Operacion Sunrisa-Screening Day 1

We got a wake-up call at 5:30 this morning, were at breakfast by 6:10 and on the bus to the hospital by 6:30. We spend about an hour setting up for screening and then got to work. Between 8:30-4:00 I single handedly screened 86 kids. Fortunately one of the nurses saw that I hadn’t taken a break and she saved me some lunch. I didn’t even know we had food! I ate at 2:00 pm. Speech is the last screening station because it always causes a bottleneck. This is because there is just one SLP, whereas there are 4-7+ nurses, plastic surgeons, dentists, anesthesia/peds people, etc. Also, I have to look in their mouths and assess palate function, get a speech sample, screen language, ask about hearing, and check on feeding. It’s a lot to go over in about 10 minutes, then when you add in the translation factor that adds even more time. Most of the crew was already back at the hotel lounging around the pool before I got back. Although screening days are tough, I have a lighter load once surgery starts.
Some interesting (and sad) tidbits about the day:
*Saw one child with Treacher-Collins syndrome. There was also a little girl with Turner syndrome, but I’m not familiar with that one, so I missed her.
*On the intake form there is a question something like “What do you believe caused your child’s problem?” On over 50% of the forms parents indicated that either a solar or lunar eclipse caused the cleft. Some parents said things like “so God could teach me patience.” The saddest one simply said “incest.” The mother of the toddler was 13, which means that she was 11 or 12 when raped. Just heart-breaking.
*A 14 or 15 year old guy came in with a medical mask on his face. Before I had him take it off I asked the translator to ask him why he was wearing it. I wanted to mask myself if he had TB or something. Turns out that he was wearing a mask because of the severity of his deformity. He had a hemangioma, which is a large tumor—like and highly vascularized birthmark all over his upper lip. It had also grown into his nose and premaxilla (from part of the palate where the 4 central incisors are). He had had surgery to remove it, but it was not highly skilled. He had no upper lip at all, was missing the columnella (the tissue between the nostrils), and his whole premaxilla. His face look very pushed in and he had extensive scarring on his cheek as well. He needs major reconstructive surgery and a bone graft and that is beyond the scope of the mission. Just not equipped to handle such complex cases. In spite of his problems, he did have good speech though.
* A couple of people coming through screening said that their only speech problem was the “rr”-rolled r. Sorry---can’t help you with that since I can’t even produce it myself.
*Lots of fat, healthy babies coming through screening which was great. It’s virtually impossible to breastfeed babies with cleft palate because babies can’t create the necessary vacuum to suck when there is a gaping hole in the mouth. If it’s a small incomplete cleft sometimes the breast can fill the cleft and it’s okay, but moms of babies with complete clefts usually have to bottlefeed. However, several moms today have somehow figured out how to nurse their babies, even with complete clefts and it was a great thing!
After screening, got back to the hotel at about 4:30 and everyone hung out by the pool for a couple of hours, then we went to dinner at Buenos Aires restaurant. Had a great meal of tostones con queso (mashed and fried plantains with a salty fried cheese), brocheta de pollo y carne (steak and chicken kabobs), rice, fries, and some dessert kind of like dulce de leche. It was all such great food and it was $6 a person. I washed it all down with a nice room temperature (read: HOT) Coca-Cola light since I can’t drink the ice here.
It’s now 10:30 and all my roommates have been asleep for about an hour. Signing off to start another morning at 5:30 am. Apparently over 100 kids are being bussed in for screening so it should be a busy, busy day.

P.S., It's hot, really hot. Upper 90s high humidity, then packed in a room with about 60 people at a time. I'm wearing shorts tomorrow!