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A reason to smile

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Since 1993, Rotarians in Chile and the United States have teamed up to provide life-altering reconstructive surgeries

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Ricardo Román was shopping with his wife at a department store in Chile in 2012 when a woman in her early 20s approached him. He didn’t recognize her, he confesses through an interpreter, but there were two good reasons: He had last seen her more than a decade earlier – and her smile had changed drastically.

  1. Surgeons Lena Pinillos, left, and James Lehman, talk with a father about his child.

  2. The team evaluated 250 potential patients; the team selected patients based on need and the complexity of each surgery.

  3. A mother finishes paperwork for her son's surgery.

  4. Lehman wears fanciful scrubs to get the kids to smile.

  5. Preparing for surgery.

  6. An anxious father waits on the floor in a hospital corridor; with so many surgeries, there are often more people than chairs. 

  7. Cleft lip and palate have a hereditary component, but their precise cause is unclear.

  8. During the February session, 82 patients underwent surgery. 

  9. A mother comforts her child.

  10. The team includes surgeons, nurses, an anesthesiologist, and a speech pathologist, as well as Rotaractors and Rotarians who handle logistics and translation.

Román, a member of the Rotary Club of Reñaca, Chile, is the national coordinator of a  program that has helped thousands of children in Chile with cleft lips, cleft palates, and other birth defects – including this stranger who now wanted to give Román a hug.

“She told me, ‘This is my Rotarian smile,’” he recalls, his voice full of emotion. “It was a very gratifying moment.”

The project got its start in 1993 when San Francisco (California) Rotarians, led by Peter Lagarias and Angelo Capozzi, sponsored a medical mission that performed reconstructive surgeries in Chile. That was the beginning of Rotaplast, a program that evolved into a nonprofit organization that has since sent teams to 26 countries.

In 2004, Rotarians in Chile assumed leadership of the program in their country. Over the years, Chilean doctors became more involved and eventually the program expanded to include breast reconstruction for cancer patients.

“It’s a great commentary on Rotary that you’ve got people in a Spanish-speaking country and people in an English-speaking country working together to get things accomplished,” says James Lehman, a plastic surgeon who joined the Rotary Club of Fairlawn, Ohio, USA, after working with Rotarians in Chile.

She told me, ‘This is my Rotarian smile.’ It was a very gratifying moment.


Rotary Club of Reñaca, Chile

In February, Lehman and a team of U.S. surgeons, anesthesiologists, and nurses visited Iquique, a Pacific port city and tourist hot spot about 80 miles south of Chile’s northern border. With financial help from the nearby Collahuasi copper mine, local Rotarians coordinate and pay for the medical team’s food, lodging, and in-country transportation. (Visiting doctors pay for their flights between the United States and Chile; an Ohio-based nonprofit funds the travel of some support staff.)

More than 250 potential patients lined up early on a Saturday morning outside Ernesto Torres Galdames Hospital to try to get a spot on the team’s schedule. They had come from all over Chile, including a family who had traveled from Concepción, 1,400 miles to the south. About 600 children are born each year in Chile with cleft lips and palates, and though the government established eight centers to treat those abnormalities, the long wait list means corrective surgery can lie years in the future. “The demand exceeds the supply of people to take care of the patients,” Lehman explains.

Using four operating rooms – one for cleft lip or palate, one for ear reconstruction, one for breast reconstruction, and one for other issues – the team got to work. Patients were chosen based on need and on the complexity of the surgery. By the end of their stay, the surgeons and their staff had operated on 82 patients. In many cases, however, the complete reconstruction may take multiple surgeries, and some patients return several years in a row to complete the procedure.

But the final surgery doesn’t always signal an end to the relationship between a patient and Rotary. Román, who has coordinated the program since 2004, recalls an occasion involving the young woman he encountered in the department store. At Román’s invitation, she described her transformational cleft lip and palate surgeries at a Rotary district conference in Chile in 2012. Moved by her story, many in the crowd of 300 broke into tears, dazzled by her Rotarian smile.

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