Desi Talk - page 10

10
January 10, 2014
CITY VIEWS
– that’s all you need to know
By Kate O’Neill
n rural Bangladesh, 700 new
smiles have appeared since
2006. Each one resulted from
the repair of a cleft palate or
lip, performed by the special-
ists who volunteer for Smile
Bangladesh.
Smile Bangladesh, a New
Jersey-based, nonprofit medical
organization, promotes, provides
and expands health care access
for the medically underserved.
“The objectives of this interna-
tional initiative make it a perfect
fit for the medical school’s mis-
sions in clinical care, education
and community health,” says
Javier Escobar, professor of psy-
chiatry and associate dean for
global health at Rutgers Robert
Wood Johnson Medical School. “I
enthusiastically support it. And I
look forward to developing a new
elective for our students, in which
they will accompany Smile
Bangladesh and learn not only
about cleft repair, but also about
inequities and opportunities in
global health.”
The need for the team’s expert-
ise is overwhelming. In this small,
densely populated South Asian
nation, formerly East Pakistan, an
estimated 300,000 Bangladeshis,
out of a total population of 161
million, have a facial cleft, or cleft
anomaly: a split lip, palate, or a
combination of both.
One in every 600 to 800
Bangladeshi babies is born with a
cleft, while the worldwide average
is one in 1,000. Yet the nation has
only 15 plastic surgeons, and few
of them are trained to repair cleft
deformities. This gives Smile
Bangladesh two leading objec-
tives: not only to make cleft
repairs more widely available
through their surgical missions,
but also to train Bangladeshi med-
ical personnel to perform the pro-
cedures.
A Diverse Team
The president and cofounder of
Smile Bangladesh is Shahid Aziz,
associate professor of oral and
maxillofacial surgery and plastic
and reconstructive surgery,
Rutgers School of Dental
Medicine and Rutgers New Jersey
Medical School. A 1991 Rutgers
graduate, he is an attending sur-
geon at University Hospital, in
Newark, and Hackensack
University Medical Center.
Aziz had already been on sever-
al cleft repair missions to South
America when he learned of the
vast need for his specialty in
Bangladesh. Although his father
was a native Bangladeshi who
immigrated to the United States in
his youth, Aziz first visited the
country on a cleft repair mission
in 2006.
During that trip, he met
Christina Rozario, then deputy
director of Impact Foundation
Bangladesh, who was coordinat-
ing floating hospital missions that
delivered health care to people in
hard-to-reach inland communi-
ties.
After returning to New Jersey,
Aziz and his wife, Anita Puran, co-
founded Smile Bangladesh to
serve those remote communities.
Puran, who earned her doctorate
in public administration at
Rutgers, serves as the organiza-
tion’s executive director.
Year-round recruitment assem-
bles a multinational, multi-insti-
tutional, multidisciplinary core
team for each mission: dental and
plastic surgeons, anesthetists and
nurses, most of whom have sever-
al years’ experience with the
group.
Their efforts culminate in
twice-a-year cleft repair missions,
led by Aziz and Rozario, who now
serves as an administrative assis-
tant in the Office of Global Health
at the medical school. Gregory
Borah, professor of surgery and
chief, division of plastic surgery,
accompanies the Smile
Bangladesh team on one mission
each year. He performs cleft lip
repairs, while Aziz concentrates
on palates.
For each mission, Aziz has
recruited two or three residents
from the oral and maxillofacial
surgery program at Rutgers
School of Dental Medicine. In
addition, Borah takes along a resi-
dent from the plastic surgery pro-
gram at University
Hospital. “I want to
open their eyes to
the fact that surgery
becomes philan-
thropy when you
provide first-world
medical care in a
third-world coun-
try,” Borah says. “I
tell them: ‘You have
the brain and the
hands, and when
you have the skills,
you can spend time
giving back wherev-
er you are.’”
Smile Bangladesh
has also widened
the horizons of its
patients and their
families. “Many of
these children have never seen
people from beyond the borders
of their villages,” says Borah.
“They are visibly struck by the
diversity among members of our
team, as we work alongside native
Bangladeshis.” Building trust can
take a little time, he adds, but
when the trust comes, it is total,
contributing to the smiles that will
follow.
