Report from CaboSmiles Mission to Mexico February 2023

Partnership Projects of Children’s Lifeline™ & Smiles International

  • Number of patients prescreened via new remote answering service: 45
  • Cases selected for reconstruction on 4.5 day mission surgical days: 22
  • Number of cases canceled due to transportation conflict from La Paz: 1
  • Surgical reconstructive procedures performed: 88
    • (reason for multiple procedures performed under the same pediatric anesthesia; it was performed this way in order to make best use of the opportunity for child’s overall safety with less exposures to anesthesia throughout care.)
  • Relative value of cases if performed in the USA at hospital setting with specialist anesthesia , surgeons, and nursing facility charges: $591,600.00 USD

Patient Notification and Screening

Mechanism of Patient Notifications: Our team tested again and proved the viability of the newly instituted remote screening and triage system. Advertisements guided patients, their parents, and neighbors to a single-access point cell phone number with an answering service, which instructed them to leave their contact information. Then, a team volunteer from Rotary Clubs living in Mexico personally called back on the weekend to gather specifics of their needs. The team member asked them to send photos, scanned copies of x-rays or CTs (if available in certain syndromic cases), and supply the service with their physical location so a visit could be scheduled if selected for possible surgery by the medical team.

This information was collated and sent to Dr. Moses, who then held a preclinic teleconference with the medical surgical/anesthesia team. With the information available, decisions were made for the selection of safety outcome-based and surgical expertise outcome-planned cases, and for arranging appointments for the pediatric-candidates to be physically screened on the first day of the clinic. This process avoided the lengthy and crowded conditions usually present in prior methods of mission care case selections. It also allowed us to have Dr. Moses carefully arrange the appropriate surgeons with the necessary skill sets to operate each of the variety of cases well ahead of the day of the clinic.

Minimization of COVID-19 exposure risks was obtained by this method, satisfying the local health authorities and avoiding blockages of future mission projects. The mission provided on-site COVID-19 testing of the parents and children, if required prior to their scheduling and following Anesthesia Health Clearances.

Increase in Cases

There are many more cases that are beginning to re-appear in the community after the closure of health care facilities and clinics during the Pandemic. This Children’s Lifeline International/Smiles International Foundation project is at the heart of the reconstruction of mission health care in the entire peninsula of Baja-Mexico. This includes care for patients traveling from the neighboring Mexican States of Sonora and Sinaloa, who arrive to the clinic prearranged by bus or ferry through La Paz. This second phase of remote mission surgical care for Children’s Facial Cleft Deformities is built upon the successful efforts Children’s Lifeline International and Smiles International Foundation in their TecateSmiles November 2022 mission project, which already proved early viability of these methods.

The Team

Team members working at the February 2023 CaboSmiles clinic

A Particular Case Study

One beautiful child presented a handwritten letter describing how poor her mother was, and that she wished something could be done for her missing nose tissue in the middle, which caused her trouble with breathing and “having ugliness.” She described how her mother gave all that she had to travel to the clinic, and was worried that she would not be treated. She handed our administrator her note in her hand made “envelope” marked with a “heart of hope,” bringing many of the clinic volunteers to tears when they learned of her message.

Her mother was given a reconstructive “wing-flap” staged surgery of her nasal columella, putting tissue into the space for a cartilage strut support graft to be done later in life. The heart of Vice President and Patient Coordinator Maribel was moved to take this child on a shopping trip, along with her mother, to provide many clothing, school, and feminine care items.

Coordinator prepares parents
Worried father with child
Surgeons hold first baby
Anesthesia interviews
Morning schedule “huddle”
Surgery “time-out” prepares
Surgery begins
Anxious mother
Child in recovery with nose shapers
Happy mother and father
Team working their magic

Our board-certified speech and language pathologists evaluate and make surgical recommendations to the surgeons for speech surgical correction throat and palate flaps. Nasopharyngoscopy is a routine at our clinics, differentiating our mission therapeutics from other less equipped mission teams.

The joint efforts of Children’s Lifeline International® and the Smiles International Foundations give hope to hundreds, if not thousands of children afflicted with facial cleft differences and deformities; that they might have a more normal future, allowing them to grow and flourish in their communities. The value of the abilities to eat, speak, breath, hear and SMILE cannot be underestimated, allowing integration into their communities as functioning young adult members of the work force.

Best regards in grateful service,

Prof. Jeffrey J. Moses DDS, FAACS
Diplomate, Amer. Board Oral/Maxillofacial Surgery President/Founder,
Smiles International Foundation

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