Humanitarian Travel Grant: Medical Mission in Guayaquil, Ecuador

Jason D. Pou, MD

Jason D. Pou, MDWith the generous support of the American Academy of Otolaryngology–Head and Neck Surgery Foundation Humanitarian Travel Grant, I traveled to Guayaquil, Ecuador, in March 2020 with the Global Smile Foundation (GSF). This team consisted of many incredibly talented surgeons, including Usama S. Hamdan, MD; Babak Azizzadeh, MD; Krishna G. Patel, MD; Laura E. Hetzler, MD; Adam Johnson, MD; Robert Mann, MD; Grace L. Peng, MD; and Alexander P. Marston, MD; as well as several anesthesiologists, pediatricians, speech therapists, nurses, administrative staff, translators, and local volunteers. This well-established, nonprofit foundation focused on providing comprehensive craniofacial care to the underserved local population while educating Ecuadorian physicians and healthcare staff to allow their local team to better provide cleft lip and palate care in the future. 

The mission began during the beginning of the COVID-19 outbreak, and our team took extreme precautions throughout the entire trip to keep patients and volunteers as safe as possible. Prescreening took place for 259 patients, and those with any viral symptoms were scheduled for screening during the following Guayaquil mission later in the year. All patients and caregivers underwent temperature checks prior to entering Leon Becerra Hospital. Hands were cleaned three separate times with alcohol spray and sanitizer prior to any patient contact. Our screening day was decreased to 226 patients to limit unnecessary exposure, and dental procedures were not performed during the trip. Even with all precautions in effect, our team performed 82 procedures on 55 patients. In addition to surgery, 70 speech therapy sessions were administered, 30 psychosocial sessions were performed, and 200 oral hygiene kits were distributed. 

Fellows, including myself, were highly involved with the team, assisting in the screening day clinic and participating in all aspects of the surgeries and postoperative care. The majority of cases were primarily cleft lip and palate surgeries, but many revision cases and velopharyngeal insufficiency procedures were performed. Cleft rhinoplasties and facial reanimation cases were also performed, including one selective neurolysis and one gracilis free flap. The partnership established between GSF and the local physicians, nurses, and volunteers is essential for the success of this mission. This allows for postoperative follow-up and continuity of care for patients between missions, while also providing a foundation for the local team to provide craniofacial care in the future. 

I am truly grateful to the AAO-HNSF Humanitarian Travel Grant program for allowing me to participate in this amazing trip. My experience with GSF has strengthened my interest in humanitarian work, and I look forward to future international missions throughout my career.