Huehuetenango School Outreach

There is nothing more satisfying than sharing inspiring stories. And few things meet that criteria like Iowa Miles of Smiles Team's (Iowa MOST's) annual medical mission to the Western Highlands of Guatemala to save children from lives without hope. Its 13th mission will commence February 24, 2018.

Iowa MOST is sponsored by the Iowa City AM Rotary District 6000 Club, and is comprised mostly of volunteer medical staff from the University of Iowa Hospitals and Clinics, including this year's medical team leader, renowned cleft surgeon Dr. John Canady, as well as other selfless expert doctors and professionals from surrounding areas. (A list of all the participants and much more can be found at

Deb Dunkhase is Iowa MOST's mission coordinator and quintessential ambassador. (She is also the longtime executive director of the Iowa Children's Museum.) Not only is Deb warm and enthusiastic (to put it mildly), she recognizes a far deeper aspect to what Iowa MOST provides: hope, healing, and life-affirming transformation; the kind that occurs when you give so completely to others, especially children.

Deb passionately asserts that being part of Iowa MOST is "one of the biggest gifts of my life.”

Iowa MOST's altruistic men and women possess a fierce devotion to children's health and well-being. This devotion is expressed in an epic collaborative effort with the medical staff at Huehuetenango, Guatemala, that demands they travel once a year to this remote part of the country to preform cleft-lip and palate surgeries for as many as 100 children in a single trip, suffering throughout Guatemala's extremely impoverished Western Highlands' villages.

The 40-member, all-volunteer team is comprised of three cleft surgeons, one eyes/ears/nose surgeon, an anesthesiologist team, surgical nurses (including our own Paula Sauceda from Davenport), a recovery team, two dentists, a pediatrician and pediatric team, and support staff, all of whom courageously make the difficult journey to operate in the most austere environments where language can be a barrier, not to mention having to overcome all manner of obstacles arising from the extreme poverty and cultural mores of their patients.

In Guatemala, one out of every 600 children is born with a cleft defect. (Globally, the average is one in 700.) However, Guatemala is considered among the poorest nations in the world, with over 75 percent living in extreme poverty. Consequently, these families have no resources for medical help.

Cleft defects, if untreated, result in all kinds of additional health problems, ranging from severe dental problems, hearing and seeing complications, and breathing and respiratory conditions, to malnutrition and eating disorders that evolve over time into other debilitating illnesses and disease.

Furthermore, the physical discomfort and pain associated with cleft defects, especially over time, erode both body and spirit. Constant, chronic pain and disability when talking, eating, breathing, occasionally smiling, and even crying are unimaginable to most of us who have modern medicines and access to medical care – myriad remedies that provide relief. Families subsisting in extreme poverty in remote areas, such as those in Guatemala, have no electricity or running water, never mind relief. Instead, villagers must walk several miles to a potable stream for a safe drink of water.

Add to this the cultural stigma attached to cleft deformities. In Guatemala's Western Highlands, children born with cleft lips, palates, or both, are considered cursed, therefore separated and ostracized from normal village life. From birth, these children are hidden away, isolated out of shame. They are not allowed to go to school, socialize with other children in the village, or work in any capacity. They live lives of unimaginable loneliness, sadness, introversion, longing for normalcy, and belonging that goes largely unfulfilled.

These innocent children are prohibited from attending school and interacting with other children, nor are they permitted to work or participate socially, leaving their potential to thrive utterly stalled. These unfortunate kids grow up totally uneducated, shamed, ridiculed, and isolated due to the cultural stigma attached to their badly disfigured little faces. Most cruelly of all is the stark absence of hope that such an existence fosters.

In America, if a child is born with cleft, his or her condition is remedied within the first year. It is usually a simple procedure to reverse or repair, allowing the baby to grow up normally with none of the emotional scarring that otherwise accrues with such defects. Those who have experienced some form of disfigurement know all too well the insecurity and sadness that constantly looms. It is difficult enough to overcome without the overwhelming socioeconomic confinement and hopeless resignation mandated by extreme poverty It is an unspeakable fate.

Is it any wonder that compassion defines Iowa MOST and the Iowa City AM Rotary Club, along with 50 Iowa Rotary Clubs who collectively fund this imperative mission through donations and two primary fundraisers? The first is a talent show organized by local high schools, whose efforts help to raise the $50,000 necessary to fund the annual medical mission to Guatemala. Rumor has it that the talent show has developed a solid reputation for creativity, high energy, and, you guessed it, talent! It is no accident that it beautifully reflects the mission it supports.

