Video on Saturday Screenings

If your child needs help, please bring him or her to our Saturday Screenings at Al Bireh Charitable Building.

Video created by one of our partners, Operation Smile

May 16 - May 29th, 2012

Happy New Year to all of you and your families.

We still have four months before the next trip to Palestine, but I wanted to take this opportunity to thank you for coming on previous trips, and thank you particularly for coming with us to Palestine from May 16th until the 29^th. As you’ll remember, on the last trip we went to Jenin (in the northern West Bank) and to Hebron (in the south). We also hosted a Basic Life Support team from Operation Smile. These individuals worked in Jenin, Ramallah, and Hebron.

During the upcoming trip, we have planned to form three teams each consisting of an anesthesiologist and CRNA, two surgeons, and a nurse. One team will go to Nablus, another to Ramallah, and the third to Hebron. We are doing this with on-going support from the Palestinian Cleft Society, SmileTrain, and Operation Smile. We hope to have teams of Operation Smile members training Palestinian practitioners in Pediatric Advanced Life Support techniques.

As in previous trips, we’ll do our best to leave together on May 16^th; return is scheduled for May 29^th. We’ll arrive on Thursday the 17^th, travel to Ramallah, and have the Interim Meeting of the Palestinian Cleft Society leadership on Friday the 18^th. This will give all of the team members a chance to get to know each other, and to be reacquainted with members of PCS. On Friday afternoon, we’ll leave for the three locations. The Operation Smile PALS course will start in Ramallah, then go to Nablus, and finish in Hebron.

The Anesthesiologists who are currently coming or potentially coming are Robert Karoukian (San Francisco), Winston Ota (Hawaii), and Janie Magee (UNC, to be determined).

The CRNAs coming are Bobby Silvers (UNC), Tim Hatcher (Los Angeles), with the third to be determined.

The Nurses coming are Cindy van Aalst (UNC), Emma Marks (UNC), with the third to be determined.

The Speech Pathologist coming is Allison Dybdahl (Los Angeles).

The Surgeons committed to coming are Libby Wilson (Los Angeles), Ray Harshbarger (Austin, TX), (possibly Ray’s Craniofacial Fellow), Steve Bureau (Calgary, Canada), Don LaRossa (Philadelphia), and John van Aalst (UNC).

We will request two rooms for the entire time of operating at each of the hospitals.

We will do Orthognathic Surgery in Nablus and in Ramallah. We’ll do a single Orthognathic case a day in these two locations (with primary emphasis on training local surgeons), in addition to cleft-related cases. We are currently putting together all of the supplies for the Ortho cases.

Thanks. This will be the first time that we’ve operated in three locations at once. We’ll need to keep in touch with each other during the week in order to provide the safe care that the Palestinian Cleft Society expects of all of us.

I look forward to staying in touch about any questions you may have.

All the best to you and your families in this great New Year.

John

(On behalf of the Palestinian Cleft Society)

A note from Speech Pathologist, Allison Dybdahl

Allison and Lydia - Speech pathologists at the PCS conference.

I have wanted to go on a cleft palate mission for the past 5 years and was ecstatic that my dream was finally coming true! To be honest my expectations were quite high since this had been a dream for so long, but I must say the trip to the West Bank greatly exceeded my expectations!!! I had the opportunity to travel to Jenin, Jericho and Ramallah and loved the diversity of the rich farmland to the busy city streets. While there, I was able to forge relationships with 6 speech pathologists and begin training them in cleft palate speech evaluation and treatment. Along the way I was welcomed into many clinics, hospitals, centers and patients’ homes and of course at each stop I was graciously greeted with mint tea and a formal sit-down introduction. There were several days I had at least 5 cups of tea because I was greeted warmly by so many individuals! I was also able to participate in 2 cleft screening days where ENTs, plastic surgeons, nurses, orthodontists and speech pathologists worked tirelessly as a team to care for the palestinian children. I was richly rewarded by the stories I heard, the families I met and the doctors I worked with. I experienced such kindness and hospitality that I left feeling like family. There is still much more training and work to do, but the Palestinian Cleft Society is working hard to provide quality and comprehensive care for children with clefts. I look forward to continuing my relationship PCS and all the wonderful staff, specialists and families I was blessed to meet.