Collaboration, Communication,
and Education
The developmental causes of
cleft anomalies are not completely
understood. Every embryo starts
out with a cleft that runs from the
upper lip to the back of the soft
palate.
The cleft should fuse during the
first trimester of gestation, but in
some cases, the pathways of
fusion are interrupted by factors
that might include, individually or
in combination, genetics and the
mother’s health, nutrition, and
environment.
In Bangladesh and many other
parts of the world, cleft anomalies
tend to be shrouded in supersti-
tion and carry a harsh social stig-
ma.
Children disfigured by facial
clefts are likely to be socially ostra-
cized, affecting their ability to
become educated, develop friend-
ships and, as adults, to marry and
become employed.
In addition to creating social
barriers, the deformity can pres-
ent a wide range of health prob-
lems, many of them profound.
Babies with cleft palates often
have difficulty nursing and require
special feeding techniques; respi-
ratory problems are common.
Cleft lips and palates can also lead
to hearing loss, dental abnormali-
ties, and impaired speech, so the
earlier the repair can occur –
preferably between the ages of
three and 18 months – the better a
child’s chance of developing nor-
mally.
While other medical missions
come to Bangladesh to repair
clefts, most do their work in the
cities. “We go where the need is
greatest, to the remote areas
where children don’t have access
to medical care,”
Borah says.
One of the pro-
gram’s greatest chal-
lenges is to reach fam-
ilies in these remote
areas, to educate them
about the clefts and
recruit patients for
surgery.
Many parents are
unaware that their
children’s deformities
can be corrected.
Therefore, the work of
Smile Bangladesh
begins with enlighten-
ment: to tell rural
communities about
the arrival of the Smile
program, inform peo-
ple that clefts can be repaired –
often quite easily, especially in the
case of cleft lips - and support the
mothers, who are commonly con-
demned as having caused the
cleft.
“Many learn by word of
mouth,” says Rozario. “Children
return home transformed, and
news spreads to the parents of
children who need surgery.When
we return to areas we have already
visited, our numbers double.”
Global Connectivity
Rozario spends a week in
Bangladesh before and after each
two-week mission, working with
the medical teams, reaching out
to patients and their families, and
coordinating logistics to provide
everything the surgical teams
need to work straight through 12-
to-14-hour days.
Her extensive experience work-
ing with Bangladeshi nonprofits
has been key to the growth and
outreach of Smile Bangladesh.
Continued on page 12
Smile Bangladesh Repairs Clefts and Restores Lives
I
Christina Rozario
Christina Rozario
Above, Gregory Borah, center, professor
of surgery and chief, division of
plastic surgery, accompanies
the Smile Bangladesh team on one
mission each year. He performs cleft lip
repairs, while Shahid Aziz, photo below,
concentrates on palates.
Former Brooklyn DA Candidate
Recruited by Victor
By Ela Dutt
A
be George, the candi-
date for Brooklyn
District Attorney who
dropped out of the race in
favor of an opponent, has
been recruited by the incom-
ing Brooklyn District Attorney
Kenneth Thompson who took
over Jan 1.
By quitting last
year’s three-way
race in which long-
time incumbent
Charles “Joe”
Hynes was expect-
ed to win, George
made it possible
for Thompson to
come out the victor
in last year’s race. Now
Thompson has offered George
the position of Deputy Bureau
Chief of the Major Narcotics
Investigations Bureau in the
DA’s office, according to the
NewYork Post.
Desi Talk has learnt George,
35, has accepted the position
which according to a reliable
source, is a “supervisory” post
and “much higher” than the
position of Assistant DA which
George occupied before enter-
ing the race for office.
George told Desi Talk he
could not comment on the
matter. But a position
for George was immi-
nent as a payback for
his stepping out of the
race.
While George had
raised some money
during his campaign,
Thompson’s name
recognition far out-
weighed his, as the
attorney who fought for New
York hotel maid Nafissatou
Diallo in the sexual assault
case against ex-International
Monetary Fund chief Daniel
Strauss-Kahn.
“I want to
open their eyes
to the fact that
surgery
becomes
philanthropy
when you
provide first-
world medical
care in a
third-world
country”
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