Teamwork

All of the kinks have been worked out out at the hospital, Fundacion Tierra Nueva, thanks to the help of Patricia Jarrin who brings many brigades to this hospital every year.    Actually it went so smoothly that it’s hard to remember everyone who passed through the four Operating Rooms.  We started with rounds and had four patients ready to go by the time the rounds were finished!  There was a beautiful baby in pre-op who caught my eye, He was 13 months old named Michael and very happy because he was under anesthesia.  We learned later that it was his second surgery by the team and that the parents were hoping that this would be on his last surgery.  Michael’s parents were so grateful and I did not want to tell them that this was NOT the end of Michael’s surgeries and luckily Susannah McCormick, the speech therapist walked in to check on Michael.

As it turns out, Smile Train is great for smiles but it’s much more complicated than that.  In the US, a cleft patient has as many as 11 surgeries then orthodonitcs or orthodontic surgery as well as speech therapy.  Even in the case of Marjory who was able to find the money to do orthodontics with some speech therapy, she will always look and sound different.

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Cleft Palate is associated with 30 other syndroms and today was an example of just that.  Maria a another beautiful patient came to see Dr. Nitta last year for microsia (ear reconstruction).  She was born without her ear completly forming.  After the surgery, she broght Dr. Nitta to the side and said she had another problem.  Her left side did not form and she was born without a breast plate. This syndrom also made her left hand smaller than her right.  Dr. Nitta told her last year that she would return with a breast implant and she did!  Maria had her breast reconstruction today and when she woke up after surgery, she had tears of joy!

It’s hard to say why these patients have cleft lip, or palate, or microsia.   There may be some link to nutrition but what I do know is it is prevalent here in Ecuador and they are not getting all the necessary surgery or ancillary services that will allow them to function completely.  It’s interesting that some surgery allows the cleft patient to look better yet they are still not able to communicate.  Most of the patients would prefer to be able to talk rather than look good.  Burns are preventable yet we see so many burns so late that you cant imagine how they have lived so long without function.  These scars are forever but these doctors are working their magic to give all of their patients hope