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Tata Steel's 'Operation Muskaan' brings back smiles

Hundreds of people born with cleft lips or cleft palates have been operated on, for free, through 'Operation Muskaan' a project initiated by steel giant Tata Steel. It's a small operation that has made a huge difference to people's lives

'Muskaan' Bano would look into the mirror every day, take a needle to her mother and ask her to stitch up her upper lip. Her mother could only shake her head helplessly. Some days she would go into the kitchen and weep silently.

All little Bano, born with a cleft lip, wanted to do was to be able to pronounce her name loudly and clearly. Clear enough for everyone in the 'basti' (hutment colony) to hear her and stop teasing her about her slurred speech. She tried ever so hard, but her name never came out the way the other kids' names did.

When the other children began going to school, Bano stayed at home. Her parents did not insist she go to school.

That is, until the Tata Steel doctors at the Tata Main Hospital (TMH) in Jamshedpur gave Bano back her name and her smile.

Since Bano's operation, and in less than two years, the Tata Steel doctors have repaired -- free of cost -- the cleft lips and cleft palates of 775 children and adults. All belong to underprivileged families in Jamshedpur, in Jharkhand's East Singhbhum district, and Gopalpur and Belpahar in neighbouring Orissa. There have even been referral cases from Haldia Port Trust in West Bengal.

Christened 'Operation Muskaan', this Smile Train project was flagged off in October 2002 by the Tata Steel Rural Development Society (TSRDS), Tata Steel's NGO community service arm. The TSRDS realised the urgent need for this form of reconstructive surgery at various health camps. At one weeklong camp in Ghatsila, doctors treated 108 cleft cases; in Deoghar, 149 people requested surgery.

The New York-based non-profit organisation Smile Train, which works across countries to eradicate cleft lips and palates, is the TSRDS's main partner in Operation Muskaan, providing financial support to the tune of Rs 6,500 per patient and ensuring updated infrastructure and trained medical professionals.

A cleft lip is a separation of the two sides of the lip. This separation often includes the bones of the upper jaw and/or the upper gum. A cleft palate is an opening in the roof of the mouth in which the two sides of the palate have not fused, or joined together, during the baby's development.

Cleft lip and cleft palate are not as rare as people think they are. Together they constitute the fourth most common birth defect. One out of every 700 newborns is born with a cleft lip and/or cleft palate. In 45% of cases they occur together.

It is widely believed that people with cleft lip are cursed (the curse of a moon in eclipse/the curse of god on the unborn child when a pregnant woman is out on such a night). "'Bachua ke honth mein grahan lag gaya ('The eclipse has left its mark on the child's lip,'),' is the thought most parents harbour, and this must be removed before we can think of eradicating cleft," says Dr R Bharat, senior specialist at the burns and plastic surgery department at the Tata Main Hospital, who has spearheaded the cleft project.

The superstition extended predicts that if a cleft is rectified the curse shifts onto the entire family, the reason why many people, sadly, do nothing about their child's condition. Parents sometimes even abandon their children to escape the so-called curse.

Like Shabo Khatun's parents did. Only a few days old, Shabo's parents dumped her with her grandmother, a widow, in their native village. They never wanted to see her again. When Shabo was three years old, her grandmother heard that a child in the nearby village had had his cleft lip repaired at the TMH for free. After she was successfully operated on, Shabo's parents returned to claim their daughter.

Sanjay Yadav from Dugdha village in Gamaharia block in West Singhbhum district places the blame squarely on his wife. "Somebody has done paap (sin), but it is not me," he said when he saw his newborn son. Mothers are often blamed for giving birth to children with clefts, and, as a consequence, they suffer a lot of the social and psychological trauma their children go through.

Sanjay did not bother to accompany his 10-month-old son Roshan to the TMH. His wife Sanju Devi, 22, took her aging mother Rajmati Devi along for support. Like his elder sibling, Roshan was delivered by Caesarean section. Sanju and her mother earnestly explain that while the elder child escaped unscathed, Roshan's lip had been sliced during the operation.

A 45-minute cleft lip (not palate) operation costs Rs 12,000 at a private clinic in Jamshedpur, Rs 20,000 in Ranchi and thrice as much in any metropolis. That's a huge amount for a poor family to spend on a facial deformity that, they console themselves, is not life threatening.

The best age to operate on cleft palates is when the child is below 18 months (for cleft lip, when the child is two to three months old) so that subsequently the face and speech are allowed a chance to develop normally.

The social stigma, the cost and the lack of awareness about repairing clefts are factors that deprive children of a good education, marriage and a normal social life. Twelve young women were able to get married after we treated them, says Dr Bharat.

An added reward for the steel major is the community's response. Children returning home after a couple of days in hospital, looking and speaking almost normally, are viewed as nothing short of a miracle.

A growing number of companies in developed countries are recognising that globalisation is transforming corporate social responsibility (CSR) from a choice into an imperative. Besides taking care of their bottom line, corporates must now adopt measures for sustainable growth through their labour practices, environmental habits and protection of community interests.

While India Inc still calculates the pluses and minuses of good corporate conduct, corporate social responsibility for the Tatas and the Birlas is an old tradition. The Tata Group invested more than Rs 150 crore on the social sector in 2002, the A V Birla Group Rs 57 crore, Reliance Rs 30 crore and Infosys Rs 5 crore. Tata Steel sets aside as much as 12-14% of its profits after tax (PAT for 2003-04 is Rs 1746.22 crore) for welfare activities. So that many more children like Bano may be gifted a precious smile.

Contact: Tata Steel Rural Development Society
'E' Road, Northern Town
Jamshedpur 831001
Tel: 0657-425999/430306
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

--By Manipadma Jena
(Manipadma Jena is a senior development journalist and consultant based in Bhubaneswar, Orissa)

Infochange News & Features, August 2004