Humanitarian service in Guayaquil

July 2018 – Vol. 37, No. 6

Alexander Marston, MD

The Global Smile Foundation surgical team performing a cleft lip repair. From left to right: Laura Hetzler, MD, Alexander Marston, MD, and Usama Hamdan, MD

I participated in a Global Smile Foundation surgical outreach trip to Guayaquil, Ecuador, in March 2018 as a recipient of a humanitarian travel grant. Shortly after arriving in Guayaquil, I met a large group of enthusiastic and dedicated Global Smile Foundation volunteers from the United States, Ecuador, Peru, Colombia, and Brazil. With a shared interest to help those in need, we quickly bonded and were eager to begin the surgical mission.

Post-mission photograph celebrating the patient care, hard work and commeraderie of the Global Smile Foundation team. From left to right: Alexander Marston, MD, Megan Gaffey, MD, Elie Ramly, MD, Laura Hetzler, MD, Fernando Almas, DDS, MD, Adam Johnson, MD, Usama Hamdan, MD

The evaluation and screening day introduced me to the diverse people of Ecuador. Some came from poor, underserved urban areas of Guayaquil, while others traveled from the central Andean mountain regions and the Amazon jungle. Many children, and some adults, were in need of surgical interventions, and I felt thrilled to be able to participate in their care. During the screening day, I was exposed to hundreds of unique craniofacial abnormalities that greatly increased my understanding of facial cleft presentations, exam findings, and associated syndromic conditions. As we completed our evaluations of over 150 patients, I looked forward to helping those in need and advancing my surgical skills in the week ahead.

The first day of surgery got off to a slow start as we familiarized ourselves with the new surroundings and hospital workflow. But soon the surgeons, anesthesiologists, and nursing and surgical staff coalesced into a cohesive and efficient team. It was remarkable to see people from all over the world come together for a common cause. As a surgical fellow, I was exposed to an extraordinarily high number of primary and revision cleft lip and palate repairs. Participating in such a large volume of these surgical procedures provided me with a unique opportunity to gain aptitude in complex and delicate cleft reconstructive methods. By the second half of the week, I was given the opportunity to perform a variety of cleft surgical procedures with close guidance from the attending surgeons.

Although the surgical schedule was very busy, I was able to see joy and hope throughout the hospital hallways and wards as a result of the life-changing surgical interventions provided by the Global Smile Foundation team. I found incredible satisfaction in being a team member on the mission, making friends with volunteers from around the world, and learning about the unique surgical procedures involved in cleft care. Nevertheless, the most meaningful part of the Guayaquil campaign was to contribute to the treatment of those affected by craniofacial disorders that all individuals deserve. I am thankful for the opportunity to have received the humanitarian travel grant through the American Academy of Otolaryngology–Head and Neck Surgery. Without the Academy’s support, my participation on the trip would not have been possible. I hope to continue developing my skills in cleft care with the goal of someday joining a similar international surgical trip as an attending surgeon.