Cusco, Peru Surgical Trip

Kay Neal: Clinic Day

I’m Kay Neal, the team leader of this Interplast surgical trip to Cusco. I’ve been volunteering with Interplast as an operating room nurse since 1986, and have traveled to Jamaica, Peru, Ecuador, Honduras, and Mexicali with Interplast teams. This is my first time to Cusco, Peru, and so far it’s been amazing. The town is so charming, and our hotel is perfect for having lots of team meetings, just as I like it! Spending time together over dinner or the famous local drink, the Pisco Sour, allows all of us to work together better as a team over the two weeks to come.

Today was clinic day, when we examine all the children who are in need of surgery and create the first iteration of the surgery schedule. It’s a three-step process that I oversee as team leader. First, the child sees one of our team secretaries with his or her parent(s) to collect basic information. Then, the surgeons examine the child to see if the surgery is possible and safe over the coming two weeks, and to explain the risks and benefits of surgery. Unfortunately, this is the first place that a child can be turned away from surgery – usually because the surgery is too complicated for such a short period of time, or because it falls outside of Interplast’s mission to provide reconstructive plastic surgery (and not orthopedic or other types of surgery).  The medical supplies that we bring down also can limit the kinds of surgeries we can do.  Finally, the child sees the team pediatrician and anesthesiologists to make sure he or she is fit for surgery. In other words, we make sure the child has enough iron/hemoglobin, does not have a cold or other upper respiratory problems, and weighs enough for his or her age to withstand anesthesia and surgery.

Kay: Ruth

  Ruth 
  Originally uploaded by interplast.

It’s really a Catch-22 when we have to turn children away from surgery, especially for nutrition issues. Here you’ll see a photo of Ruth, a seven month old infant who came to clinic for her cleft lip and palate. Although Ruth is seven months old, we all thought she was a newborn until we saw her chart! Unfortunately, the Catch-22 is that we can’t operate if a child is severely underweight, because it’s so risky for anesthesia. But, it’s so hard for children with cleft lips and palates to get proper nutrition with a cleft. The food or milk often slips through the opening in the roof of their mouths, running out of heir nose, and, it’s extremely difficult to breastfeed with a cleft lip.

It was heart-breaking to turn Ruth and her parents away, after they waited so long. But, through our fabulous translator, Mary Whitehead, our team pediatrician, Dr. Kathy Gallagher, gave the family great nutrition advice. I hope we’ll see them again next year. In the meantime, we have filled up our surgery schedule for the next two weeks, and I expect us to be very, very busy… Tune in to see some of the children who will receive free surgery…

PS – Hi Kids!!!