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Bogota stint gives oral surgery resident glimpse of global need

Aug. 23, 2012, 9:44 AM

Vanderbilt resident Benjamin Foley, D.D.S., left, with Andrews Duque, D.D.S., director of Craniofacial Surgery at the Roosevelt Hospital in Bogota, Colombia.

While Benjamin Foley, D.D.S., was on a two-week surgical rotation in Bogota, Colombia, the impact of limited access to health care was as clear as the fused jaw of a 6-year-old child.

What started as common ear infections led to the fusing of joints in the jaw of not one, but three young children Foley treated while in Colombia — children whose families either couldn’t make it to a doctor for antibiotics or simply didn’t have the money to do so.

As part of the Vanderbilt Oral and Maxillofacial Surgery residency program, Foley and others are experiencing first-hand both the personal rewards and challenges of global health care.

“It’s truly a tale of two worlds. We might see cases like these once or twice in our careers in the U.S.,” Foley said.

“What should be a simple remedy for a common infection, when left untreated turns into a much bigger health problem and, unfortunately, the norm for many in impoverished areas across the globe.”

Samuel McKenna, M.D., D.D.S., chair of Oral and Maxillofacial Surgery, first observed this several years ago while on a mission trip in Bogota.

While assisting with trauma cases, he met Andres Duque, D.D.S., director of Craniofacial Surgery at Roosevelt Orthopaedic Children’s Hospital in Colombia.

The two quickly realized the benefits of establishing surgical rotations for Vanderbilt’s oral surgery residents in the region.

Residents participating in the program treat patients in both the area’s public hospital and private Roosevelt Hospital. Through Duque’s association with the volunteer Airforce Reserve, Vanderbilt residents also have an opportunity to travel by military plane to outlying regions to perform cleft lip and palate repair.

On a typical day, Foley consulted and treated up to 25 patients. Most were children under age 2 requiring cleft lip and palette repair.

But residents on rotation in Bogota also treat adults with craniofacial surgical care, including teenagers with jaw deformities and adults with facial trauma injuries following automobile accidents, one of the leading causes of death in the region, just behind infectious disease.

McKenna expects to expand the care provided to include instruction on recent advances Vanderbilt has made in the area of virtual oral surgery, which eliminates much of the guesswork in reconstructive facial surgery.

“We are so fortunate to be able to participate in such a wonderful, cross-cultural training program,” said McKenna. “Our residents learn critical surgical skills while gaining a real appreciation of how global surgery can positively impact public health. And surgeons there see some our latest advances in craniofacial care. It’s a win-win all the way around,” he said.

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