AAO-HNSF Humanitarian Travel Grant Report: Guayaquil, Ecuador

Christopher M. Shumrick, MD

In March 2023, I had the opportunity to join my attending Alexander P. Marston, MD, a double board-certified pediatric otolaryngologist and facial plastic and reconstructive surgeon at Tufts Medical Center, in a surgical outreach trip to Guayaquil, Ecuador, coordinated by the Global Smile Foundation. The main goal of the trip was to provide the necessary equipment, supplies, personnel, and expertise for cleft lip and cleft palate repairs. We joined the founder and director of the Global Smile Foundation, Usama S. Hamdan, MD, as well as primary facial plastic and reconstructive surgeon Krishna G. Patel, MD, PhD, of the Medical University of South Carolina in performing these procedures and providing care during this week.

The Global Smile Foundation is a nonprofit organization focused on providing comprehensive cleft lip and palate care to underserved populations around the world. Past and current missions include trips to Central and South America as well as Africa and the Middle East. Cleft lip and cleft palate patients are born with these defects, sometimes as part of a larger genetic syndrome or sometimes randomly acquired. These defects can cause issues with feeding and speech development during early life. Additionally, psychosocial issues can arise later in childhood into adolescence and adulthood. Surgically repairing the cleft defects and providing continued cleft care contributes to these children living a less burdensome life.

We had the privilege of serving these patients at Hospital León Becerra de Guayaquil. Through this hospital, the Global Smile Foundation has established continued care for these patients in Guayaquil, allowing for continuity after the conclusion of a trip. There is a growing number of adolescent and adult patients who had prior surgeries under the Global Smile Foundation who return for continued follow-up and/or revision surgeries. Often, these patients and their families travel many hours by bus from remote areas of Ecuador to seek this care.

My trip to Ecuador was my first international surgical outreach journey, and it was a powerful experience in many regards. Cleft procedures, no matter where they are performed, often make profound impacts on patients’ lives. Contributing to these life-changing interventions for patients who would otherwise not have access to such care was deeply rewarding. This trip opened my eyes to the troubles of humans who live outside the American bubble. I gained an appreciation for the resources we often take for granted here in the United States and learned that even under frugal conditions, amazing care can be provided to those in need. Because of this trip, I plan to continue participating in global outreach trips throughout my career.

My participation in this trip was made possible in part by the AAO-HNSF and the generous contribution of the AAO-HNSF Humanitarian Travel Grant. These generous grants can be seeds for fruitful humanitarian care by otolaryngologists for generations to come.