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Smile Train: the other Indian Oscar winner

Andrew Buncombe
Tuesday 24 February 2009 20:00 EST
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When Brijmohan and Ruchi Gupta's baby was born, the young couple were nothing less than stunned. Their joy over the arrival of their first-born, Dimpy, was tempered by anguish over their son's twisted snarl of a mouth. "We were shocked to see it. We had never seen anything like it before, either in our family or elsewhere," said Mr Gupta, sitting today at Delhi's Sir Ganga Ram hospital.

In India, an estimated 35,000 children are born with cleft deficiencies every year. In the past those children may have been condemned to lives of ridicule, hardship and discrimination, but because of the efforts of a charity, those children now have a second chance. And it doesn't cost them a rupee.

The work of the global charity Smile Train was featured in the 39-minute film Smile Pinki, which netted the best short documentary award at this year's Oscars. Directed by American filmmaker Megan Mylan, the film tells the story of Pinki Devi, an eight-year-old girl from the state of Uttar Pradesh who underwent surgery to repair a cleft lip for which she was once mocked as "hothkati" - the girl with the torn lip. "Thank you Pinki. Thank you for letting me tell your incredible story," said Ms Mylan during her acceptance speech.

Like Pinki's parents, Mr and Mrs Gupta had no idea that their child's problem could be solved by straight-forward surgery. At the hospital, staff explained to them that the operation could take as little as an hour. Three month-old Dimpy will undergo surgery in a couple of days. "We're much more relaxed now that we've had it explained. Now we've no worries. We've seen other people in the same situation," said Mrs Gupta.

Dr Rakesh Khazanchi is the head of the hospital's department of plastic surgery. He said that all parents are shocked until they discover that the problem of a cleft lip or palate can be repaired simply. While a cleft lip was largely a problem of appearance, a cleft palate meant someone could suffer from problems with speaking, eating, facial development and dental set-backs. "If it is just a lip problem then one operation may be enough," he said. "If it is a palate they may need three or four [until after puberty]."

In the past 10 years, Smile Train has funded around 400,000 operations to repair cleft palates. Of those 150,000 have been in India. This year, the charity expects to pay for 50,000 such operations here, a figure which means they are slowly starting to tackle India's backlog of cases.

"We always say that cleft palates are not a medical problem but an economic problem," said Satish Kalra, the charity's South Asia director. "The incidence of clefts is as high in the UK as it is in the [impoverished Indian state of] Bihar - around one in seven hundred. It's an economic problem, so let's solve it. You can treat someone for as little as $250 (150 STERLING)."

Mr Kalra said that in rural India there was still a huge amount of superstition and myth attached to clefts. The most common, he said, was that if a pregnant woman used a knife or scissors during a solar eclipse her child would suffer the defect. Such has been the spread of this belief that in the southern Indian language of Telugu, the phrase for a cleft is "lip of the eclipse".

Elsewhere, where a child's pre-maxilla protrudes through the gap created by the cleft, they are often likened to Ganesh, the elephant God. "Invariably if these children are boys they will be called Viniyaka, one of the names of Ganesh," said Mr Kalra.

At Sir Ganga Ram hospital, Kelsang Choetso and her 16-month-old daughter Dolma had also been seeing the staff. When her daughter was born with a cleft lip and palate, Mrs Kelsang said she had fainted. "This was the first time I had seen anything like it. I thought I must have eaten something wrong during the pregnancy," she said.

But now, following two operations, her daughter' face has been largely repaired. In a couple of months, specialists will operate again to build up her nose. When they have finished, there will be no trace of the problem that once disfigured her.

That has also been the case of Pinki, the beaming star of the Oscar-winning movie. But while she was flown to Los Angeles to enjoy the ceremony, fatigue got the better of her before the award was announced. Dr Subodh Kumar Singh, the Varanasi-based surgeon who performed her operation, told the BBC: "Before the awards, she was very good on the red carpet and posed for pictures with the rest of the team. But she got tired and fell asleep."

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