The second fundraiser is very successful – and scrumptious! One of the team surgeons, Dr. Dan, fishes in Alaska for fresh salmon and he will fish for you, offering fresh salmon at $20/lb. and delivered to your door. Each year, all proceeds support that year's medical mission. Visit to place your order for fresh salmon, knowing that your purchase goes directly to Iowa MOST and its medical missions in Huehuetenango, Guatemala. It is a comfort knowing that all funds donated go directly to necessities (all personnel are volunteers) such as medical supplies, travel costs, food, housing, and whatever else contributes to a mission's success.

It is dedication, out-of-the box fund-raising using good old fashioned transparency, and a tireless commitment to improve the lives of children that characterizes Iowa MOST, and by association, its donors. Visit /donate to learn more and to contribute whatever you choose. By doing so, you will become part of something extraordinarily special.

It must also be noted that Huehuetenango, Guatemala's own Rotary Club performs a herculean effort every year, reaching out into the community, traveling to the remote villages to recruit children for the mission, overcoming monumental obstacles to get children to the hospital for screenings and, if their health permits, life-changing surgeries.

The Guatemalan team must overcome social and cultural taboos and deeply-rooted fears, as well as provide most of the resources to expedite parents' ability to make the journey with their children, including transportation where possible (often much of it on foot, carrying their toddlers with cleft defects), housing, food, comforting parents, and providing advocacy as their child goes through the process.

It is hard to imagine the amount of work, coordination, and infinite details that must coalesce for this mission to succeed year after year. Deb explains, “Lots and lots of details go into medical missions. Most of us don't speak Spanish, so much of communication is openness and facial expressions. You basically step into that world and give of yourself. We want the families to feel safe and cared for and not be afraid. The hospitals in Guatemala are so under-supplied and lacking in resources, people are afraid to come to hospitals. Because the patients are kids, we add a lot of play into the experience. We play, sing, and bond with the kiddos and parents as much as we can to make them comfortable.”

The first day is set aside for screenings of each child to confirm he or she is healthy enough to have the surgery (or surgeries). Each child is seen by a surgeon, pediatrician, anesthesiologist, and dentist, all of whom perform physical examinations to identify any additional or related issues that need to be addressed with the cleft repair and/or extraneous problems that might interfere with a successful outcome.

Iowa MOST's primary concern is safety for these children. If a child has complications that prohibit the cleft surgery, the team is often able to secure the proper care to resolve that child's issue(s), clearing him or her for the cleft procedure(s) during the next mission.

“Often the same kids are seen year after year that need follow up procedures," says Deb, "so we get to watch their progress. They are so sad when they first come, and are scared witless, as are their parents. But once they get through the first procedure and experience the initial changes, they slowly start to smile and come out of their shell. Their personalities begin to emerge and we get to watch the transformation. It is really exciting, and why we do what we do.

"And as wonderful as what we do for the kiddos is," Deb emphasizes, "the impact it has on the volunteers and team is even more so."

One final story illustrates the almost magical spirit of what takes place during Iowa MOST missions. After years of repairing cleft lips and palates for children and teens, an older villager approached the team and asked to have surgery to fix his cleft lip. This elderly man was 70 years old when he reached out to this extraordinary medical team who happily and successfully performed the surgery. His own bravery brought him to the welcoming care offered by Iowa MOST's medical mission, where he was given relief from a lifetime of isolation and physical suffering, and best of all, new hope.

If you are interested in following this year's Iowa MOST mission, you can follow team member Taise Winkleblack, who writes Iowa MOST's blog and documents and photographs their missions at

Deb summarized perfectly the essence of Iowa MOST. “Everybody's quest in life is to lead a happy healthy life ... . I really believe that what you do here on this earth that makes every individual person happiest is helping someone else, especially helping someone who is really in need. So this [Iowa MOST] is such an opportunity, whether you go on the mission, or you help raise money for the mission – no matter what you do, by getting associated with this, you are helping these young children in such dramatic ways, it's hard to even comprehend.

"You are taking a child who is trapped in a little hut with a dirt floor, somewhere high in the mountains of Guatemala, no chance of an education, really unhealthy because of all these medical complications from cleft. And with one tiny 10-day trip to Guatemala, you're able to change that child's life so that the child has some hope of a future, where they can get out there and get a job, get married and have a family, and have some happiness in their lives. To be connected with a project like that, that really directly changes a child's life, is remarkable. It is such a gift for me, and for anyone else who is involved with this, to have the opportunity – a real true gift.”

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