open the door and walk in. My first thought is that I am experiencing so much anxiety, as I’m having trouble breathing and my chest is tight, but quickly realize I just have to get used to breathing through my mask. I am evidently far from my comfort zone—I’ve never been in an operating room to see surgery performed. Despite my apprehension, these skilled individuals are so at home. They work well as a unit and flow together in unison, just like the 70’s rock music lyrics and medical equipment that echo quietly in the background of the busy room. In the midst of the surgery, we hear a loud “ OH!” Apparently Dr. Narsete’s pants are loose and falling down. His scrub technician Edna quickly- and laughingly- rushes over to help pull them back up. It’s only appropriate that Dr. Shepard starts to quote the famous American Idol song “pants on the ground, pants on the ground.”

Baby Mateo is now finished with surgery. Dr. Cinclair brings him into the PACU, and the little guy is crying. This is a good sign, though—it means that he is breathing on his own. The PACU nurses are taking such gentle care of him as together they place little casts around his arms to prevent him from touching his mouth. He looks so darling in his green smock and straight black bed hair, and as they care for him all of the team can’t help commenting on how cute he is! I saw him right before he went into surgery, and I can’t stop smiling as I get my first glimpse of his nose and mouth as he lies on the recovery bed. Baby Mateo has a new smile!

Now it is almost 7 o’clock and the sun has just set over the city. The last two patients are in the PACU recovering and waiting to be taken upstairs to sleep overnight. Most of us are finished with our work so we changed out of our scrubs in preparation for the ride back to the hotel. Eleven children have had surgery completed today and all have been successful!







1 in 700 children are born with a cleft lip or palate

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