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Santa Marta Columbia

T.H.A.I. Children Mission to Quito, Ecuador March 2014

In March 2014, I had the amazing opportunity to venture to Quito, Ecuador with the HUGS foundatoin to aid children with a severe facial disfigurement called microtia, in which they are born without ears. It was a huge change from what I’d already seen in my previous missions, which dealt primarily with cleft lip and palate deformities. One major difference other than the types of surgeries that we would be doing was the location. Although Quito is located in the similar South-American cultural plane as Colombia, Quito is at an altitude of about 10,000 feet above sea level, compared to Santa Marta’s sea-level elevation. What is interesting is that the rate in which children are born with microtia is exponentially higher than those at sea-level — which means that the altitude probably affects the way these children were born. Because I live at sea-level, I was advised to take medication in order to ensure a comfortable stay during the mission without contracting altitude sickness. Luckily, I never did contract it. The hospital that the team of over 32 (5 surgeons and the rest support staff and nurses) worked in was spacious, but as is usual with medical facilities in these developing countries, the team had to set up its own medical areas in order for each surgery to be carried out. After screening, surgery began. What I noticed was that microtia surgery took much longer to perform than cleft lip and palate surgery. Whereas cleft surgery usually takes an hour and a half to successfully complete and suture, microtia surgery can take up to five or six hours to complete — the reason behind this is because of the technique in which the surgery is performed. First, the surgeon must remove rib cartilage from the patient’s chest, which, in itself, is a very interesting procedure. Using sharp scalpels, the surgeon cuts through the rib and takes a sizable piece that is large enough to fashion into a new ear. The rib cartilage is then carved carefully into the shape of a normal human ear.

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A young Ecuadorian boy with a microtia deformity being marked up before surgery.
An Ecuadorian girl with a microtia deformity.  
Andrew with an Ecuadorian teenager about to have his ear repaired. Andrew participating in the surgery of a girl with microtia.
Andrew with an Ecuadorian teenager about to have his ear repaired. Andrew participating in the surgery of a girl with microtia.

This process takes around three to four hours to complete. After the ear is fashioned, the deformed ear is then cut into and the new ear is placed inside, then sutured up. The amazing part about the procedure is that the result looks natural. While I was busy helping suture, hand supplies to doctors, and talking to families, I also filmed various aspects of the surgeries and took countless pictures of things around the hospital. When a day would be over, we would then pack up our things and take a bus back to our hotel. In total, we worked on about 62 patients with microtia. Free time was usually spent walking around Quito and taking in the immense beauty of the natural world around us. Volcanos, trees, buildings, and mountains surrounded us, and at night, the city sparkled brightly as the altitude continued to rise. The day before the team had to leave, me, my father, and a few other doctors decided to take a “tour” around Quito — this entailed hailing a taxi cab and having the driver bring us around the city to see the most amazing sights and venues that were customary tourist destinations. I even learned some Spanish from Carlos, who was the driver.

The next day, the day we were supposed to leave, we had a few hours time to spend before jetting off back to the United States. Since me and my father have become something of mountaineers, we decided to climb one of the highest peaks around us — Rucu Pichincha, which is 15,413 feet. Thinking the climb was to be a cakewalk, me and my father brought only one bottle of water and two pairs of hiking boots to suffice for the trip up, which would only take a few hours. By the time we were a few hundred meters below the summit, we couldn’t see anything around us. Clouds had rolled in, and the temperature had dropped significantly until my hands became numb. Shivering and fearing for my life, it took an immense amount of effort for me and my father to ascend the last few hundred meters, but nonetheless, we made it to the top. And believe me, it was the farthest thing from a cakewalk. We descended, packed, and after having said goodbye to Quito, we came back to the United States.

Team
A photo with the whole team!
Quito
A photo of Quito from the volcano Pichincha.

