Report on the Cleft lip and Cleft palate repair at Lata Mangeshkar Medical.
College Hospital, Nagpur, India. Jan 22, 2009 – Jan 30, 2009. (Charity
programme ...
Report on the Cleft lip and Cleft palate repair at Lata Mangeshkar Medical College Hospital, Nagpur, India Jan 22, 2009 – Jan 30, 2009 (Charity programme conducted by Northern Cleft Foundation) http://www.northerncleftfoundation.co.uk
My name is Krishna Devarakonda and I am a registrar in Anaesthetics in the North West Deanery. I have chosen to specialise in paediatric anaesthesia and towards that I thought that the charity cleft lip / cleft palate repair camp conducted in India would be beneficial both on a personal note, being involved in a charity event, and also on a clinical front, benefiting from exposure to some interesting patients undergoing maxillofacial surgery. The Northern Cleft Foundation is a group of Anaesthetists (including a paediatric anaesthetist) and Maxillofacial surgeons, mostly from the North West of United Kingdom. They, along with a team of nursing staff (scrub nurses & recovery), anaesthetic and surgical trainees and medical students, have visited various places in India to perform free cleft lip and cleft palate repair surgeries on children and adults from villages, towns and cities in India. The team visited India between Jan 21st and Feb 1st 2009 to perform the charity procedures at the Lata Mangeshkar Medical College Hospital, Nagpur. Dr Pattabiraman Venkataraman, one of the organising Anaesthetists, had previously liaised with the members of the Rotary Club, Nagpur West and organised for the medical college hospital to be used as the place for the charity surgeries. The prospective patients were selected from various parts of rural Maharashtra state, India by the local doctors. The selected patients were then transferred to the medical college hospital and the Rotary club members and the Medical College for up to 4 days arranged the stay for each patient and 2 family members of that patient within the hospital. Only ASA 1 and 2 patients were selected as patients to undergo the cleft lip and cleft palate repair surgery. We arrived at Nagpur in early hours of 22nd Jan 2009. After resting a while, the Hospital staff and the Rotary club members in a brief welcoming ceremony hosted us and we soon got busy with pre anaesthetic evaluation of the patients to be operated upon during the first 3 days. We rounded up the day by visiting the operating theatres, familiarising with the available anaesthetic machines and monitors and assisting the nursing staff organise the drugs, instruments and disposables. We operated upon 68 (Female ‐ 33, Male ‐ 35) patients over the next six and a half days and the break up of the patients is as follows Cleft Lip ‐ 29 Cleft Palate ‐ 21 Cleft Lip +palate ‐ 10 Cleft Lip Revision ‐ 05 Palate Fistula ‐ 03 Age Group: 16 yrs – 10 We rested on 26th January, as it was a national holiday in India (Republic Day). All patients were thoroughly evaluated and an informed consent was obtained from them or their parents (in case of children). The procedures were performed in 3 operating theatres that were nominated for the Northern Cleft Foundation surgeries. There was a multi parameter monitor in each theatre and emergency airway equipment and drugs were available to hand. Anaesthetic trainees under direct consultant anaesthetist supervision anaesthetised the patients. The procedures were carried out by 3 Maxillofacial surgeons (Consultant and trainee) from Cardiff, Liverpool and London respectively. There were 2 medical students in the team who got the opportunity to see the procedures initially and later assist in a few. The patients were taken to the recovery after the surgery, where they were nursed by 3 recovery nurses with medical input from the 3 senior anaesthetists of the team. There was a varied case mix as suggested by the statistics mentioned earlier. There was an interesting case of a child with Treacher‐Collins Syndrome who was posted for revision of his cleft palate repair. The team from the Northern cleft foundation was invited one evening to a meeting organised by the Nagpur branch of the Indian Society of Anaesthetists and the meeting had discussions pertaining to the surgeries on cleft lip /palate. The transport, to and from the hospital, and the catering was organised by the Rotary Club, Nagpur West. On the evening of the 29th of January, the Rotary club had organised a night out at the Vidarbha Cricket Association where all members of the Northern Cleft Foundation were given the Certificate of Appreciation. There was also an overnight trip organised by the Rotary Club members to the Pench National Park and Tiger reserve starting on the 30th January after the last patient was discharged. We boarded the flight to Manchester on the 1st of Feb and arrived on the 2nd of February. I was expected to raise at least £1500.00 towards my flight and expenses and also sponsoring few surgeries. I am grateful to the International Relations Committee (IRC) at the Association of Anaesthetists of Great Britain and Ireland, for the travel grant that contributed towards the total expenditure. The kind donations from friends and family and from my own purse made up the remaining sum of money. The details of the team and some of the pictures from the trip are in the website of Northern Cleft Foundation mentioned above. Thank you Kind Regards Krishna M Devarakonda
