Dr. Eyal Winkler examines a young patient as a concerned mother looks on.When Dr. Eyal Winkler, Dr. Yitzchak Zilinsky and Dr. Yigal Shochat, three experienced plastic surgeons from Israel’s Sheba Medical Center arrived in Huancayo, Peru this past February, they knew what to expect. Waiting outside the rural local clinic were about 70 children, all suffering from some variation of cleft lip/ palate disorder.

Cleft lip/palate is a birth defect in which either the lip or the palate (roof of mouth) or both failed to close in the womb, leaving a separation that can affect eating, speech, and hearing. After hearing about the visit from the Israeli doctors, these children and their families flocked to the clinic, for free, quality treatment for the potentially life-threatening defect. For most of them, this would be their only opportunity.

The mission to Huancayo, in the Peruvian Andes, was the sixth cleft lip/ palate mission to the developing world for Sheba. Winkler has been leading the Sheba team since 1998, when Interplast, an international organization providing free reconstructive surgery for people in developing nations, asked the hospital to join them on a mission to Katmandu, Nepal.

Winkler was one of three Sheba doctors who went to Nepal, and by the end of the week, he was hooked. “We loved it,” he told ISRAEL21c. “We had the feeling of fulfilling our mission as doctors.”

After the Nepal mission, Winkler and Sheba administrators decided that they wanted to operate these missions on their own. As hospital CEO Dr. Ze’ev Rothstein explains “our policy is to extend help wherever it is needed.”

So they created ‘Operation New Smile’ – with the goal of providing needed plastic surgery and medical care in the Third World.

Operation New Smile’s mission hinges on creating cooperative relationships with doctors and medical technicians in the countries where they work.

“It’s not just I’m landing in Hanoi airport and I’m saying the great Dr. Winkler is here and bring me your kids,” – explains the jovial doctor with a smile. “We want to work together with them. It’s a mission of cooperation, it’s a mission of sharing techniques and assisting each other and learning and teaching at the same time,” said Winkler.

Cleft lip/ palate is a congenital deformity that causes failure in facial development during pregnancy. It occurs in different grades of severity, which are divided into two major categories: cleft lip (hare lip or hair lip) and cleft palate. In Israel and the West, surgery to correct these deformities is common and occurs early in a child’s life.

A child born with cleft lip will be treated by the age of 10 to 20 weeks, and with a cleft palate by the age of 18 to 24 months. Because of the important role of the palate in speech and in eating, it is considered critical to correct the deformity early in order to allow a child to develop normally.

“Nobody’s really sure of the gene that causes it or the surrounding conditions that lead to it. It might be both,” explains Winkler. “You do see more cleft lip palate kids among alcoholic women for example. But nobody really understands it.”

“In the Third World there are thousands or maybe tens of thousands of kids, nobody really knows, that are both born undiagnosed prenatally with cleft lip/palate problems and that do not receive treatment.”

Operation New Smile is doing what it can to change that. In 1999, the Sheba team traveled to Haiphong, Vietnam on their first ‘Smile’ mission. Four doctors went with the Sheba team – two plastic surgeons, a pediatrician and an anesthesiologist. They worked 12 hours a day for a week, operating on babies and toddlers up to three years old. In the end, they operated on between 30 and 50 children suffering from cleft lip/palate.

The team’s first emergency intervention came at the end of 2001. A fire, most likely caused by makeshift fireworks, broke out in the Mesa Redonda section of Lima, Peru. Hundreds of people were killed and hundreds more disfigured in the chaos. The Peruvian government appealed for help, and Israel sent Winkler and a colleague to Lima immediately.

“We packed some bandages, some ointments, some knives and started our long way to Peru. We were there within 72 hours of disaster. And we found ourselves in one of the hospitals working hard with the [local] team, shoulder to shoulder,” recalls Winkler. He and colleague, Dr. Joseph Haik, now head of Sheba’s Burn Unit, worked with the Peruvian doctors and medical staff for approximately ten days, treating hundreds of patients.

Peruvian president, Alejandro Toledo and his wife Eliane Karp de Toledo were grateful for the doctors? work, thanking them publicly in a press conference and taking them on a private helicopter ride above the Andes. First Lady Eliane de Toledo had spent several years living in Israel, and when. Winkler told her about Operation New Smile’s work with cleft lip/palate children she offered to help them set up missions in Peru. The group has done three subsequent cleft lip palate missions to Peru, two to the Amazonian region of Peru in 2001 and 2004, and the most recent to Huancayo in February.

Funding for the missions comes from wherever. Winkler and the hospital can find it – sometimes the Israeli Ministry of Foreign Affairs helps, sometimes private donors, and sometimes the doctors pay out of their own pockets. Sheba offers the doctors the time off and the surgical instruments they bring with them and leave behind for their colleagues in the countries they visit.

“We try to always bring stitches, suturing material, and surgical instruments,” explains Winkler. “That’s our highest level of donation.”

He hopes that he can establish regular sources of funding that will enable the group to organize more missions to areas in need.

As Israelis, Winkler believes the missions overseas serve another important purpose. “We feel that we are the real ambassadors of Israel,” he declares.

Sheba CEO Rothstein puts it another way: “Sheba Medical Center is Israel in a nutshell – we represent willingness to help, professionalism, research, education – everything that Israel is proud of.”

The missions can be an emotional roller coaster even for the experienced surgeons. In Huancayo, they met a three month old baby with a major cleft palate that they believed likely had some brain involvement.

“He was dehydrated, malnourished, being kissed by his mother,” describes Winkler sadly. The surgeons knew there was nothing they could do for him, for he was too weak to survive the operation. “He has probably already died.”

But there are also the children for whom the treatment can mean a whole new life. In Huancayo, they met a ten year old boy called “onze” or eleven in Spanish. He had gained this nickname because of an eleventh finger. The boy also had a cleft lip.

“He was hidden by parents, never brought to parties as a child,” explains Winkler. “And when he went to school, everybody laughed at him because he had a tiny finger coming out of first finger.”

The team operated on onze, removing the extra finger and correcting the cleft lip.

“The first time he saw himself in the mirror he started weeping. His parents acted like we were Jesus Christ coming the save them, they called us savior, savior,” says Winkler, obviously moved by the experience.

It’s making this kind of a difference in the lives of people around the world that makes Winkler and the Sheba team eager to organize more missions.

“They call our OR [operating room] a theater, because we are like actors there,” explains. Winkler. “And at the end of the show, at the end of the week, mothers, and children are weeping, crying and falling on our legs. Kissing us. So this is something you cannot replace, I mean no money in the world can buy. And after you are experiencing it once, you always want to come back, no matter how hard it is.”

For Winkler, the work of helping those in need abroad is also critical in spreading an important message to those at home, his three children ages 13, ten and one.

“They’re so proud of me. They can’t wait for the age when they can join me,” explains the proud father. “They prepare pictures for the kids, they prepare presents to send, they give them toys they’ve never touched for them to play with. And I feel that this is the most important thing of the trips. It’s raising kids into a giving atmosphere.”

“I think when you see poverty to its edge you learn the value of the life you lead. You have to thank god for the shefa – the abundance – that we have.”