Microtia is a congenital birth defect in which children are born without ears (either unilateral or bilateral, depending on the case). Naturally, this deformity causes deafness in the ear affected by the deformity because of the lack of an opening in which sound can travel through. Despite this, however, all of the bones in the inner ear are usually formed, so after the surgery to repair the look of the ear is performed, the patient can then undergo another intensive surgery that restores their hearing. Besides the physical incapabilities of the affected child, the victim usually faces extreme ostracism by peers around them, especially in countries that have little to no understanding of disfigurements. Men who are affected by microtia tend to grow their hair out until it can cover their ears, due to the shame in which the deformity causes. It goes without saying that this facial disfigurement is something that needs to be taken seriously and is one that needs to be treated, if possible. The surgery to repair microtia is rather amazing. First, surgeons cut into the upper stomach of the patient in order to harvest a sizable section of rib cartilage from the patient’s chest. Once the rib is harvested, the surgeon then carves the rib cartilage into something that resembles a human ear. After the ear is perfected, the surgeon then cuts into the deformed ear of the patient and fits in the new ear. When the surgery is done, the new ear looks normal. Microtia takes around 4-6 hours to complete, but once it is done, it is worth every minute.

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An Ecuadorian boy with a case of unilateral microtia.
ear_replacement
This is a section of rib cartilage that was fashioned into an ear. The blueprint below the actual ear serves as a frame of reference for what the ear should look like once it is finished.
Ear Insertion
This is an actual insertion of the new ear into the affected side of the head where microtia is present.
Ear results
As is obvious, the result looks just like a normal ear.



Santa Marta Columbia

THAI Children Mission to Santa Marta, Colombia October 2012

In October 2012, I arrived in Santa Marta, Colombia after traveling from Bogota, Colombia, with my father, Dr. Andrew Jacono. When we arrived, we and the team stayed at a secure military base due to political unrest with the F.A.R.C., a group of rebellious Colombian dissidence. Our safety was ensured by military escort to and from the hospital in the heart of Santa Marta. On the first day, we screened over 150 children with facial birth defects, facial burn injuries, and childhood facial tumors.

Approximately 70 children were surgical candidates and had surgery during our week-long visit. The most common surgical treatments were for cleft lip and palate deformities. Other conditions included microtia (creation of an external ear from rib cartilage when a child is born without one) facial hemangiomas (blood vessel tumors that engulf the face) and an extremely rare facial cleft called a Tessier-7. My part as team member including assisting the medical staff on screening day, first assisting during surgeries, recovery room nurse assistant, and consoling parents after their children’s surgeries.

I was extremely moved by many of the stories and their wonderful outcomes. After a short 1-2 hour operation, these children were transformed from their facial deformities to normal appearing children who could speak and eat normally to my and their parent’s delight. It made me realize that we are extremely fortunate in America to have access to healthcare and proper medical facilities. I created a video journal that you can see on the top-right corner of this page. It documents the journey for many of these children and their families as well as a discussion with a high-ranking military officer discussing the military’s problems with the F.A.R.C. I also had an opportunity to see a family’s life at their home in Colombia first-hand after their child’s cleft lip surgery.


Thai Children

I had the wonderful opportunity to console this mother before her child’s life-altering surgery.

Thai Children OR

The team getting ready to operate on a child with a cleft lip.

Thai_Children_bilateral

This child had a severe bilateral cleft that made it difficult to eat, drink, and breathe.

Thai Children Waiting

The patients waiting to be screened for surgery.

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This child had a severe Tessier-7 facial cleft that reoaired on our trip with surgery.

Thai Children_Cleft Lip

This child with a unilateral cleft lip was a candidate for surgery and underwent treatment on this mission.

Thai Military Escort

The military escort that kept us safe as we traveled to the hospital.

Thai_Children_ICU

A 6 month old child requiring post-surgery ICU care with our team of pediatric professionals.

   

Thailand

Mission Trip to Thailand, February 2012

T.H.A.I. Children’s first mission was to Northeast Thailand in February 2012 and was a huge success. On the trip they reconstructed approximately 50 faces, reestablishing happiness to these children whose lives were full of sorrow and regret. Children were treated with cleft lip and palate deformities, facial burn injuries, and congenital tumors. One of the most interesting cases was a set of identical 7 month old twins that had their cleft lips repaired simultaneously on the same day. Their picture is shown on this page to the right.

Image 1

February 2012 Surgical Mission Team Thailand

Andrew Jacono with Minister

Andrew Jacono with the Prime Minister of Health of
Thailand and his father.


Andrew Jacono with Thai Family

Andrew Jacono With Identical Twins About to Have Their Cleft Lips Repaired

 

 

 

 


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