New Smiles in Honduras
Professor Michael Earley is a consultant plastic surgeon who worked for many years at Children’s University Hospital, Temple Street. He recaps on a recent mission experience below.
In December I travelled to The Republic of Honduras on my 18th medical mission with Operation Smile. Honduras is situated in Central America, bounded by Nicaragua, El Salvador, and Guatemala with the Atlantic and Caribbean Sea to the North and the Pacific to the South. It has a population of 8 million. The country is rich in natural resources but the population in general is poor and corruption rife.
We flew directly into Tegucigalpa, the capital city. ‘Teguci’, as it’s known locally, is situated in the central highlands. Its airport is notorious for its landings on a postage stamp runway within the city suburbs, and its virtually vertical take-offs in order to clear the surrounding mountains. Certainly an exciting start and end to a busy 10 days of work!
The climate in Teguci was pleasantly warm by day and cool at night with some rain in December. The locals complained of the cold while we were there! Crime is a major problem, and it’s not safe to go downtown. The Operation Smile team travelled together in groups to ensure our safety.
Operation Smile’s cleft care centre in Teguci was founded by Dr Oscar Sarmiento with local and Operation Smile support and is open throughout the year. This centre manages to deal with all simple cleft lip surgery. Complex lips and palates are dealt with at international medical missions which occur a couple of times a year in Honduras. As a result medical missions mostly include more complicated cleft lip surgeries, and cleft palate surgeries and are an opportunity to train local doctors and nurses on advanced techniques.
The Operation Smile team had a large international representation with volunteers from over a dozen countries including local Honduran volunteers, regional volunteers from South and Central America, and volunteers from the U.S. and Europe. It was a strong team that worked well together and achieved a remarkable mission outcome. We screened 143 patients, and provided 89 surgeries. The most common reasons for not being able to operate were chest infections or babies not yet old enough to receive surgery. Thankfully all of these patients received full health checks and will be scheduled for surgery at a later date.
The Operation Smile programme in Honduras is an incredible example of how people can work together to reach as many patients as possible. Over the past few years Operation Smile has implemented programmes aimed at finding patients who are located in hard to reach rural areas, or who may not have heard of Operation Smile. In Honduras, this involved partnering with the national network of electricity supply workers who travel to rural areas as part of their work. These workers were able to identify patients with clefts based in the rural areas they visited, provide them with information on Operation Smile, and in turn provide Operation Smile with their information, allowing us to reach more people in Honduras who need our help.
This aim of reaching even more patients is further supported by Operation Smile’s patient advocate programme. Patients face many difficulties in coming to Operation Smile for surgery including challenges with arranging travel and lack of knowledge of Operation Smile’s work. Sometimes patients and their families can just be terrified and overwhelmed by the process of getting to the hospital and committing to surgery. Operation Smile’s patient advocates are parents of children who have received surgery who now volunteer their time to assist other patients and their families who need Operation Smile’s help. This includes visiting them in their homes to explain the process of getting surgery, assisting them with travel arrangements, and generally being a support for them to lean on as they navigate their journey through surgery. Their help and assistance is invaluable.
Overall this was a productive and well organised mission. The future lies in Operation Smile continuing to provide support for the local surgeons and helping to provide a comprehensive cleft programme to include orthodontics, and speech therapy so that we can provide the very best treatment to the Honduran children who need our help.