Addressing the unmet need for cleft care in Honduras

December 19, 2014

Operation Smile is committed to understanding and then addressing the unmet need for cleft care in Honduras.

In order to quantify the need for unmet care, a prevalence study is being conducted in partnership with a Honduran development enterprise that surveys the nation’s electric meters each month.  A network of more than 300 company employees will visit every household in Honduras that has electricity and will inquire as to whether any individual living within or near the household is in need of cleft care.  Patients will then be sequenced into care with Operation Smile either at the Comprehensive Care Center in Tegucigalpa or at a surgical program being held in another area of the country.

A planning meeting took place this week in Tegucigalpa.  On Tuesday afternoon a mother arrived at the Operation Smile Care Center with a two month old infant.  She had been traveling all day from the southernmost state of Choluteca.  She received a flyer with contact information for Operation Smile from an electric company worker and then began the journey to Tegucigalpa.  She arrived in tears, exhausted from the journey and uncertain of where she was going.  Center staff quickly welcomed her in and walked her through an introductory session about Operation Smile, cleft lip and palate, and caring for a child with a cleft.  Despite the weather being 75 degrees, the mother was quite cold as it much cooler here in Tegucigalpa than it is at her home in the south.  Center staff quickly gave her a sweater that had been donated by a local nonprofit.

The mother said that she was very scared as many people in her community told her that babies like her own would almost certainly die.  People told her the baby would die during surgery.  Her husband said that she should not bring the child for surgery, fearing the rumors that the child would die during surgery might be true.  The mother came anyways. 

Center staff arranged for her to stay at a nearby shelter and gave her a stipend for food. The next morning the mother and infant came back to the Center for their initial appointments with a psychologist, audiologist and plastic surgeon.  

One component of the prevalence study will be better understanding the barriers patients face in accessing care.  Fear of surgery, community opinions of cleft and family permission are all important factors that contribute to a mother’s ability to get care for her child.  As we better understand these factors, Operation Smile will be able to provide education and tailor programs to be congruent with patients’ needs and constraints.  It is our goal that the patient voice will guide programming and ensure that care delivered by Operation Smile is patient-centered and ensures equitable access to care for all those living with cleft lip and palate.


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