Description of Mexican Cleft Surgeons' Experience With Foreign Surgical Volunteer Missions in Mexico

Abstract

Mexican cleft surgeons have a high volume of primary cleft palate repairs in their domestic practice with good outcomes. Visiting surgeons may play an important role in Mexican cleft care through educational collaborations that complement the strengths of Mexican cleft surgeons.

Systematic review of low-income and middle-income country perceptions of visiting surgical teams from high-income countries

“…In a Mexican study, more than half of the surgeons who had encountered patients operated on by ‘ surgical missions ’ reported having performed corrective surgeries because of complications from visiting surgical teams, where >70% of the local surgeons were never paid for these corrective surgeries. 44 This is in line with our analysis which indicates a significantly larger number of disadvantages reported among studies of ‘surgical missions’ compared with studies of ‘combined clinical and teaching visits’ . As indicated by studies of short-term missions in Central America, 21 44 45 poorly conducted work may leave scars that take a long time to heal—both for the patients and for local partners whose trust in visiting surgical teams is tainted.…”

“…Potential areas of contention associated with visiting surgical teams were highlighted in 22 (73%) studies 17 18 21 22 25–27 29 31 33 35–46. These were further subgrouped as ethical dilemmas and inequity, insufficient knowledge transfers, poor quality of care, administrative and financial issues, competition and language barriers.…”

“…Twelve studies described ethical concerns and inequity (40%) 17 18 21 27 35–37 41 42 44 45. Inequity was exemplified as lack of local involvement in associated research endeavours27 and local surgeons being set to undertake administrative tasks such as translations and booking of patients for HIC surgeons21 and project coordinators receiving the tasks of acting as ‘a tour guide’ ,41 while ‘giving up’ operative slots to visiting surgeons 29.…”

“…As indicated by studies of short-term missions in Central America, 21 44 45 poorly conducted work may leave scars that take a long time to heal—both for the patients and for local partners whose trust in visiting surgical teams is tainted. 44 To address this issue, further accountability measures may be needed. Ibrahim et al have previously suggested the development a framework of monitoring and evaluation of international surgical initiatives in LMICs including establishment of LMIC databases to inform monitoring and evaluation, longitudinal and contextual assessments of initiatives and encompassing the wider community in evaluation strategies.…”

Ethical Dilemmas in Global Plastic Surgery: Divergent Perspectives of Local and Visiting Surgeons

“…17–19 The complications that arise from surgeons operating outside of their scope of practice and providing a lower standard of care may strain an already resource-poor health system that is left to manage these patients without the necessary resources. 20…”