There’s a shadow behind the bright smiles of Bali’s
children.
For about every 600 live births in Indonesia, one baby will
be born with a cleft lip or cleft palate. The cause isn’t
known, but malnutrition and lack of folic acid in the mother’s
diet may be factors. Some deformities, like a simple cleft
lip, are cosmetic and easy to repair. Cleft palate, where
the bone at the top of the mouth has failed to close, is more
serious as it involves the teeth, bones, hearing and ability
to speak. Babies with this deformity can’t feed properly
and are in danger of aspirating milk and food into their lungs
through the cleft.
Without surgery, most of these children will never grow up
to lead normal lives. The dramatic before and after pictures
of children who have had their deformities repaired tell poignant
stories of rescued lives.
Over 2,000 children from Bali and Lombok have had their smiles
rescued, but there are thousands more in the shadows.
The John Fawcett Foundation has repaired about 1500 facial
deformities in Bali and Lombok and continues to treat cases
as they are encountered. The Rotary Club Nusa Dua started
a Cleft Lip and Palate Project in 1994, working with John
Fawcett and financing about 350 operations until 1997. From
1998 to present the Club has solely financed about 526 operations,
and by the end of this year will have provided 1 billion rupiah
to the project.
Now there is a Bali-based organization dedicated solely to
the treatment of cranio-facial deformities. Yayasan Senyum
(Smile) Bali was established in 2005 to serve as a bridge
between Sanglah Hospital, the regional public hospital and
the Australian Cranio-Facial Institute in Adelaide. The Institute
is headed by Dr David J. David, who has worked for over 20
years in Indonesia and established cleft centres in Jakarta
and Surabaya. The goal is to open such a centre in Bali which
will also serve Lombok. Dr David and his anesthetist and nurse
travel to Indonesia twice a year to hold clinics, perform
the life-changing surgery and train local hospital staff in
special procedures such as nasendoscopy.
Dr A. A. Asmarajaya, trained by Dr. David, is the only plastic
surgeon in Bali and is Head of Surgery at Sanglah Hospital.
This kind man performs the surgeries, with Rotary Club Nusa
Dua and other donors covering the nursing, medicine and other
associated costs. Although a cleft lip is more unsightly,
it is the easiest to repair and can usually be done when the
baby is six months old. Cleft palate is much more serious,
and because it’s not so visible the condition is often
neglected. Cleft lip and palate operations performed in Bali
cost between US$ 150 and $400.
Senyum Bali is headed by Mary Northmore-Aziz, an Indonesian
citizen who has been working with people with cranio-facial
deformities in Bali for over ten years. She is the inspiration
behind the Smile Shop in Ubud, Bali’s first thrift shop,
and the Smile House, which offers safe pre and post operative
accommodation and food to surgery patients and their families.
Although cranio-facial surgery is free to poor patients, Sanglah
Hospital in Denpasar is as remote as the moon to many poor
families. “We try to make telephone contact with affected
families when we hear about them,” Mary explains. “We
explain that the surgery is free and encourage them to come
to Sanglah. But it’s very difficult for poor farming
families to do this. Many have never left their villages and
have no cash for such a journey. Now we can send ojeks from
Denpasar to pick them up and bring them to Smile House.”
Next comes the daunting two-day process of registering the
patients at the hospital, assisted by Senyum Bali staff and
volunteers. They may then need to wait for up to a week for
an operation. After surgery, the mother and patient spend
another night or two at Smile House before they return home.
Stitches are removed a few days later at their nearest clinic
or hospital.
Smile House, located near Sanglah Hospital, was made possible
by a grant from a generous Singaporean donor whose gift covered
the contract for two years and purchased the furniture. The
clean and cheerful residence is managed by Rusmini, whose
own severe facial deformity was repaired recently in Adelaide.
She cooks, cleans and provides comfort and reassurance to
the patients’ families. She and Oki, the Senyum Bali
coordinator, are funded by the Smile Shop in Ubud. Sue Frost,
another full time member of the team, is funded through the
Australian government AVI programme. She sets up and maintains
databases, patient records and publicity material and assists
in clinics and patient care.
Complicated cases must be sent to Australia and there are
currently seven patients in urgent need of treatment in Adelaide.
This treatment is free, courtesy of the Government of South
Australia, but patients are asked to contribute A$1000 towards
their costs, and A$1500 more is needed for each patient to
support associated costs such as passports, flights, etc.
These patients will require extensive surgery and treatment
for cranio-facial, orthodontal, hearing and speech conditions.
The Smile Shop in Ubud, opened in December 2006, has proved
a popular fund-raising arm for the Yayasan. Businesses and
individuals donate high-quality new and lightly used stock
which is snapped up by the local community. In the 48 days
it has been open, the shop raised 32 million rupiah. Volunteers
currently keep the shop open three days a week; additional
volunteers will enable the shop to open more often. Please
call Peta at 0361 785 7366 if you’re willing to commit
to a 4 hour shift each week. The Shop is always in need of
stock, so please drop by with good-as-new clothes, towels,
sheets, DVDs, children’s books in Indonesian and other
articles.
Generous donations in cash and kind from BIWA, the British
Community Committee in Jakarta, Maspion, Tropical Living and
the Australian Consulate General have helped support Senyum
Bali to date. Mary’s wish list now includes the salary
for an Indonesian social worker who can counsel the families
during the often-frightening process of traveling to the city,
negotiating the complex bureaucracy of the hospital and dealing
with the surgery. She’s also searching for funds to
send the seven urgent cases to Adelaide.
It doesn’t take a lot of money to bring a child with
a cranio-facial deformity out of the shadows. Check out the
following websites for truly inspiring documentary evidence
of how a single inexpensive surgery can change a life.
Find out how to make a donation to Senyum Bali by visiting
www.senyumbali.com or calling Mary Northmore-Aziz at 0811
395 963.
To support the Rotary Club Nusa Dua or view their project
photos, visit www.cp.rotarybali.org
To support the Indonesia Humanitarian Foundation and see photos
of its work, visit www.humanitarianprojectsindonesia.com
To learn more about the Australian Cranio-Facial Unit, visit
www.cranio-facial.com.au
