Stories From the Field:

Peru

Microtia Surgery in Cusco

Gloria Moran, a Registered Nurse on the Lunder 3 Operating Room, was granted a Center for Global Health Travel Award to spend one week in Peru with Medical Missions for Children.

I traveled to Cusco, Peru in May 2012 with Medical Missions For Children (MMFC.org) on a travel award from the MGH Center for Global Health. MMFC is a nonprofit organization with a dedicated group of approximately 375 volunteer surgeons, anesthesiologists, nurses and dental specialists.  We travel to resource-limited countries to offer medical care to those who would otherwise not be able to access or afford treatment. The surgeries include cleft lip, palate deformities, and microtia - deformity of the outer ear. 

On this trip to Cusco, I was part of the microtia team. Our team had one operating room and the cleft lip and palate team worked in another room.

The first day at the hospital, Es Salud, was a busy day of screening all the potential patients for surgery. The patients were seen by anesthesia and surgery to make sure they were medically cleared for the surgical procedure.  After the screening was completed, the team made a tentative schedule for the week.

On the first three days of surgery, our team performed nine cases of first stage microtia. This procedure is the longest, requiring about three hours, and involves harvesting rib cartilage to reconstruct an outer ear.  A template is made of the patient’s normal ear and this is used as a guide to make the new ear from their rib cartilage.  The newly formed ear is placed in a skin pocket beneath the scalp where the new ear will be located.  Once this is in place, a drain is put in and the incision is closed.  When suction is applied to the drain, the tissue covering the cartilage is sucked down and the ear takes shape.  It is truly amazing to see and one of the reasons I love doing these surgeries. 

On the last operating day of the week, we concentrated on stage two and three microtia which involves making a slit behind the ear to release it from the scalp, lifting it up, and using a skin graft to cover the back side of the ear.  This type of procedure, called the elevation stage, is less involved and is therefore done at the end of the week. 

We saw all of our post-op patients in clinic on our final day in Cusco --it was a wonderful and emotional day.  Patients were surrounded by their families and we all took a group picture, exchanged hugs, thank yous, and finally, good byes. 

I’ve traveled with MMFC for over 20 years and I hope to do so for another 20.  The smiles and gratitude of each and every child and family make these trips worthwhile experiences.  I always receive so much more than I give.  Thank you, Mass General Center for Global Health for supporting an unforgettable mission.