It also means rough roads lead from the rural community of Assin Praso to the historic city of Cape Coast.

Though the physical condition of the highways is the same for all who travel between the two cities, the round trips made by Mariana and her daughter, Ramata, were among the most challenging.

Now 4 years old, Ramata was born with a cleft lip and a cleft palate. Mariana was determined to access safe surgical care to repair her daughter’s condition.

Five times, Mariana raised enough money for bus fare and took Ramata to Cape Coast in search of a free surgical option. Five times, the return trip was made all the rockier by heartbreak.

Each time doctors assessed Ramata’s health, she was either anemic or too underweight to receive safe surgery. Even if she would have been deemed healthy enough for surgery, she had no way of being able to afford its cost of 300 cedi ($75).

Disappointed but undeterred, Mariana remained vigilant about finding care for Ramata despite her extremely limited resources — she earns a meager living carrying water containers and gathering firewood for her neighbors. When Mariana met a non-medical volunteer from Operation Smile Ghana who was conducting an awareness campaign in Assin Praso, the lives of the family would change forever.

At first, Mariana didn’t believe that the surgeries Ramata needed would be free when she called Operation Smile Ghana Patient Coordinator Clement Ofosuhemeng to learn more about the organization and its work. He assured Mariana that there would be no cost for any procedures needed to repair Ramata’s cleft condition and that Operation Smile would provide a bus to take patients from the Assin Praso area to the next medical mission in Cape Coast.

After Mariana and Ramata made the three-hour trek back to Cape Coast for the Operation Smile medical mission, yet another roadblock diverted Ramata away from care for a staggering sixth time. Ramata had passed her comprehensive health assessment and was approved for cleft lip surgery when she contracted malaria — a major health scare for the young patient in its own right.

Fortunately, Ramata survived her bout with malaria and returned to good health as she and her mother looked forward to the next Operation Smile medical mission in the eastern city of Ho. It would be here that she would receive the life-changing procedure which had proved to be so elusive.

In the months leading up to the Ho medical mission, Ramata started attending kindergarten and immediately developed an affinity for school and learning. She also experienced bullying from some of her classmates while others would stare at her cleft lip and shun her. The teasing and isolation drove Ramata to tears.

Mariana also suffered social hardships after Ramata was born. As her family offered little, if any, emotional support, she became the target of insults and blame from some of her neighbors for having birthed a child with a cleft condition. While these words infuriated Mariana, they also hardened her resolve to find a surgical solution for her daughter — to give her the chance to pursue an education without it being derailed by cruel treatment from her peers.

Again, Ramata and Mariana boarded the Operation Smile bus and made the 10-hour trip from Assin Praso to Ho. Again, she was cleared for surgery after her patient health assessment, but this time made it to the operating room without further complications and received surgery to repair her cleft lip.

When Mariana saw Ramata for the first time after surgery, she was overjoyed by the fact that her daughter would look like all the other children in their community.

Finally, Ramata truly began her journey toward becoming cleft-free. She returned to Ho twice over the following year to receive procedures at Operation Smile medical missions to repair her cleft palate.

Mariana marveled at the care and attention Ramata received during the missions and was amazed by the love and care the volunteers showed the patients and their families. She said that she is happy to share Ramata’s story with everyone she meets and would tell other mothers in her community who give birth to children with cleft conditions about Operation Smile’s work in Ghana so they can avoid the anguish and frustration that she experienced in searching exhaustively for safe surgical care for her daughter.

ARII, a local non-profit, is a volunteer-based international relief and development organization responsible for promoting human dignity and sustainable livelihood in Africa. The organization is supported by the Just Care Foundation and together, they delivered skills development training in bead making, weaving and batik tie-dye making, a typical local wax fabric dying. To ensure the audience could benefit from the newly acquired skills, another local NGO, I-Vol AFRICA, ran several modules of basic microfinance to teach parents and guardians how to raise funds to purchase the items to run a business and learn how to market and sell their products, what to do with the revenues they make, how to save, how to reinvest, and what to spend.

Sabrina Ghiddi, advisor for Operation Smile, had the opportunity to participate in more than one medical mission and witnessed first-hand the impact of Operation Smile in the life of the patients and families.

“Looking at the number of days patients and guardians had to stay for the medical mission, and the brief time needed for the surgery and the recovery, we saw an opportunity in capitalizing the time available at the shelter with something that would add up to the new smile the patient has, bringing a lasting change also to the guardian and to the community where they live,” said Ghiddi. “We achieved this through workshops that would enhance their skills and knowledge with the aim of fostering their mindset to enable them to go back to their villages with a brighter outlook for their life and the one of the community as they would share what they had learnt at the shelter.”

When the medical mission concluded, the 45 volunteers, doctors and nurses came to the patient shelter to see the impact of the shelter workshops. Following a thank you celebration, the new artisans were able to showcase their new craft, and volunteers were able to view and purchase the goods they produced, such as purses, slippers, bracelets, and fabric. With these funds raised, Ghiddi purchased for the patients a ‘starter kit’ that they will use to start their new venture.

“I was so impressed and touched by the ingenuity,” said Operation Smile volunteer nurse Heather Harper. “It goes back to the saying, ‘Give a man a fish, feed him for a day. Teach a man to fish, feed him for a lifetime!’ I love to see independence fostered and confidence strengthened, especially among women!”

In addition, ARII and Just Care also delivered a child development training with the aim of helping families of Operation Smile beneficiaries with the needed skills and relevant worldview to enhance childcare and child support at the family level. This is to ensure that parents and guardians take part in the issues that affect the growth and development of their children to ensure that the operated children can in the future thrive and develop fully so that they can also contribute meaningfully to national life as they grow.

Throughout the medical mission, the Peace Corps volunteers were also extremely active in organizing workshops around AIDS/HIV, health and nutrition, hand-washing, and Ebola. Lastly, there was a training delivered on clefts. This was aimed at removing any association with spiritual curse that is very common in Ghana.

“I was very impressed to see that Operation Smile, along with local charities, really embraces the future for people and not just the present,” said Electronic Medical Records volunteer Maria Bryant. “I would hope to see this model recreated in other mission sites ultimately putting smiles on even more faces for many more reasons.”