The Ikeaesque floor plan is configured for maximum retail exposure and minimum convience, each ascending escalator lost in an opposing corner. Around and around in ever dizzying circles, ever up into the stratopherics and the sports department. We need to buy a football.
A short glance at a map for Provincia Santa Fe, with a bit of local geographical knowledge and you start to understand that booking clerk's incredulity at our decision to get off the train in Ceres. It's a less than obvious way to attempt an attack on the Paraguayan capital, Asunsion. It was a city escape, a chance to heat acclimatise, a nice distance to get into cycle travel mode. However the real reason is more prosaic. Alison, my sister was going be in town volunteering with "Operation Sonrisa", or as I've known it: 'Op. Smile'. A medical 'not for profit' organisation who carry out cleft palate restoration and many of the issues that are associated with the condition. She has volunteered for more years than I can remember, we, by donor and familial association.
Each of our travels have a habit of managing to not quite coincide, often missing each other by just a few days. That, and we really do want to see how a major medical NGO operates on the ground. Time to correct some deficiencies.
Our tour starts on the upper levels of the massive military hospital, the honour guard were bugling the national flag up the pole, but not for our arrival. Moving down through the floors, down through the differing procedures that a patient progresses along. From the initial assessment, pre-med preparation, a games area where the patients play with plastic syringes and gas masks, to the door of the operating theatre. Which is quite far enough for me. Finally to the recovery ward and the mirrors.
The pervading impression is one of calm, efficiency and a complete and utter absence of blood and bandages. There's no drama, yet it is dramatic. The before and after facial changes are remarkable. Near instant. Only a matter of one hour in the theatre and a life is transformed. Hence the mirrors, and the temporary tongue restraint. It would be near inhuman not to want to explore the new you, the new and entire mouth, the new and normal lip.
At dinner that evening, Alison offers to complete the the tour. Would we like to sit in on a lip operation tomorrow? Seize the opportunity, grab the moment. It's the epitome of travel. Only not for me; they don't need someone disgracing the occasion. I understand they were grateful.
However, The Navigator is made of tougher stuff.
I arrived at the hospital at 8am, in time for the first procedure do the day. I was to be observing a cleft lip correction for a wee girl, Mayra, of about a year old. Alison and I were duly swathed in blue Tyvek gowns, caps, shoe covers and masks and proceeded into the theatre to observe the preparations. My first thought was to be deeply grateful that it was cool - the unit that the technician had sourced after a breakdown yesterday was doing a great job. Then to note how full the place seemed, with at least 15 folk, all masked and gowned, working and supporting three operating tables - and the whole procedure running like an oiled machine. And the smiles. Despite everyone wearing masks, smiling eyes were everywhere.
We watched as Mayra was prepared for surgery, tucked up in warm wraps with heating pads on her ankles and then submerged under a blue surgical sheet with only a small space to expose the lower face. Then the team stood back to 'take 5' and review before starting the procedure. Dan, the floating surgeon for today, stood with us at the foot of the table and explained what was to happen. Don't worry; I won't go into great detail. Suffice to say it was a privilege to watch skilled and dedicated folk at work. An hour later, Mayra had a repaired lip and straightened nose, and in a few days she will be trying out her new smile. Back in the recovery room, she came round quite quickly and before long was proving that her lungs were completely unaffected. She will return to a future mission to have her cleft palate repaired.
The Paraguayan medical system has been heavily proactive in reducing the visible evidence of cleft palate within the community, such that this mission is operating primarily on under one year olds. Yet still they will have the occasional adult and teenager presenting themselves. One father and son family and J.... who is nineteen. It doesn't take a psychologist to divine the playground ostracisation that he's suffered, so it's little wonder that he spent an hour in the recovery ward, staring at his new image. The staff present of a football, the fact that it was in the correct team colours, was a fortuitous bonus. It would be the final act in his remarkable day.
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