Miriam Guashpa woke up at 1 am in the cold, pitch-blackness of her home in Flores. She was cuddled up with her three children in the same bed, which makes her happy and warm. They have no heating and little space. In the high altitude agrarian communities of rural Ecuador, nights are cold.
She and her son Rodrigo rose by candlelight and prepared to go to Quito to get the medical treatment they had been waiting years to get. Rodrigo was born with a cleft lip and cleft palate, this was to be the last of three surgeries needed to repair the palate.
Rodrigo’s sister cried and told her mother ¨please take care of by brother,¨ as she said goodbye. Rodrigo and his mother climbed down the rickety wooden ladder that led to the attic they slept in, walked across their dirt kitchen floor and outside past the guinea pig and rabbit cages up the hill to the dirt road. They caught the last bus to Riobamba and headed towards a better future for Rodrigo.
Clept lips and palates, often comorbid conditions, are birth defects of often unknown cause, although smoking, certain medications, and alcohol use increase the odds of it occurring. The cleft lip is a cosmetic defect, Rodrigo’s mother has a smaller but barely noticeable cleft lip. She said that her mother had a drinking problem. This likely contributed to the cleft lip, and to her passing it onto Rodrigo.
The cleft palate impairs functioning and development in a number of ways. Children with this defect have problems eating and speaking normally.
When Rodrigo was an infant, his mother had to feed him by putting a straw far back in his throat, poring liquid into it, and plugging his nose. He got two surgeries through the public health system when he was an infant six months after he was born, and another surgery six months later. After that, the doctors in the public health system said there was nothing more they could do, Rodrigo needed to see a specialist. Miriam, a poor farmer and single mom, couldn’t possibly pay for that.
At age 8, Rodrigo’s speech sounds garbled and unclear. Birth defects like these often have social consequences that cause significant additional problems. He cried as he told us how the children at school imitate his speech and hit him. His birth defects have made him a social outcast.
At three in the morning they met MEDLIFE nurse Valeria in Riobamba and headed towards Quito. Valeria has met them and walked them through every doctor’s appointment leading up to this surgery, often at three in the morning. Together with another foundation that works to give healthcare to the poor, Metrofraternidad, MEDLIFE was able to pay for all exams and the surgery that Miriam couldn’t have paid for on her own.
On Monday morning they got the pre-surgery checkup, and Rodrigo passed. That night the three of them slept in Quito.
The next morning Rodrigo went in for his two-hour surgery. His mom accompanied him on the way in and on the way out in scrubs, then changed back into her traditional Andean skirt. She said she was very afraid for him before the surgery, afraid something could go wrong, that he might die. She was relieved that he seemed to have made it out ok.
As he lay in the recovery room, she tried to get him to eat and flipped through channels on the TV, mostly telenovelas. This is one of the few times she has been able to surf channels on a tv, she has hardly ever watched one. There is no electricity in her home.
Her parents were both born in Flores as well, they raised animals to get by just like she does, pigs, cows, rabbits, guinea pigs. Farming is a family business, but her daughter hopes to become a teacher.
MEDLIFE is working towards a better future for the entire family by constructing a new home for them as well.
Miriam was going to spend the next couple of days at her brother’s home in Quito, so she doesn’t have to travel the 6 hours home with him. MEDLIFE bought her a cell phone so she can be contacted for the checkup appointment. Usually she is contacted directly by a house visit, but that will not be possible while she is in Quito. Valeria will accompany her to the checkup appointment as well and continue following up until Rodrigo has fully recovered.
The doctors said the surgery had gone well. When Miriam finished feeding Rodrigo, she peered inside his mouth, smiled, and said ¨it’s closed¨