Surgery Brightens the Future for 38 Children in Peru

In a small hospital in Arequipa, Peru, a team of 20 clinicians – in seven days – changed the lives of 38 children who otherwise may not have had much of a future. In fact, they would have suffered immensely due to conditions created by a cleft lip and a cleft palate. Children born with this deformity often experience speech, hearing, dental and feeding difficulties not to mention social, emotional and psychological problems. 

The 22-person volunteer team, which was organized and subsidized by the nonprofit Healing the Children New Jersey (HTCNJ), included LVPG plastic surgeon Randolph Wojcik, MD, Chief of the Division of Plastic Surgery at Lehigh Valley Institute for Surgical Excellence, part of Lehigh Valley Health Network. This is the fifth such volunteer trip Dr. Wojcik has completed with HTCNJ, four of which were to Thailand.

Surgery to repair a cleft of the lip or palate closes the cleft defect, and also enables a child to function and grow normally. Cleft lip repair, also called cheiloplasty, is highly individualized. It can include separating the mouth and nasal tissues, correcting the distance between the upper lip and nose, restoring nasal symmetry and nostril shape, reestablishing soft-palate muscle function to promote normal speech and other procedures.

“We operated from 7 a.m. to about 5 p.m. every day, leaving time at the end of the day for the last patients to recover,” Dr. Wojcik says. “Then we caught the one bus back to our hotel. Our team took turns staying at the hospital and rounding during the night. It was an immensely humbling and rewarding experience.”

Dr. Wojcik says they were fortunate to have access to two translators. He was able to meet and talk with the children’s parents and grandparents before the surgeries and again after. Besides himself and the translators, the team comprised a second surgeon, two anesthesiologists and a pediatrician along with certified registered nurse anesthetists, surgery technicians, operating room nurses and recovery nurses. Local nurses at the hospital also assisted the team. 

“We had only two anesthesia machines so we could only complete a certain number of surgeries per day,” Dr. Wojcik says. “I wish we could have operated on all the children who were waiting for us.”

To gather surgery candidates, HTCNJ put out a message about the availability of cleft lip and palate surgeries in Arequipa preceding the trip. The organization assembled a list of 100 children who wanted to be considered. From there, the team selected and triaged patients into categories based on severity and the health of the child. Dr. Wojcik says this produced the most difficult part of the trip: having to turn away some of the patients.

“Some children and their families traveled hundreds of miles – even slept in the back of their pickup trucks – just to have the chance for this operation,” Dr. Wojcik says. “I’m not someone who says ‘no,’ but we just can’t get to everyone. That’s what drives us to keep doing this.”

One experience from his trip to Arequipa stands out for Dr. Wojcik. It involved a child with a complex case of cleft lip and palate. So complex that no other surgeon the family consulted with was willing to take it on. Often because of their deformity, the child cannot eat properly and get the nutrition they need to grow and be healthy. This was true in this instance, so the child was placed on a feeding tube for 57 days until becoming strong enough to undergo the operation.

Dr. Wojcik clearly remembers the mother’s reaction when she saw her child for the first time after the surgery. “She put her hands over her mouth and just cried,” Dr. Wojcik says, adding that the whole family just kept hugging each other and crying with joy. “It’s because of our entire team that these miracles happen,” he says. “Everyone plays an intrinsic, vital role in restoring their lives.” 

This trip and his connection with HTCNJ are synonymous with Dr. Wojcik’s core values. “My dad used to give me a hard time for going into plastic surgery because of the association with cosmetic procedures. But what I wanted was to make a difference in people’s lives,” he says. “This work brings me back to why I went into this profession to begin with. Restoring someone’s confidence is amazing. The impact of changing a person’s entire life with an operation has made this my passion.”

Dr. Wojcik, who believes that “everything we see and do becomes a part of us,” says that his work with HTCNJ has also helped him practice here at home.

“We’re always learning, always growing,” he says. “I learn from these trips how to be a better surgeon, better caregiver, a better person. These trips round out my experience and make me more whole.”