Her biggest reason to smile ...
She can

Maritess Emalon is a wisp of a girl, tiny as an elf, with caramel-colored skin and big, luminous eyes that seem to dance with her smile. Doug Sutherland has looked into those eyes when they held no light, back when she had no smile.

Maritess' smile vanished 16 years ago when she was 3-years-old, in a fall down a flight of stairs. The fall left her lower jaw broken where it hinges to her skull. Doctors in Bacolod City, her hometown in the Philippines, told her parents there was nothing that could be done.

When the broken bone grew back, it fused to her skull and left her with a deformity that not only robbed her of her smile but stole her childhood and threatened to shorten her life.

The condition left her chin so far out of alignment she appeared to have no chin at all.

It turned eating into a grim, shame-filled chore. She did so only by pushing food through the right side of her mouth with a finger. At mealtimes, she would slink off to a corner of the room and eat alone instead of at the table with her family. She wore her hair long, and before she began eating, she would flip her head so that the strands would cascade over face and cover it like a veil. And she always had a towel or a handkerchief ready to hide her mouth.

That broken girl vanished following a long operation performed in late June by Tim Turvey, chair of oral and maxillofacial surgery in the University's School of Dentistry. Turvey unlocked Maritess' mandible, moved her chin forward to its normal position, removed teeth too decayed to repair and later fitted her with dentures. Turvey also oversaw Maritess' nearly four-month regimen of intensive physical therapy.

She is a different person than the one who arrived here on June 21, and no one understands that any better than Sutherland. The ordained minister organizes medical missions in the Philippines for Christians in Action, an inter denominational missionary group based in California. Maritess was among about 8,000 patients seen at the group's last clinic in April.

Four months after the operation at Carolina, Sutherland sat across a table from Maritess at the Ronald McDonald House on Old Mason Farm Road, which has been home to Maritess and her interpreter, Lailanie Soldevilla, for most of their stay in Chapel Hill.

Everybody was in a giddy, happy mood. The three of them were set to leave for California the next day, but the conversation was about how far Maritess had come since the operation in June.

Jenny Foster, the development director for the Ronald McDonald House, said the staff would miss Maritess, and what Foster would miss most of all would be her chirpy singing. One of the first songs Foster heard her singing in English was "Praise the Name of Jesus." Another of her favorites, which Maritess gladly demonstrated, went like this: "This is the day, this is the day, this is the day that the Lord has made. ... I will rejoice and be glad in it."

Since the operation, Maritess has gained six pounds. When asked about her favorite food all she could do was giggle and say, "Hmmm."

"You need to say McDonald's hamburgers," Sutherland joked before launching into the story about their sightseeing trip to Washington, D.C., the day before. "And guess where we went for lunch," Sutherland said.

"You didn't," Foster said.

Sutherland laughed. "We did."

They ate hamburgers, of course. And did Maritess like hers?

"No," Maritess said laughing. She looked over at Foster. "Sorry."

And then they all laughed some more.

Maritess wore khaki painters pants and a gold necklace that disappeared under a Tar Heels T-shirt. Above the neckline of her shirt, following the same arc as the necklace, was a pink scar left from the operation. It had already started to fade. And her hair was short because she no longer needed the long strands to hide behind.

Everybody else talks about Maritess' pretty new smile, Sutherland said, but the most dramatic transformation he sees is in her eyes. Sutherland took pictures of Maritess back in the Philippines, before the operation, when empty eyes stared back. Those eyes are gone, he said.

"The change that I see in Maritess -- I don't look at her mouth, I don't look at her teeth, what I see is her eyes. In those pictures, she had no light in her eyes, no sparkle at all. Her eyes are beautiful. Look at the sparkle. She's got a light there now that wasn't there before."

Men on a mission

Before it is possible to imagine the kind of childhood Maritess endured, you must consider the grinding poverty that she and her family faced all the way through it.

"The father is a fisherman," Sutherland said. "He is very poor. They live in a hut by the sea. It's a slum area, with raw sewage and germs everywhere. It's a wonder that she even survived as long as she did."

There, life boils down to a daily battle of survival, and besides Maritess, the Emalons had seven children they had to worry about just trying to feed. Over the years, her parents grew increasingly indifferent not only to Maritess' hopeless condition, but to her.

When Maritess was 15, her parents pushed her into going to work as a housemaid. She could do nothing to improve her lot, but the money she sent back could at least help her family, Soldevilla said.

The second family Maritess worked for as a housemaid decided to try to do something about her condition by taking her to the clinic, Soldevilla said.

At the clinic, a volunteer named Larry Parworth examined Maritess. He was a lieutenant colonel in the Air Force, stationed in Okinawa, who had paid his own way and given up a good chunk of leave time to work at the mission.

Parworth also is an oral and maxillofacial surgeon who had trained under Turvey at the dental school.

"If Larry had not been there I don't know what would have happened," Sutherland said. "We had a dozen dentists who were on the medical mission, but the dentists did not have the expertise to diagnose Maritess. Once he saw her, I have never seen anybody get so focused. Larry's a happy-go-lucky guy, but when the subject of Maritess came up and he started thinking about her case, his eyebrows just sunk down."

Sutherland remembers sitting one morning with Parworth at a hotel, wondering what could be done for Maritess. Parworth already had taken her around to all the hospitals in the city to have tests done so he would know exactly what her problem was and whether it could be fixed in the Philippines. And he knew it couldn't.

Then Parworth blurted: `'We can do something about Maritess. I think I need to call UNC."

Sutherland handed Parworth his cell phone, and Parworth made the call right there. On the other end of the phone he found Tim Turvey, his former mentor at Carolina, and the one surgeon Parworth knew who could help, and just as importantly, would help.

