Friday, December 16, 2005

Las Consultas


The first day of the cleft lip/palate clinic in Puerto Vallarta is the consultas. This is when all of the children in the program are seen by the surgeons, dentists and orthodontists. Decisions are made about who needs surgery and when it should be done. Progress is noted and interventions and treatment plans are adjusted. It is also a time when families reconnect and share their stories. They can be tremendous support for each other.

We saw 84 children in las consultas on Wednesday. Fourteen were scheduled for surgery on Thursday. The others will be seen again in February and many will continue with regular orthodontic and other medical and dental visits in the meantime. Some will be lost to the program, sometimes for reasons we will never find out about. And there will be newcomers every 3 months as well, babies, of course, but also people who just finally seek help. One girl had her open palate repaired yesterday at age 18. Usually this surgery is done at or around one year of age. Who knows why her family waited so long to seek treatment.

There were two children on Wednesday that affected me deeply. One little seven year old boy was born without ears. He had scars on each side of his head. He was there with his sister, a young adult, who told me that he couldn't hear at all. The dentist spoke to her at length, in Spanish, so I didn't understand some of it. The boy is not in school, has had no sign language instruction and can only signal a few words with his parents and other siblings. One can easily see that he is a bright little boy and it is sad to think of him all alone in there. Dr. Cecelia, the dentist, assured me that there are plenty of resources in Puerto Vallarta to help deaf children. What I don't know, though, is the rest of the story. What else does that family have to deal with?

Little Efrian came into the world three weeks ago. He was born with a bilateral cleft lip and palate defect which severely interferes with his ability to suck. His mother had a bottle of breast milk with her so she was trying her best to feed him, but this baby was skin and bones. At a glance, I was afraid for his life. He is in grave danger of dying from malnutrition.

Dr. Cecelia gave Efrian's mom a special nipple for his bottle and showed her how to use it. He showed great interest and hopefully he will learn quickly how to eat with this new device. There wasn't much time for teaching and a lot depends on the mother. I saw her talking later to another mother who had a chubby, healthy looking 5 month old. She had told me how scared she was the first two months. These babies choke a lot and it can be frightening to feed them. These are courageous people, the parents and the kids. I hope we see little Efrian again in February.

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