Meet the Irish doctor giving African children their smiles back
Cleft palate is a debilitating condition which leaves children struggling to eat and speak. Without surgery, impoverished Africans face a lifetime of hardship. Now the pioneering work of plastic surgeon David Orr is giving fresh hope to families in Ethiopia.
It's rare that a doctor would be so happy to speak to a journalist that he'd clamber out of the river where he'd been fishing and stand chatting in his waders.
But consultant plastic surgeon David Orr willingly sacrificed a peaceful morning's angling on the Owenduff river in Co Mayo - and all chances of hooking a salmon - to wade out onto the riverbank to talk to a reporter.
And not only that - given the weak mobile phone signal in the area, Orr also had to set off in search of a working payphone on which to talk to the Irish Independent.
But then this father-of-three is deeply passionate about the charitable life-saving work he carries out every year on the other side of the globe.
Orr, who is attached to St James's Hospital and Our Lady's Children's Hospital, Crumlin, is one of those featured in an RTE documentary tomorrow night on the work being done in Ethiopia by medical volunteers from Ireland and the children's charity, Operation Smile.
Orr has been a passionate participant in the programme for more than 10 years.
For the last decade or so the 53-year-old medic has been a member of a team of volunteer specialists who annually sacrifice two weeks' holiday to fly out to a hospital in the rural Ethiopian city of Jimma, to perform life-changing surgery on children and train local doctors.
The children, who suffer from a debilitating cleft-lip and palate which renders them incapable of speech, are often forced to make an arduous journey of some four or five days duration to reach the busy hospital in the province of Oromia in the south west of the country.
In many cases, says Orr, the local community will usually have contributed funds and resources to pay for the family's journey in a bid to help these children - many are often socially isolated as a result of the disfiguring condition, and kept at home from school for fear they will be teased by their classmates.
More than 750 babies are born each year in Oromia, with cleft lip and/or cleft palate, while well over 6,000 people in the region live with untreated cleft conditions which usually result in significant difficulty in eating and speaking.
One such child is 10-year-old Hawa, whose story is featured in tomorrow night's RTE programme Behind a Smile.
Hawa arrives at the hospital in Jimma after a long journey with her mother and father.
In Ireland this little girl would have been treated as a baby and gone on to live a normal life.
However, the sophisticated surgery required to set her condition right was not available to Hawa in Ethiopia, and as a result of her facial deformity, she spent her childhood in isolation, staying home from school and avoiding social contact.
"Hawa was kept away from school for this reason," says Orr, who operated on the youngster with the help of one of the trainee Ethiopian surgeons he and his team are training in the necessary surgical techniques.
"We select promising surgeons to train in cleft-lip repairs and by the time we're finished training them they're extremely good," he says.
About 100 Irish medical professionals are involved in Operation Smile's missions throughout the world.
Orr first heard about Operation Smile through a colleague on his team at Crumlin in 2003, and participated in his first mission in Kenya in the same year.
However, the psychological foundations for his volunteer work in Africa had been laid decades previously.
As a 22-year-old medical student working on a summer programme in Malawi, Orr had first-hand experience of the value of specialists giving their time for free to those who needed it.
"I remember a retired British orthopaedic surgeon coming out for two days and doing an incredible amount of work.
"He was using the cases as a way of training local doctors in specific selected orthopaedic techniques, and it struck me how very valuable it was to have a specialist of this calibre this knowledge into that situation," he says.
Orr, who specialises in the treatment of cleft lip and palate comes from a well-known medical family - his father was a GP in the picturesque seaside village of Greystones in Wicklow, his mother was a nurse, and his wife, Susan Smith, is a GP and Professor of General Practice in the Royal College of Surgeons.
Shortly after participating in his first Operation Smile mission at the hospital in Jimma in 2005 - at the time, he recalls, the facility had just two general surgeons to serve a population of about 15 million - he and others on the team realised that simply treating the children wasn't enough.
Long-term, they realised, what was actually needed was on-the-spot training to teach local doctors how to carry out the sophisticated surgery.
"We have a very good system here in Ireland for looking after children with cleft lip and palate; it is a long, complex, treatment from the time they are born because they can be born with breathing and feeding difficulties as a result of the condition."
Treatment and speech therapy can go on until late teens or even adulthood, he says.
Jimma had a university and medical school, and Orr and other members of the team decided to focus on helping the local health service develop its own plastic surgery department.
"I have kept coming back to Jimma almost every year for the past eight or nine years. We operate on the children and we are also teaching local trainee surgeons.
"Over the past 10 years the hospital has gone from having just two general surgeons to about 14 fully trained surgeons and they're training more, while over these years the medical school has also developed."
It's truly inspiring, says Orr, to see how these surgeons are prepared to remain in this remote and challenging environment when there's so much more money to be earned, and in more congenial environments in modern well-equipped hospitals in Addis Ababa, or throughout the developed world.
"I think the people who stay behind and work in these really tough systems are fantastic.
"They are phenomenally committed and very inspiring people who could earn a lot more money abroad - yet they choose to stay and work in their own country to develop their own systems."
The local health service has decided to set up a local specialist plastic surgery department:
"Each year we would treat about 100 cases, so over the years, about 1,000 cases of children and adults have been treated by an international team made up of people from Ireland and elsewhere."
'Behind a Smile' will air tomorrow night on RTE1 at 11.30pm.