A Doctor’s 17-Year Mission to Repair Faces and Restore Lives in Mayotte
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For 17 years, Dr. Nathalie Degardin has led medical missions to Mayotte, a French island in the Indian Ocean, providing life-changing reconstructive surgery to children born with cleft lip and palate and other facial malformations. What began as occasional support in 2008 has blossomed into a sustained humanitarian effort,offering hope and a future to children previously condemned to social isolation.
The need is profound. Mayotte’s maternity ward, the largest in France with over 10,000 deliveries annually, sees between 15 and 20 children born with clefts each year. Without intervention, these children face notable challenges – difficulties with speech, feeding, and the pervasive stigma that can lead to ostracism. Dr. Degardin and her team are working to change that.
From Temporary Support to Long-Term Commitment
Dr. Degardin, Head of the pediatric plastic surgery department at Timone hospital in Marseille, initially traveled to Mayotte as a temporary replacement for a colleague. Though, the impact of her work quickly solidified into a long-term commitment. “I had a 17-year-old girl, in her final year of secondary school, with a cleft palate that had never been operated on. She was incredibly intelligent and motivated,but her speech was so affected that she was afraid to speak in public,” Dr. Degardin recalled. “That’s when I realized this wasn’t just about surgery; it was about giving these children a voice and a chance to reach their full potential.”
Today,the missions operate under the umbrella of the association MAFACE,dedicated to all types of facial malformations,and SPRATON,focused on Pierre Robin sequence and related congenital sucking-swallowing disorders.
These centers provide complete care, addressing not only the physical aspects of these conditions but also the associated respiratory and feeding challenges. The SPRATON center, in particular, offers support from prenatal care through infancy, recognizing the critical need for early intervention.
Building a Sustainable System of Care
The missions to Mayotte, conducted twice yearly in September and march, are carefully timed to coincide with periods of lower epidemic activity. Each 10-day trip focuses on operating on approximately 15 to 20 children. The first day is dedicated to consultations, assessing new patients in the morning and following up with existing ones in the afternoon.
Recognizing the limitations of relying solely on visiting surgeons,Dr. Degardin is actively working to build local capacity. Currently,she travels with a pediatric anesthesiologist and an operating room nurse from Timone Enfants,as sufficient staffing levels are not consistently available on-site.”Cleft surgery is not very demanding in terms of resources,” she explained, “but you need a very experienced pediatric anesthesiologist, because sometimes, for example, we have to operate on children who are malnourished or have sickle cell disease.”
Dr. Degardin is also planning to facilitate training opportunities for nurses from the Mayotte CH at her Competence Center in Marseille, equipping them with the skills to provide improved initial care. This collaborative approach is further strengthened by the work of Dr. Emeric Robert, who recruits patients for pre-missions and ensures post-operative follow-up, and the dedicated dentistry team who have established the ORARES skills center for rare dental malformations. This ensures patients receive complete care, mirroring the standards available in mainland France.
A Legacy of Care and collaboration
In 17 years of missions, there have been no reported cases of major mortality or morbidity. While minor post-operative revisions are occasionally necessary, the overall success rate is remarkably high. Beyond the medical achievements, Dr.Degardin emphasizes the profound human connections forged over years of service. “I have been following some patients for over 15 years. Bonds were created with them, with their families and with the teams,” she said. “It’s always a lot of emotions and very strong human relationships.”
Dr. Degardin credits the enduring success of the mission to the consistent support of both the AP-HM and the CHM administrations, as well as the pioneering work of Drs. Joëlle and philippe Pariaud,the ENT specialists who initiated the program. She believes the mission’s lasting impact warrants recognizing their contributions by naming it in their honor. This ongoing commitment to serving vulnerable populations,she hopes,will inspire future generations of medical professionals to prioritize patient care and dedicate themselves to making a meaningful difference in the world.
