René was the fourth child born to his family in the small town of Ricaurte, Ecuador, and the only one with a cleft lip and palate. He struggled to survive his first days, as more breastmilk seemed to come out his nose, choking him, than went down his throat. The baby was always hungry and at severe risk of malnutrition.
Then, a few months after René's birth, his mother’s fear for her child turned to joy when a foreign mission group landed offering to perform free cleft surgeries. René received his treatment, but unfortunately, the hole in palate, called a fistula, reopened after the mission left the area. As mission groups only stay in one location for a short time then leave, René was unable to get the proper follow-up care he desperately needed.
Due to his fistula and lack of access to speech therapy during his formative years, René grew frustrated that no one understood him when he spoke. The fistula caused him to struggle to eat solid foods, forcing him to spend years eating little besides tapioca or porridge.
Then catastrophe struck. When René was three, his mother passed away from bone cancer, a tragedy that became unimaginably worse when René’s father abandoned his children soon after, never to return. René’s seven-year-old sister, Cristina, was now forced into the role of primary caregiver. Cristina remembers those years, “At first our relatives would help financially, but the money soon ran out and we were on our own again. We borrowed water and electricity from our aunt, but there was rarely enough.” For her siblings to survive, Cristina dropped out of school and worked as a nanny and a cleaner.
School offered René no relief — he was teased every day for his speech. Yet he refused to miss a day because he knew, even as a child, that Cristina was sacrificing her own school career to give him a better life.
By 2017, Cristina and René’s siblings had left the house, leaving them alone in the family’s small home with no one to rely on but each other.
Later that year, René saw on the local news that Smile Train was partnering with the local medical facility, Fundacion Mashna Asirinki mas que una Sonrisa, in the nearby town of Cuenca to provide cleft surgeries and other comprehensive cleft care services like year-round speech therapy, all 100 %-free. Overjoyed, he met with Smile Train partners Dr Andrea and Dr Cristian Astudillo. After a lifetime of waiting and struggle, René’s fistula would finally be treated.
The doctors immediately sensed that one surgery couldn’t be the end of their relationship. Once they learned more about René and Cristina’s living circumstances, Dr Andrea and Dr Cristian personally organised transportation for René to travel to Cuenca for speech therapy. Even now, almost three years later, they continue to make sure he attends every session. The doctors also rallied the local medical community to ensure Cristina and René received the nutritional and dental care that had been beyond their reach since their mother passed away.
Despite all she’s weathered, Cristina maintains a positive outlook on life. “I would like to go back to school so I can get a better job and better take care of my brother. When I’m 18 next year, I hope to save enough money from my job so I can go to evening classes,” she said.
René enjoys his speech therapy sessions, saying that it makes him very happy to know he’ll be now able to speak up in the classroom with more confidence. And as a child who has always been conscious of the way he looks, his newfound confidence will grow even greater once Dr Cristian revises the cleft lip surgery he received as an infant.
René now wants to be a cleft specialist like his heroes Dr Andrea and Dr Cristian, “I know that there are many other children out there living with untreated clefts like me, and I want them to know that they are not alone and there are people out there willing to help them.”
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