Correcting cleft lip and cleft palate birth abnormalities, which affect approximately one in every 700 infants worldwide, usually requires an operation—a procedure that can be hard to come by in remote regions of Guatemala. However, thanks to a team of surgeons and anesthesiologists from New Hanover Regional Medical Center, infants, and even some adults, who reside in a small village in Guatemala are having their clefts repaired.
The team works with the nonprofit Sharing the Journey International and is led by Dr. Michael Jaskolka, director of NHRMC’s Cleft and Craniofacial Program. Other team members include Dr. William Curtis of NHRMC Physician Specialists – Maxillofacial Surgery; Dr. Steve Wells and Dr. Chris Dixon, anesthesiologists who practice at NHRMC; and Ryan Hilton, a former NHRMC nurse anesthetist.
Drs. Jaskolka and Curtis have traveled to Guatemala for the past seven years and have been joined by several anesthesia members over the past four. There, in a small clinic outside San Cristobal Verapaz, they typically perform 35-40 operations in three and a half days. While the days may be grueling, they’re also rewarding, and the NHRMC team plans to continue their work in Guatemala as long as they can.
“It’s something we believe in,” said Dr. Jaskolka. “The people there don’t have any access to care. We are trying to do something good for other people who don’t have the same opportunities we have here.”
Cleft lip occurs when the tissues of the lip don’t join completely, and cleft palate occurs when the tissues of the roof of the mouth don’t join completely. While the exact cause of cleft lip and cleft palate is unknown, contributing factors include a genetic predisposition and environmental factors such as poor nutrition and a lack of perinatal care.
Depending on the type of cleft, individuals with the condition can have difficulty eating or speaking. Additional complications can include ear infections, hearing loss, or dental problems. Individuals with cleft issues may face social isolation or develop emotional problems.
“There’s a certain stigma with unrepaired cleft lip and palate,” said Dr. Jaskolka.
Through the work of the NHRMC team and other surgeons who travel to this tiny village, those with cleft lip and/or cleft palate get a chance to live a normal life.
Performing cleft lip and palate surgeries in a remote Guatemalan village presents some unique challenges. One is the age of the patients, who are often older than those in the U.S.
“This often makes the procedures more difficult because the defect is wider,” said Dr. Jaskolka.
Also, while the surgeons have plenty of supplies, which are paid for by the nonprofit and shipped by the doctors to the village ahead of time, operating conditions are less than ideal. The surgeons work in a single operating room with two beds, limited lighting and no air conditioning. Then there’s the weather, spotty electricity, and unsafe water to deal with.
“It’s very hot,” said Dr. Jaskolka. “Depending on storms and the generators, the power goes out. And the water quality isn’t good. We have to be careful because of those types of situations.”
One thing that’s made the team’s task easier is the two ventilators NHRMC donated last year. Unlike in previous years when the ventilators regularly stopped working, on this last trip they ran without a hiccup.
Dr. Jaskolka has seen progress over the years he’s been involved with Sharing the Journey International. The organization has a local storage facility for their many supplies; and have developed a feeding program at the clinic which helps to ensure that infants who are to receive the operation receive proper feeding and basic care and are healthy when the team arrives.
Because the team returns year after year, the doctors can perform operations in two stages, as is done in the United States, and provide continuity of care.
For Dr. Jaskolka, performing cleft surgeries in Guatemala is all part of what drew him to the field.
“It is a valuable and rewarding area of surgery that makes a difference for kids,” he said.