Dear Editor,
SMILE Train is an international charity that was established in 1999 and has a reputation for its work in 87 countries across the globe. This organisation works with the notion of “teaching a man to fish” and aims to achieve every aspect of care for children who have cleft lips and palates.
Many children with cleft lips and palates are unfortunately stared at, ridiculed and at times neglected for their appearance and speech. These children who are intellectually gifted may not be exposed to the same opportunities as their peers because of their parents’ reluctance to send them to school or expose them to the public. Children with cleft lips and palates often navigate life with their smiles hidden; fortunately for our Guyanese population, this is about to come to an end with the introduction of our Smile Train Cleft Centre at the Georgetown Public Hospital Corporation (GPHC).
This local Smile Train team is headed by Dr Shilindra Rajkumar and his team, which includes doctors from the departments of Plastic Surgery, Paediatrics, Maxillo-facial Surgery and Anaesthesia, along with a competent core team of theatre and ward nurses.
This team, which is constantly expanding, has restored the smiles of 31 children through 38 cleft procedures since the inauguration in September 2019. These surgeries were carried out on three separate surgical missions with the second and third being delayed by two years due to the COVID-19 pandemic. The last surgical mission which was undertaken between April 8 – 11th, saw 13 patients: seven lips and six palates were operated on under the guidance of Smile Train Plastic Surgeon Louise Laberge and Anaesthesiologist, Dr. Richard Raker.
The Smile Train team is currently in the process of planning its fourth mission, which is expected to take place in September 2022. Currently, the team is undertaking active recruitment throughout the 10 administrative regions of Guyana to identify potential patients and refer them to the GPHC’s Plastic Surgery Department. When a patient is identified, the parents/guardians are contacted and the plans for care and surgery are made and all questions by the guardians are addressed in person or via telephone for outlying regions. The parents are then provided with a contact number for the doctors in the programme so their concerns can be addressed as they arise, and patients are referred to the specialist doctors if needed.
As the surgery dates approach, patients from the hinterland who require assistance with transportation are contacted through their respective Regional Health Services and supported by DeSinco’s Trading, who make all the necessary provisions for transportation, including flights, from the hinterland to the hospital.
The patient’s preparation continues with the combined efforts of the Plastic Surgery, Paediatrics and Anaesthesia teams to ensure that the patients are optimised for surgery and receive the necessary procedures safely. However, surgeries are not the only aim of the Caribbean’s only established Cleft Centre, but the holistic care of the patient which caters for their developmental needs. As such, three elements will be added to the programme from this year, including: Orthodontics for implants and alignment of the teeth; Speech Therapy to improve pronunciation of words for communication; and nutrition, to assist with the patient’s growth and development.
Smile Train Cleft Centre’s team is determined to provide this service to all patients with cleft lips and palates in Guyana and the Caribbean, so that they can receive the care that they deserve, to live healthy, happy lives.

Yours sincerely,
Georgetown Public Hospital Corporation