Dr. Grégoire Akakpo-Numado is the head of pediatric surgery — as well as the only pediatric surgeon — at the University Teaching Hospital (CHU) in Lomé, the capital and largest city of Togo, a small, French-speaking country in West Africa. Though he has held this position since 2015, he recently celebrated one year as a Smile Train partner. To mark the occasion, Dr. Akakpo-Numado shared his winding journey to pediatric surgery with us and the impact his partnership with Smile Train is already having not only on his patients, but on the whole culture of healthcare in the region — and how he expects that impact will multiply with each coming year.
I earned my bachelor’s degree with high honors, then went home still not really knowing what I wanted to do. This made my father angry — he couldn’t understand how I could go to all that effort earning a degree and still not know what I wanted to do with my life! I had to make a decision. I had heard that medicine was very difficult, and I’ve always liked a challenge, so I applied to medical school.
That was how I decided to become a doctor.
I had hoped to parlay my success as an undergrad into a scholarship for my next phase, but I was not so fortunate. I began medical school here in Lomé and prepared myself to be in debt once I graduated. But then, a month into my program, I got my lucky break after all when I heard my name over the radio — I had been awarded a scholarship to study dental surgery in Senegal!
I couldn’t believe it; I had never traveled like that before! I only had a few days to prepare, so I organized my suitcase and my passport and my other documents, then, as a last thing, went to say goodbye to my high school math teacher, who had become my very good friend.
I told him everything that had happened, and he was thrilled… until I mentioned I would be studying dental surgery. That moment will stay in my memory forever — his face was bursting with pride, then suddenly sank like a punctured balloon.
He explained that, unfortunately, there is no culture of dental care yet in Togo. He worried I would go to school, then come back, open my practice, and have no patients and nothing to do. To prove it, he took me on his bike to meet his one of his sisters.
She had studied dental surgery then went to France to work as a maid — even after she was licensed as a surgeon! — just to earn enough money for the equipment she needed to start her clinic. It was beautiful equipment. I saw it all there, millions of francs worth, sitting pristine in her empty clinic, waiting for the one or two patients a month she might use it for.
I went home disappointed. Clearly, I had a decision to make. After much thought, I ultimately made the difficult choice to go back to school in Lomé to continue my general medical studies without a scholarship. My dad was mad again, but that was ok.
What My Patients Need
As I began my studies, I realized that I wanted to be a pediatric surgeon because I love working with children, and surgeons can treat patients from their first diagnosis through to their final result. At that time, there was no residency program in pediatric surgery in Togo, however, so, following graduation, I did residencies in France and Ivory Coast, then, at last, got a job at Tokoin Sylvanus Olympic Teaching Hospital in Lomé.
After a few years there, I came here to the University Teaching Hospital (CHU) to establish a pediatric surgery department. I am still the only pediatric surgeon, though I have trained many other doctors and nurses in my tenure.
I learned of Smile Train by accident and, at first, almost couldn’t believe it was real. Here was, finally, an organization that was truly interested in knowing exactly what my hospital and I needed to guarantee our cleft patients the in-house, long-term, sustainable care they need to thrive.
Getting Aboard Smile Train
It started when I met Dr. Nicole Bouba, Smile Train’s Program Director for West and Central Africa, by sheer coincidence at a conference a few years ago. I was immediately interested in becoming a Smile Train partner, of course, and after the event, she came to my office to explain all we needed to do to be accepted, including completing a full safety audit of CHU and a lot of paperwork. It seemed quite complicated, but she assured me that we would get through it, and she walked me through step by step, along with Becket Gbede, Smile Train’s Program Manager for our region.
The happy day when we were at last accepted came just about one year ago, and nothing has been the same here ever since. Partners for Life Our partnership came just in time. Mission groups haven’t come to Togo at all since the pandemic. Now, thanks to Smile Train, babies from families who cannot afford surgery will no longer have to wait indefinitely for the care their child needs. We can provide it that very week, to the very highest standard, for free.
Partners for Life
Our partnership came just in time. Mission groups haven’t come to Togo at all since the pandemic. Now, thanks to Smile Train, babies from families who cannot afford surgery will no longer have to wait indefinitely for the care their child needs. We can provide it that very week, to the very highest standard, for free.
You can’t imagine the faces of these mothers when we tell them this news. They come to us having not slept a wink since their baby was born with a cleft. They tell us their child can’t eat without choking and cries and cries day and night. The mother is crying, too, because she has no money for care, even to save her baby’s life. And instead of helping, too often, her family wrongly blames her for her child’s cleft. She feels completely alone and afraid and unable to do anything other than watch her baby waste away.
So, we greet her with a smile and tell her she’s come to the right place; everything is going to be ok now because we are going to give your baby the care they need to smile and thrive, now and always, completely free, thanks to Smile Train.
That indescribable moment of joy and relief also creates an instant trust, an instant connection, between us. When families know the care their child needs will always be available at the exact time they need it, they begin to feel invested in their child’s cleft journey. They call us from time to time to ask questions, and we call them as well to check in on them. It really makes things easier. Smile Train gives me the freedom to schedule the patients at the time I think is best, and I perform their surgeries without any problem.
Bright Smiles, A Brighter Future
Over the next five, or even the next two or three years, I can see the CHU campus becoming a holistic center for treating clefts, offering surgery, speech therapy, orthodontics, and nutrition support. This last piece is especially urgent because we currently have 10 babies who have reached the age of cleft surgery, but I cannot do it because their weights are too low; it would be unsafe.
So, this is a major problem, and with help from Smile Train's Dr. Nina Capo-Chichi, we are thinking about how to set up a nutrition program to help the children can eat as they must to reach a healthy weight.
I’m very optimistic about the future, both for our patients and their families and for our partnership with Smile Train. On behalf of my staff, my patients, and their families, I want to say thank you to Smile Train and their wonderful donors for helping us provide high-quality, long-term, local care to cleft-affected families in Lomé and across Togo.
You really are helping us save lives and create smiles each day!