Our 2018 Complex Surgical Mission Our wonderful volunteer nurse Catherine Collins has spent eight weeks in Ethiopia during our 2018 Complex Surgical Mission. Here she writes about two of our patients with a condition known as tongue-tie. When I first met Arasa and Mergersa, I couldn’t identify what condition had brought them to Project Harar. Both were accompanied by their fathers as their mothers were at home caring for their other children of which there may be many. The fathers were mystified by their little boys’ condition. After investigation, both boys were diagnosed with tongue tie. Tongue tie occurs when the membrane connecting the tongue to the floor of the mouth is particularly short or thick, restricting the tongue’s full range of motion. As a result, children with this condition are unable to speak, eat properly and cannot control their saliva, meaning they dribble continually. Bonding difficulties between mother and baby due to problems breastfeeding are common and children find it hard to sleep. All babies in the UK are assessed for tongue tie at birth, and if identified, a simple procedure is needed to fix it. The cases of Arasa and Mergersa particularly struck me because my own nephew had tongue tie and was treated when he was just 2 days old. He probably doesn’t even know that he ever had the condition as there is no physical evidence afterwards. Arasa and Mergersa were aged 5 and 6 and because they were unable to access treatment for this simple procedure, they had never learnt to speak, found it very difficult to communicate their needs and neither had been to school or interacted with other children. Their families believed that there was something seriously wrong with them and Mergersa’s father actually thought his son was deaf. Project Harar carried out a full assessment of the boys, including a hearing test, and no other abnormalities were identified. Within a week, Project Harar had arranged for them to be operated on by local surgeons in Addis Ababa. Both were a little swollen when they returned to the Project Harar base after surgery and not used to the freedom of their new tongues! We encouraged them to move their tongues using games, and their fathers to do the same. Slowly, the boys came out of their shells and interacted with others for the first time. One of the absolute highlights of the mission for me was when the boys were each given a toy car to keep and play with. They rolled the cars back and forth along a wall, engrossed in play and unaware of everything around them. Suddenly, to my amazement, they started talking to each other. A few of us volunteers grabbed each other silently and we just stood back and listened, close to tears.Arasa and Mergersa were discharged a few days later and will be followed up by Project Harar in three months’ time to see how they are getting on. I am hopeful that they will be able to start at school soon and have full lives ahead of them.