Michaela Close, M.D., a MUSC College of Medicine resident, was awarded a Center for Global Health Student & Trainee Travel Grant to pursue a global health project in San Salvador, El Salvador. View more photos of her time in country in this Flickr photo gallery.
My experience in San Salvador, El Salvador with the Global Smile Foundation was a formative and deeply rewarding experience that significantly contributed to my surgical training. As part of a multidisciplinary team, we evaluated 74 patients with cleft and other craniofacial anomalies and performed 38 surgical procedures for 25 patients over the course of one week, in addition to providing dental and psychosocial care. The magnitude of need was immediately evident, as well as the meaningful impact that coordinated, specialized care could have on patients and their families.
Working with the Global Smile Foundation, I was able to see the importance of emphasizing sustainability and partnership with local providers. The Global Smile Foundation has a long-term relationship with the community and hospital network in San Salvador. This has allowed them to create a system of support that extends beyond short-term service delivery and focuses on building longitudinal systems of care. There are providers the foundation has worked with annually, who are now able to perform craniofacial surgeries independently and provide follow up throughout the year. Over time, the foundation has changed the nature of the surgeries and services it provides each year in response to the needs of this community.
During the week of our trip, we worked with local surgeons, OR staff, anesthesiologists, and surgical trainees. I was able to witness firsthand the effectiveness of collaboration and bidirectional knowledge exchange between the US and El Salvadorian teams. Teaching operative techniques and discussing perioperative management underscored that effective global health efforts require humility, mutual respect, and a commitment to fostering local capacity. The local team’s role in providing ongoing follow-up further emphasized the importance of continuity and local investment.
This experience also broadened my understanding of delivering high-quality care in resource-limited environments. The OR equipment was somewhat more limited than that available in the United States, but the quality of surgical care was clearly maintained. Limited resources required adaptability, efficiency, and thoughtful prioritization, while maintaining safety and standards of care. I was very impressed by the high quality of care that these patients received and surgical outcomes that were equivalent to those I have witnessed in the United States.
This experience solidified my commitment to incorporating global outreach into my future career. It demonstrated that, as a facial plastic surgeon, I can contribute not only through direct patient care but also through education and long-term partnership. In pursuing global outreach as an attending surgeon, I hope that I can apply the same principles of sustainable global medical outreach demonstrated by the Global Smile Foundation, providing high quality surgical care, responding to the needs of the local community, and helping to build local capacity.
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