Operation Smile

Operation Smile is a volunteer medical services charity that has provided reconstructive surgery and related healthcare to over 115,000 children and young adults in 25 countries since 1982. We focus on children with cleft lips and palates, a common deformity that can cause significant breathing, speaking and feeding problems as well as severe social isolation. We are currently focused on a project in Chechnya, where Operation Smile volunteers will work toward sustainable development through the training and education of local people as well as providing free restorative surgery.

Due to our successful partnerships in Russia and some key relationships in Chechnya it was decided that the area would be an ideal candidate for Operation Smile's work. Therefore we have decided to undertake several ‘Needs Assessments' to evaluate what can be done there. The initial ‘Fact Find' has already taken place, and proved to be a great success. As well as demonstrating a great demand for our work, all the administrative introductions have been made, clearing a path for our medical and logistical Fact Finds which are scheduled to take place in April.

In April the 16 Chechen children we treated in Russia last year will be provided with the standard 6 month post-operative assessment. During this, we will also work out further details for our project. We are confident there is proof that Chechnya is in great need of support for their medical infrastructure, and therefore we are assessing the best means of responding to these needs.

The Need for innovative and sustainable healthcare programmes in Chechnya is great. Operation Smile has identified a lack of resources essential for medical infrastructure, including ongoing training and education for medical practitioners. We have scheduled a programme of activities to offer a solution to these problems, and we hope to find ample support for our efforts, which include:

A Medical Project in Grozny: Operation Smile's mission is to help children suffering from facial deformities by performing essential surgery to reconstruct a child's face, followed by providing them with the after-care needed to allow them to live their lives unhampered. By sending volunteers to Chechnya to perform free surgery to the highest standards of care, Operation Smile can guarantee great numbers of children the essential surgery that they would not otherwise receive. Post-operative care is also offered to ensure a complete and successful recovery from this life changing surgery.

We will begin our work in Chechnya with a project in autumn 2008. This will provide free surgery for around 50 children, but the main emphasis will be on the experience gained by our local volunteers. This inaugural project will be the first of many. It is not unusual for our partner foundations to provide 150 children with life-changing surgery during a week-long project; our aim is build the capacity of our Chechen partners to the point where they are able to help large numbers of children. The children will be offered the highest standards of care, and we will be providing six month post-operative aftercare to all patients and their families. Our first project in Chechnya will set the standards, and encourage skills dissemination and volunteerism.

The Grozny project aims to educate local medical professionals in fields such as performing surgeries, enhancing neurological skills training, nursing, biomedical support, dentistry, and speech therapy. Our educational goals will be further achieved through specific programmes designed by Operation Smile medical professionals:

A Basic Life Support Course will be provided to Chechen medical professionals. Accredited by the American Heart Association, this course focuses on developing the practical skills of the participants and is therefore based on hands-on activities. The vast majority of the course time is dedicated to actual practical experience.

This will be a ‘train-the-trainer' BLS course: 24 participants will be trained in basic life support (the ‘Provider Course'), and of these participants, six will be educated in the training programme itself (undertaking the ‘Instructor Course'), allowing them to become trainers themselves. Each of these 6 Chechen workers will go on to train another 24 people, of which six will be trained to be trainers, leading to a continuing programme of education well after the original trainers have left.

In order to be awarded AHA Certification, there must be no less than one certified instructor per six trainees and the participants must practice on specific training equipment. Once training is completed, all the trainees will be tested before receiving full documented AHA certification.

Operation Smile will also offer a Paediatric Advanced Life Support course similar to that of the Basic Life Support Course. Also accredited by the American Heart Association, this course focuses on developing the practical skills of the participants and is therefore based on hands-on activities. 80-85% of the course time is dedicated to actual practice during which the participants take turns in assuming the roles they may have to play during a real life emergency situation. If the participants are to be awarded certification, a ratio instructor/trainee of 1 to 6 has to be observed and a training station must be available. Additionally, in order to ensure AHA testing and documentation requirements are carefully observed, an instructor or a foundation representative must be identified as responsible to handle this aspect of the course. Therefore we have budgeted for 12 medical professionals to receive PALS training.

An instructor course is also available wherein participants will be educated in how to conduct this course in the future. After individuals have been certified as an instructor, an Instructor Course is conducted for newly certified providers to train under mentoring from their instructor. Mentoring events will be held until mentor determines newly certified instructors are ready to teach on their own (usually 3-4 mentoring events).

Critical Nursing Skills Training Programme (CNSTP) will also be conducted. This is a three day intensive training program for pre/post-operative, operating room (OR), and recovery room (RR) nurses. The training will focus on critical nursing skills specific to children receiving reconstructive surgery for cleft lip and cleft palate deformities. This programme will assist in-country local nurses from Operation Smile partner countries in their understanding of material through a series of tests, practical application demonstrations, and competency check lists.

The goal is to teach the critical skills of nursing with the aim of implementing a standard level of nursing knowledge and care necessary to deliver safe patient care during all medical projects performed under the sponsorship of Operation Smile. The programme will include lecture sessions, practical application demonstrations, and tests. Of all the nurses who receive training, two will be identified to serve as in-country trainers for this programme in the future.

Medical Diplomacy - Operation Smile brings together health professionals to improve the quality of life for the children, families, and communities that share in the Operation Smile experience. By creating international partnerships, Operation Smile builds trust, bridges cultures and share knowledge. We are hoping to initiate a rolling programme of medical fellowships, to strengthen our relationships within in the medical community and disseminate best practice.

Operation Smile UK will undertake this programme of work with the support of our Chechen partners and Operation Smile Russia. Operation Smile Russia has been providing treatment for children with facial deformities for 15 years. Last year saw OS Russia launch a new education programme in Life Support Training, meaning they can now provide continuous training to the medical personnel in our partner hospitals. In May the foundation successfully trained 24 healthcare professionals in Basic Life Support and 12 volunteers in Paediatric Advanced Life Support, as well as undertaking a medical project in Vladimir which was staffed entirely by Russian volunteers.

We aim to extend this success to our work in Chechnya. Operation Smile Russia has developed and led the programme, but OSUK will be providing funding, capacity building support and, in the initial stages, volunteers. We hope to find the funding to cover the costs of this vital work, and in doing so bring happiness to the children of Chechnya, one smile at a time.