The Road to Ramata's Smile


Photos: Margherita Mirabella

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While Ghana offers some of Africa’s most beautiful landscapes, from lush rainforests to tropical beaches, it also suffers from a critical lack of adequate physical infrastructure, health care services and economic opportunities, resulting in some of the world’s most significant barriers to safe surgical care for its citizens.

It also means rough roads lead from the rural community of Assin Praso to the historic city of Cape Coast.

Though the physical condition of the highways is the same for all who travel between the two cities, the round trips made by Mariana and her daughter, Ramata, were among the most challenging.

Now 4 years old, Ramata was born with a cleft lip and a cleft palate. Mariana was determined to access safe surgical care to repair her daughter’s condition.

Five times, Mariana raised enough money for bus fare and took Ramata to Cape Coast in search of a free surgical option. Five times, the return trip was made all the rockier by heartbreak.

Each time doctors assessed Ramata’s health, she was either anemic or too underweight to receive safe surgery. Even if she would have been deemed healthy enough for surgery, she had no way of being able to afford its cost of 300 cedi ($75).

Disappointed but undeterred, Mariana remained vigilant about finding care for Ramata despite her extremely limited resources — she earns a meager living carrying water containers and gathering firewood for her neighbors. When Mariana met a non-medical volunteer from Operation Smile Ghana who was conducting an awareness campaign in Assin Praso, the lives of the family would change forever.

At first, Mariana didn’t believe that the surgeries Ramata needed would be free when she called Operation Smile Ghana Patient Coordinator Clement Ofosuhemeng to learn more about the organization and its work. He assured Mariana that there would be no cost for any procedures needed to repair Ramata’s cleft condition and that Operation Smile would provide a bus to take patients from the Assin Praso area to the next medical mission in Cape Coast.

After Mariana and Ramata made the three-hour trek back to Cape Coast for the Operation Smile medical mission, yet another roadblock diverted Ramata away from care for a staggering sixth time. Ramata had passed her comprehensive health assessment and was approved for cleft lip surgery when she contracted malaria — a major health scare for the young patient in its own right.

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Fortunately, Ramata survived her bout with malaria and returned to good health as she and her mother looked forward to the next Operation Smile medical mission in the eastern city of Ho. It would be here that she would receive the life-changing procedure which had proved to be so elusive.

In the months leading up to the Ho medical mission, Ramata started attending kindergarten and immediately developed an affinity for school and learning. She also experienced bullying from some of her classmates while others would stare at her cleft lip and shun her. The teasing and isolation drove Ramata to tears.

Mariana also suffered social hardships after Ramata was born. As her family offered little, if any, emotional support, she became the target of insults and blame from some of her neighbors for having birthed a child with a cleft condition. While these words infuriated Mariana, they also hardened her resolve to find a surgical solution for her daughter — to give her the chance to pursue an education without it being derailed by cruel treatment from her peers.

Again, Ramata and Mariana boarded the Operation Smile bus and made the 10-hour trip from Assin Praso to Ho. Again, she was cleared for surgery after her patient health assessment, but this time made it to the operating room without further complications and received surgery to repair her cleft lip.

Finally, Ramata truly began her journey toward becoming cleft-free. She returned to Ho five months later for her first cleft palate surgery and is scheduled for her next procedure at the Tamale medical mission, which coincides with World Smile Day on Oct. 7.

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In countries like Ghana, where people living with cleft conditions face daunting barriers to surgical care and often experience shame or stigmatization, Operation Smile is committed to sustaining medical missions to serve every possible patient it can reach. The organization is committed to returning as many times as it takes until every patient with a cleft condition is healed.


“Every child that has a facial deformity is our responsibility. If we don’t take care of that child, there’s no guarantee that anyone else will.”

- Kathy Magee, Operation Smile Co-founder