​​It was a case of smiles all round earlier this year, when the division of Plastic and Reconstructive Surgery, supported by the German NGO, Big Shoe, performed 11 reconstructive procedures during the Tygerberg Academic Hospital Smile Week.

The procedures included operations to help children with cleft palates and other facial anomalies, as well as a rare procedure in which a six-year-old patient, who was born with a Tessier 10 facial cleft, underwent surgery to repair the condition.

Smile Week, operated by the Smile Foundation NGO, has been taking place across the country for years, and Tygerberg Hospital has been working with them since 2008. Big Shoe, which was launched in 2006 during the World Cup in Germany, is dedicated to raising funds for children in need of reconstructive surgery in Africa. 

Dr Alexander Zühlke, Acting Head of the Division of Plastic and Reconstructive Surgery, said the results of the procedures are life changing, not just for the young patients themselves, but for their entire immediate families.

“For me, this is something that I do on a regular basis – we do sponsored operations every Friday at Tygerberg - but any opportunity we have to do a successful operation that helps a child to live a normal life, is, in my opinion fantastic. It is truly rewarding. 

“In a Smile Week or a Big Shoe event, it is like our normal Fridays on steroids. We have a whole lot of children, all together in the ward and many of their parents are there too. It is a great opportunity for the parents to talk to each other as it becomes an informal support group. There is a lot of hype and excitement and it is always a special occasion.

“What is always amazing is to see the faces of the children and their parents after the operation. We always explain to them what we are going to do in the operation, but it is difficult for them to envisage it. There are different reactions – from being amazed to being overwhelmed with feelings, from both the children and their immediate family. It is just as rewarding for the surgeons and other staff involved in the operations."

The children operated on during a typical Smile Week are from the Western Cape. “Approximately one in 1000 children born have a cleft lip/palate," said Zühlke.

“The Smile Weeks are very important as, if we didn't have them, as well as our Friday theatre lists, it would take much longer to complete the needed operations. The waiting lists would build up – and the children would have to be operated on at a later stage, which is not ideal.

“These special weeks afford the children and their parents protected time and space that is just for them, when they are operated on at the right time and with the right treatment after their operation." 

During a Smile Week, a range of other activities take place aimed at the children and their parents.

“Besides the reconstructive procedures, the patients and parents are given psychological support. A private psychologist prepares the patient and their parents for the procedure as it can be a stressful and sometimes traumatic experience, even though it ends happily," said Zühlke.

“Sometimes during Smile Week, the nurses receive training in various skills, such as wound management and dressings.

Then there is usually a party for the children, at which volunteers come and play with them; we have face painting and other activities and the children get goody bags which include items like pyjamas, a toothbrush and a soft toy."

Zühlke and his colleagues also recently hosted the Western Cape Stormers at Tygerberg hospital, where they met with children who have received corrective surgery through the Smile Foundation. This season, Vodacom will reward every try scored by a South African Super Rugby team with a donation of R3 000 to the Smile Foundation.

“Those guys are huge heroes. It was great to have them here, to play with the kids. For the older children, it was a great opportunity to meet their heroes."