Since 1982, Operation Smile has provided free reconstructive surgery to 98,000 children and young adults in 30 countries and trained thousands of foreign health care professionals.

The organization recruits hundreds of volunteers in nursing, pediatrics, surgery, child life, anesthesiology, dentistry, speech pathology and biomedical technology to staff missions at 25 sites worldwide. Each mission averages three weeks—two weeks for set-up and patient screening and a week to perform surgeries (mostly cleft palate and lip) for some 200 patients.

Amy Peters, a 17-year veteran of Hopkins’ pediatric intensive care unit, has participated in six Operation Smile missions to the Philippines, Venezuela, Vietnam, Palestine and Kenya. Her ICU background, she says, is an asset, as she’s well-versed in emergency care and is adept in both pre- and post-operative settings as well as in the recovery room.

But in these remote regions, the mostly make-shift conditions are far from ordinary. “Post-op isn’t fancy. It’s a room with 40 cots,” says Peters. “Often, the volume is so high that patients have to double up.” Supplies are limited, and cultural differences can make familiar care patterns obsolete. In the Philippines, nurses routinely wash and reuse gloves; in Palestine, Muslim women aren’t allowed to face male health care workers.

Then there’s the heartbreak of turning away desperate families—many of whom travel great distances by foot—because an underlying condition makes the child unsuitable for surgery.

Still, the opportunity to teach brings Peters back again and again. And of course, there are the children:  “In many cultures, they wear face masks to hide their deformities,” says Peters. “There’s no greater reward than giving a patient a mirror after surgery and watching that brand new smile take shape.”

--Hopkins Nurse, Spring 2006

PHOTO: Amy Peters: PICU nurse, Operation Smile volunteer