It's been nearly a decade since it happened, and Sudeep Kukreja, MD, a neonatologist in Orange, still can't relate the story without breaking down. He was on his first medical mission with Operation Smile--the group that provides free cleft lip and palate surgery. And the "it" was a simple act of kindness that changed his life and cemented his dedication to service abroad.

Location: Brazil. Year: 1997.

After working for nearly three days, Dr. Kukreja's team had just completed the screening of about 600 potential patients, from newborns to one lucky 65-year-old man. It was late Friday night.

The next day, on Saturday, doctors were to post a list of the patients accepted for surgery. Every potential patient brought family, friends or both, because most had traveled hundreds of miles for the opportunity.
Close to 1,500 anxious people milled about all night that night, waiting for the list to be posted, hoping their little boy or big sister would have a chance at a new life. But when the list went up, fewer than 300 were fit for surgery, which is typical of most missions.

One family brought a 17-year-old girl on a 350-mile journey, a journey that ended in heartache. Her name was not on the list. But there was happy news. Her neighbor, a 5-year-old boy, was accepted for surgery.

The locals spoke Portuguese, so the Operation Smile doctors had interpreters. But language couldn't translate the impact of Dr. Kukreja's experience with one woman. "The mother of the 5-year-old came to me and said, 'Doctor, this young lady is my neighbor. She does not have any friends and nobody wants to talk to her or be friends with her. She'll never marry. Please do the surgery for her. I'll take my son's name off the list.'"

That spirit of selflessness inspired Dr. Kukreja to complete another 13 missions for Operation Smile. The missions usually run about two weeks, and he calls them "wonderful vacations" for the rewards he gets. "You show the kids a mirror after surgery. Their eyes gleam. You have to see that to believe it."

Dr. Kukreja is so taken with healthcare missions, in fact, that he started his own medical volunteer organization this past year--and successfully completed his first mission with the group in December. It's called Arpan, a Hindi word meaning "dedication" or "to give."

"Whenever I'd come back from a mission with Operation Smile, I'd show pictures and tell stories about it," Dr. Kukreja says. "One friend said, 'Why don't you start your own organization?'"

Nine months later--after making crucial local contacts through an Operation Smile colleague and, also through him, securing essential financial support from the Bhansali Trust, based in Gujarat, India--the first Arpan mission, consisting of about 35 volunteers, left for Deesa, India, for 10 days. The team included surgeons, internists, pediatricians, an ocular plastic surgeon and a urologist.

"Every mission has two parts," Dr. Kukreja says, "the service part and the education part. You want to train the local doctors so they can be self-sufficient." Indeed, Arpan's mission is "to nurture, advance and protect the health and well-being of medically underserved populations around the world."

So far, Dr. Kukreja's volunteer travels have also taken him to the Philippines, China, Kenya, Morocco, Thailand, Lithuania and Vietnam--all places that have a limited supply of neonatologists.

As it happens, his choice of neonatology almost never happened and only came about because of his preference for math and machines. "My grandfather and father were both engineers, so I had that inclination," Dr. Kukreja says. "But I wanted to be a pilot. I wanted to fly planes. Medicine was actually my father's desire."

After medical school in India, Dr. Kukreja went to the United Kingdom to continue his education in pediatrics. "That's when I was exposed to neonatology," he says. "It includes a lot of mechanical ventilators and other high-tech machines. All that attracted me."

He also likes the challenge of patients who can't talk. "When I was in medical school," he relates, "we were taught that the best thing for patient care is a detailed history. Most of the time you can do a diagnosis with just that information. You don't need a million tests. When I was doing rotations in the newborn wing, I realized the babies couldn't tell me what was wrong with them. There's no history. That fascinated me."

It still fascinates him, and he still delights in taking care of kids. "I'd like to continue with my organization," Dr. Kukreja says. "We're looking into taking a group of doctors to Zambia and another to Northern India this year."

In fact, he'd take a group of doctors to every village and every town around the globe if he could. "The difficult part of the missions is wanting to stay and keep helping," he says. "There are millions of similar children, and it will take thousands of similar organizations to take care of their basic healthcare needs."