Nationwide Children’s Hospital Pediatric Otolaryngology Outreach to Managua, Nicaragua
Melissa A. Scholes, MD On January 23, Meredith N. Merz, MD, led a humanitarian mission from Nationwide Children’s Hospital to Managua, Nicaragua, sponsored by Assemblies of God. I accompanied Dr. Merz as the pediatric otolaryngology fellow, joined by pediatric anesthesiologist Iwona Bielaska, MD, and family physician Brian D. Williams, MD. Our team, “La Brigada,” volunteered at Managua’s Hospital Lenin Fonseca, a public hospital and training center for otolaryngology residents. Our focus was to perform otologic surgeries in children, as there are no pediatric otolaryngologists in Nicaragua and few otolaryngologists who perform any type of ear surgery. Nicaragua is the poorest country in Central America and second poorest in the Western Hemisphere. Supplies were tight, but the doctors at Lenin Fonseca do an amazing job with what they have. Nothing goes to waste, and what we consider disposable is reused for as long as possible. Our first day was spent meeting potential surgical candidates in the clinic. We worked among the attendings and residents where there was a whirlwind of teaching and pathology. Noemi Callazo, the missionary for Assemblies of God in Nicaragua, was helpful in translating and facilitating communication. She has a working relationship with the doctors at the hospital, and helps facilitate care for those with the greatest need. The residents screen patients throughout the year for visiting teams and they did an excellent job performing pre-operative work-up. Our next three days were spent in the operating room. As with most equipment, there is a desperate need for operating microscopes in Nicaragua. We brought a microscope head and light source to attach to an existing stand and ear instruments and supplies that were generously donated through Medtronic. The majority of surgeries were otologic. The residents enjoyed learning more detail about ear anatomy and surgery. An urgent tracheostomy was performed on a newborn and a bronchoscopy on a child with a strangulation injury. Dr. Bielaska also had the opportunity to teach the anesthesiology residents about pediatric anesthesia. Dr. Williams saw patients and served as a liaison for the Nationwide Children’s Hospital team and the doctors from Lenin Fonseca. This was the first humanitarian trip for Dr. Merz, Dr. Bielaska, and me. It is difficult to express the total of our experience—we were challenged, humbled, and stimulated at every turn. Thank you to the AAO-HNSF Humanitarian Efforts Committee and Alcon Foundation for their support.
Melissa A. Scholes, MD
On January 23, Meredith N. Merz, MD, led a humanitarian mission from Nationwide Children’s Hospital to Managua, Nicaragua, sponsored by Assemblies of God. I accompanied Dr. Merz as the pediatric otolaryngology fellow, joined by pediatric anesthesiologist Iwona Bielaska, MD, and family physician Brian D. Williams, MD.
Our team, “La Brigada,” volunteered at Managua’s Hospital Lenin Fonseca, a public hospital and training center for otolaryngology residents. Our focus was to perform otologic surgeries in children, as there are no pediatric otolaryngologists in Nicaragua and few otolaryngologists who perform any type of ear surgery. Nicaragua is the poorest country in Central America and second poorest in the Western Hemisphere. Supplies were tight, but the doctors at Lenin Fonseca do an amazing job with what they have. Nothing goes to waste, and what we consider disposable is reused for as long as possible.
Our first day was spent meeting potential surgical candidates in the clinic. We worked among the attendings and residents where there was a whirlwind of teaching and pathology. Noemi Callazo, the missionary for Assemblies of God in Nicaragua, was helpful in translating and facilitating communication. She has a working relationship with the doctors at the hospital, and helps facilitate care for those with the greatest need. The residents screen patients throughout the year for visiting teams and they did an excellent job performing pre-operative work-up.
Our next three days were spent in the operating room. As with most equipment, there is a desperate need for operating microscopes in Nicaragua. We brought a microscope head and light source to attach to an existing stand and ear instruments and supplies that were generously donated through Medtronic. The majority of surgeries were otologic. The residents enjoyed learning more detail about ear anatomy and surgery. An urgent tracheostomy was performed on a newborn and a bronchoscopy on a child with a strangulation injury. Dr. Bielaska also had the opportunity to teach the anesthesiology residents about pediatric anesthesia. Dr. Williams saw patients and served as a liaison for the Nationwide Children’s Hospital team and the doctors from Lenin Fonseca.
This was the first humanitarian trip for Dr. Merz, Dr. Bielaska, and me. It is difficult to express the total of our experience—we were challenged, humbled, and stimulated at every turn. Thank you to the AAO-HNSF Humanitarian Efforts Committee and Alcon Foundation for their support.