Arts & Sciences
Nicaragua - Multi D outcomes in cleft lip and Palate repair utilizing mHealth / Telemedicine
Cleft palate patients require extensive multidisciplinary care. International volunteer groups that provide cleft lip and palate surgery have to date been largely unsuccessful in accomplishing this due to a variety of obstacle. The Hopkins based volunteer / research group has partnered with a Nicaraguan foundation to provide multidisciplinary cleft palate care. The project has started to use a variety of innovative strategies, including the use of telemedicine, to address the lacking resources. The goal is to create a model of care that approaches that provided in the US.
As a participant of GHEFP, I had the privilege of assisting a nutritionist at the APROQUEN Clinic in Managua, Nicaragua for several weeks. APROQUEN or Asociacion Pro Ninos Quemados De Nicaragua, provides free health care to children with varying degrees of burns as well as those with cleft lip and/ or palate. Each morning, I shadowed the rounds of the burn unit, during which, the nutritionist made note of the dietary habits of the patients and suggested ways in which a change in diet could assist in the healing process. He often suggested the inclusion of foods high in protein like “gallopinto” or rice and beans. While in the burn unit, I also had the opportunity to watch a procedure in which burned skin was removed from the patient before they were wrapped in gauze and ointment. Despite the severity of the burn, the dynamic of the medical professionals was very lighthearted, perhaps in an attempt to remain positive despite the unfortunate circumstances.
My main purpose while at APROQUEN was to collect data concerning cleft lip/ palate patients in order to determine if the condition has an impact on the nutrition of children. As part of the data collection, the patients’ height and weight were measured along with their arm and head circumferences. I was responsible for asking the parents of the patients a set of questions to determine their nutrition level. For example, it was important to determine what formula the patients were being fed, whether the child was delivered prematurely or full-term, when they began eating solid foods and how frequent their meals were. With answers to the aforementioned questions, along with the anthropometric data, we hoped to determine a correlation between nutrition and having a cleft lip/palate so that perhaps steps could be taken to alleviate the nutrition disparity and improve the healing process of the post-operative cleft patients. Working with APROQUEN, I learned the importance of being personable and understanding while interacting with patients. Talking with the parents and interacting with the children also forced me to practice Spanish, which I hope to use when I work with Doctors Without Borders in the future. My GHEFP experience has only confirmed my desire to build my medical career around providing high-quality healthcare to areas that might otherwise go without.
1. Waiting Room - Abroquen's waiting room adorned with photos of past patients
2. The Backyard - Aproquen includes a small house for overnight patients with fruit trees and a small playground
3. The captial - my mother and I in the Capital Square