For the last 20 years, Ramatulai’s voice had been locked inside, as she was completely unable to open her mouth. 

The rare condition, temporomandibular joint (TMJ) ankylosis, affected Ramatulai from early infancy when she experienced trauma to her jaw as a newborn. 

“She cannot yawn, she cannot shout, she cannot chew,” explained Dr. Leo Cheng, the volunteer Mercy Ships maxillofacial surgeon who would eventually free Ramatulai’s jaw through surgery on the Global Mercy™ in Sierra Leone. Because of the ankylosis in her jaw joints at a very young child, the growth of her lower jaw was stunted, resulting in a severe overbite which worsened over time. 

Not only did the condition present Ramatulai physical challenges, it also left her feeling isolated and outcast for looking different. 

Back to the Beginning 

Ramatulai’s mother, Haja, sought medicine to help heal her baby’s mouth after it became evident that she couldn’t open her jaw properly. But medicine couldn’t provide a cure, and the problem only worsened as she grew into childhood. 

Ramatulai resigned to struggling for the rest of her life. Her mother explained, “Even to eat, she does not know how to open her mouth. Also, when she is cleaning her teeth, the toothbrush will not go inside her mouth.” 

Ramatulai noted eating and raising her voice as the most physically painful activities. Eating involved breaking food into small pieces, then resting it in the gap behind her front teeth from the overbite that she had developed. She would then use her finger to push the food into her throat. Each bite took tremendous effort, leading Ramatulai overwhelmed and malnourished. 

“I normally lose hope whenever I think about my condition,” she said. “I sometimes feel ashamed among people.” 

A Glimmer of Hope Ahead 

In 2023, Mercy Ships returned to Sierra Leone for its sixth field service over the span of 30 years. There, the first glimmer of hope appeared for Ramatulai – she was welcomed on board for maxillofacial surgery to repair her jaw. “I was very happy and overjoyed,” she said. “I know I will be beautiful after the surgery.” 

Not only had Ramatulai seen pictures of other patients treated by Mercy Ships, but she also personally knew a woman who had recovered from the same condition that she had. “We’ve seen so many people whose surgeries were done successfully by Mercy Ships,” she shared. 

Now, it was Ramatulai’s turn to become one of them – and just in time. 

“This surgery is not just a transforming surgery,” Dr. Cheng shared. “It could be lifesaving surgery.”  

Unable to open her mouth, Ramatulai’s airway was prone to blockage, making her susceptible to choking. “There are a lot of implications that we don’t think about. Because they couldn’t open their mouth, they couldn’t keep their teeth clean, so there are holes in the teeth,” Dr. Cheng explained of the infection and health risks patients with TMJ ankylosis face. 

Dr. Cheng was excited to imagine the new opportunities Ramatulai would have to speak with confidence and even sing! These newfound capabilities were profound for Ramatulai, but most apparent to others after her six-hour surgery was her new face, completed by a filled-out chin. 

At home in the United Kingdom, Dr. Cheng performs rib grafts when operating on ankylosis because his patients are children, so they need transplants that can grow with them. With Ramatulai, Dr. Cheng borrowed muscle and fascia from the right side of her head, employing a method developed by Mercy Ships’ lead surgeon Dr. Gary Parker to treat adults with ankylosis in low-resource countries. 

A Special Homecoming Surprise 

Ramatulai healed quickly from her six-hour surgery, and the result was a bubbly and beautiful young woman who nobody would ever guess had struggled with basic functions every day for decades. 

Amanda Harris, an American nurse volunteering in the hospital ward, took care of Ramatulai for the duration of her stay on board, and even dropped her off at home after she had fully healed. Amanda explained about Ramataulai’s transformation, “After she went to her surgery, she just came back a different person. She started talking and telling us about her family and dancing through the wards, and it’s just so sweet. She has a lot of love to give.” 

Sent home from the Global Mercy only three weeks after her life-changing surgery, Ramatulai decided to surprise her family with her homecoming. “I remember her mom’s face specifically,” Amanda remembered. “Shocked, trying to see what’s happening—what’s going on. It was overwhelming for her, and then after she started to hug Ramatulai, she was crying and smiling and so thankful.” 

After 20 years, Ramatulai’s voice is fully unlocked for the first time, and her family can share in her joy!