Carolina Camacho - Operation Smile Educations Manager

Working in partnership with the Palestinian Cleft Society, Operation Smile conducted an American Heart Association’s (AHA) Basic Life Support (BLS) training program at the Government Hospitals in Ramallah, Jenin and Hebron. This course was developed to provide healthcare professionals with the ability to recognize several life-threatening emergencies, provide Cardiac Pulmonary Resuscitation, use an Automatic External Defibrillator, and relieve choking in a safe, timely and effective manner. Training was conducted between December 2^nd and December 10^th and provided instruction for 123 local doctors and nurses, of which 23 were certified as instructors and 100 as providers. The new instructors and the members of Juzoor, a local organization that conducts life support training, are committed to future implementation of AHA certified courses. Conversations to bring Pediatric Advance Life Support (PALS) in May 2012 have already started between the partners.

Operation Smile is a humanitarian nonprofit organization that provides effective reconstructive surgery for children born with facial deformities such as cleft lip and cleft palate. In addition to its surgical work, the organization also provides training to local volunteers to ensure that every child receives quality care every time and everywhere they receive surgery. The program just completed in Palestine exemplifies the organization’s commitment towards sustainability at the local level.

A researcher's note from the December 2011 mission

I am a 4th year medical student at the University of North Carolina at Chapel Hill interested in public health and Palestine. I have been developing a congenital anomalies database for the past several months in order to meet three primary goals: (1) to determine the incidence and prevalence of congenital anomalies in the West Bank and Gaza; (2) to help understand the causes of such anomalies in the Palestinian population; and (3) to lay the foundation for a nation-wide health care registry.

During the December 2011 Palestinian Cleft Society mission, I administered this congenital anomalies database for the first time. This pilot involved interviewing the parents of patients undergoing surgeries by the team. The patients were primarily children with congenital anomalies, such as cleft lip and palate, as well as microtia. Many of the children had speech difficulties and some were syndromic, having an array of other major health issues. My pilot will hopefully help me assess whether or not I am collecting quality data. I intend to maximize the quality of the data I collect in order draw accurate conclusions regarding congenital anomalies in the West Bank and Gaza.

During my time in the West Bank, I interviewed the parents of patients using a 500-question survey. I conducted these interviews in Jenin and Hebron Governmental Hospitals. I asked questions regarding the health status of the patient and his or her family, and learned a great deal about the socio-cultural elements that affect health and health care access. In the setting of military occupation, I learned that many of the patients struggle to receive care for the treatment of complex conditions such as cleft lip and palate. For example, prior to the founding of the Palestinian Cleft Society (PCS), no Palestinian providers were trained to treat clefts. As a result, patients had to travel to surrounding countries in order to receive essential care or wait for foreign surgical teams to provide this care. Those patients who were unable to afford the expense of traveling for care often lived with their disfiguring conditions. PCS is helping close a gap in health care in the West Bank, but there are still many vast gaps that need attention. Yet many of these gaps are a consequence of the occupation, which limits resources available to Palestinians and restricts patient ability to travel.

My interviews illuminated many environmental factors that may play a role in the development of congenital anomalies. When querying parents about toxin exposure during pregnancy, several mothers admitted to major gas inhalation during pregnancy as a result of political conflict. Additionally, many of the parents live in villages or refugee camps, which largely rely on rain as their primary water source. I also found that amenities such as heating and air conditioning, which are present everywhere in the United States, were infrequent within the sample of parents I interviewed. While a lot of these environmental concerns are not surprising, I believe that it is important to document them in order to study whether or not they affect the health status of a pregnant Mother’s unborn child.

While I was able to conduct 47 interviews and to train local staff to conduct interviews, I found that my time in Palestine flew by too fast. I was overwhelmed by the warmth and kindness of the people I encountered. I was repeatedly humbled by the commitment shown by the Palestinians working with children with congenital anomalies. The health care providers worked long-days and showed tremendous compassion towards their patients. The team worked together to perform over fifty surgeries in two and a half weeks. This meant that the surgeons were in the operating room for about twelve hours a day and the speech pathologists were working with patients throughout that time. All of the providers worked hard with the shared goal of providing essential care for Palestinian children in need.

During my time in Palestine I learned most from the people around me and I look forward to my return in May.

Screening in Jenin and Ramallah

PCS has sponsored three screening sessions for Palestinians with clefts: in Jenin on November 26th; in Ramallah on December 3rd, and in Hebron on December 4th (See attached pictures). Over 200 patients with clefts were evaluated. In addition, many patients with ear and nasal abnormalities, and facial burns were seen and evaluated.
Our surgery schedule in Hebron begins on December 5, 2011.
We’ll continue to give you updates.