A BASIC concrete building with minimal sanitation, basic equipment and poor electricity in the Philippines is a far cry from plastic surgeon James Gaffield's pristine Bundaberg surgery.
But that building will be home to Dr Gaffield next week as he embarks on a 10-day charity mission, performing cleft palate and lip surgeries on children in Manila.
"A friend of mine started this organisation, Operation Restore Hope, about 20 years ago," he said.
It is the eighth year Dr Gaffield has travelled to the Philippines, and he will be one of four doctors who will perform more than 80 free surgeries for children with cleft conditions.
A cleft lip, also referred to as a harelip, is a wide gap in the upper lip.
A cleft palate is a large, gaping hole in the roof of the mouth.
Dr Gaffield said the instances of children in Asian countries who were born with a cleft were twice as high as those in Australia.
"One in 500 children are born with a cleft in Asian countries," Dr Gaffield said.
He said the reasons for this were due to both genetics and diet.
"(The children) are heavy into rice and sweets," he said.
Dr Gaffield said in Australia, the surgery to repair a cleft was rather inexpensive and only took about an hour.
"The problem (in the Philippines) is that for many children, the surgery never happens," he said.
"It's expensive for them.
"The public system there does a little bit, but there are tons of people who slip through the cracks."
Dr Gaffield said the cleft surgery was more effective if performed when the child was about one-year-old.
"Once you learn improper speech, it's almost impossible to correct," he said.
The doctor said the results spoke for themselves.
"The older kids who have these things, they are very, very shy," he said.
"It doesn't affect your intelligence but they are socially isolated - they tend not to speak at all because they sound strange and kids tease them."
Dr Gaffield, who will be assisted by nurse Sacha Kay, said the trip was self-funded with materials, such as gauze, being donated by the Friendly Society Hospital.
The plastic surgeon said he did not have to think twice about why he was involved with the charity.
"It's something I can do and there is a need for it."
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