Turvey took over from there. When he explained Maritess' situation to UNC Hospitals officials, they quickly agreed to provide treatment at no cost. "It is a credit to the hospital that they backed me 100 percent, and they took on the expense once we told them her story," Turvey said.

After Parworth contacted Turvey, he asked if Soldevilla would accompany Maritess to the United States and serve as her translator. The task of getting Maritess' parents to sign the consent papers for the operation fell to Soldevilla as well.

When she explained the procedure, they did not act as if they were scared or excited. "They really didn't care," Soldevilla said. "When I asked for their consent, they just said, `Well, it's up to her.'"

Days later, Maritess sat across from Turvey at UNC Hospitals. Turvey remembers that day and the hard time he had looking at Maritess and thinking of her as a grown woman instead of a frightened little girl. In a way, he knew, she was both. She was 18 but was so malnourished she weighed less than 60 pounds and stood 4 feet, 6 inches tall.

She would not look at him at all. "She would not even look at me when I would address her and would constantly cover her face with her hand because she was so embarrassed," Turvey said.

Looking into her decaying mouth, in a way, was like looking into a crystal ball. And Turvey saw the same thing that Parworth had back in the Philippines: Had the rotting teeth been allowed to stay in her mouth, they eventually would have killed her.

For people living in the United States, the statement may sound like hyperbole. Over here, Turvey said, hardly anybody dies from a dental infection. But in Third World countries dental infections are one of the leading causes of death, Turvey said. "If you don't have money over there, you are out of luck."

The operation took eight hours. Turvey freed her bottom jaw from her skull and advanced it into the correct position using bone grafts taken from her hip. During his career, Turvey had seen a number of patients with similar conditions, but Maritess' was probably the worst, he said. "She had absolutely no ability to move her jaw at all. When I say frozen, it was frozen. She couldn't open it a bit."

For the next four months, Turvey met with Maritess for physical therapy. As she learned to eat and talk, he watched with amazement as the personality that had been locked inside her, as stiff as her jaw, began to break free.

Back to the future

Before returning to the Philippines at the end of this month, Maritess and Soldevilla will spend time on the West Coast, traveling from northern California to Los Angeles. They will stay with various Christian in Action groups -- and share her story.

In a way, Sutherland said, what has happened to Maritess is a sort of modern-day Cinderella story. No, there was no evil stepmother to inflict misery, just cruel fate. There was no fairy godmother waving a magic wand, either, or a handsome prince riding up to her house with a lost glass slipper. Still, there were common ingredients.

In place of the prince, there was Parworth who couldn't stop thinking about the little girl with the broken jaw until he thought of a way to help her.

And there was Christians in Action, the organization that sponsors the medical clinics in the Philippines and paid for the cost of flying Maritess and Soldevilla to Chapel Hill. And there was the staff at the Ronald McDonald House, where Maritess stayed during her physical therapy.

In place of a fairy godmother, there was Soldevilla who was at Maritess' side every step of the way. In the Philippines, Soldevilla has her own church and her own ministry helping the poor, or at least those among them poorer than she. She lives off about $20 a month. "When Dr. Larry asked me to accompany Maritess, I didn't look for currency. I looked for her life, for her future."

There was no magic wand, either, but there was Turvey, who with skill and scalpel repaired her broken face.

To Turvey, part of the story that needs to be told is how UNC Hospitals underwrote this girl's entire hospital stay, and how other doctors besides him who were involved in her care did the same -- from the pediatrician to the radiologist to the anesthesiologist to the dentist.

Sutherland agreed. "We are so grateful for what UNC has done because, as an organization, we could not have taken care of this without UNC's involvement," Sutherland said. "It would have just been impossible for us to fund that."

Beyond the medical care, there was love and kindness. For a girl who had grown up with so little of either, they held the power to knit a magic all their own. "It's not only her face, there's an emotional healing inside of her from the hurts she experienced over the years of her life," Soldevilla said. "The love, you know, heals her and gives her the fullness of joy to enjoy life more."

Turvey saw that transformation, too. "During the period of time I was able to observe her, she went from an absolute introvert to a very delightful, charming patient who was very grateful for things. She really seemed to appreciate somebody taking an interest in her. Even though she spoke very little English, her facial expression spoke for itself."

It was difficult for them both to say goodbye. "I hugged her and wished her good luck and I told her I expected a lot from her."

And why shouldn't he? With her new look has come a new outlook that allows dreams.

Part of that dream is seeing her family again, Soldevilla said. Another part is having her family see her, the way she is now, for the first time. "I think she's looking forward to a different kind of acceptance because of her new face."

Her story is not so much about a happy ending as it is about a fresh start, the chance to begin anew. For the next few years, Maritess will stay at the children's home in Bacolod City where she will try to earn her high school degree. She still has a lot of catching up to do. The last time she was in school she was in fifth grade.

As Turvey observed, she is a little girl, still, yet a grown woman. The week before Maritess and Soldevilla left, all their friends and supporters gathered at the Ronald McDonald House to celebrate Maritess' birthday.

It was Oct. 19, and she had just turned 19.

No need to ask about the food that was served, or for that matter, the song. It may have been the first birthday cake that Maritess saw with her name etched in the icing. But even if it wasn't, it had to be the first time she dared blowing out all the candles, or believe her wishes could one day come true. And maybe one of them already had.

Even with the new face and continued support, Maritess' future remains uncertain, but at least now she knows she has one. And who needs to go looking for a glass slipper, anyway, when you've just found the sparkle inside.