Humanitarian and Global Outreach - Department of Otolaryngology

Department of Otolaryngology's Global Outreach and Humanitarian efforts.

There is an increasing interest among medical students, residents and resident applicants, fellows, and faculty to perform humanitarian work. While this is often thought of as international mission trips, humanitarian initiatives are so much more.

Within the Department of Otolaryngology, humanitarian activities are included in all three pillars of the academic mission: clinical care, research, and education.

These efforts include:

Care of underserved populations, both in the US and abroad.
Research into healthcare disparities.
Access to care and social determinants of health.
Educational activities for patients and practitioners who may have limited resources.

International Clinical Activities

Cuba Mission Trip

The MUSC Department of Otolaryngology's outreach trip to Cuba — MUSC's Dr. Rod Schlosser with residents and staff of Calixto Garcia Hospital in Havana, Cuba.

Faculty member: Rod J. Schlosser, M.D.

Host Organization: Medical Education International (Christian Medical and Dental Association)

Location: Several hospitals through western Cuba

Summary of Activities: Medical Education International (MEI) focuses on educating host healthcare providers. This involves lecturing to physicians, residents, and students. At times, this also includes accompanying host providers in clinic and the operating room. We donate needed supplies and equipment. Teaching is done similarly to residency training in a mentorship model. The goal is to teach local providers how to do procedures and care for patients, so these activities continue even when we are not in the country.

Potential Involvement of Students and Residents: This includes lecturing peers or accompanying peers on rounds. Due to cultural concerns, it would not be appropriate to have US residents “training” local attending physicians in the OR. Because of this, and the desire to teach local surgeons (attendings), US residents may scrub in and assist, but they typically will not operate.

El Salvador Global Health Initiatives - Global Smile Foundation (GSF)

Faculty Member: Krishna G. Patel, M.D., Ph.D.

Host Organization: Global Smile Foundation (non-profit)

Location: Hospital Nacional de Niños Benjamin Bloom, the only children’s hospital in the country and the main treatment center for children with cleft, San Salvador, El Salvador.

Summary of Activities: Global Smile Foundation (GSF) has multiple arms of service. The first arm is focused on education and, within the one to two-week trips, didactics are performed within the local hospital focusing on topics on the specialized care of children born with cleft lip and palate. GSF also sponsors, annually, a fellowship for a locally trained surgeon to travel with the team and operate alongside the members of the team. The purpose is to expose the fellow surgeon to multiple experienced cleft surgeons to advance their breadth of knowledge and training. The goal for the fellowship-trained surgeon is to operate within the country and provide care for patients in need independent of GSF. The second arm of the organization focuses on providing care for individuals within El Salvador who do not have the resources to undergo the procedures involving the repair of a cleft lip or cleft palate. The third arm is a global international network that holds international conferences and simulation lab training. Supplies are donated as part of the humanitarian effort.

Potential Involvement of Students and Residents: Students will learn the importance of establishing trusting relationships with the host professionals in the Hospital Benjamin Bloom. They will accompany peers on rounds and assist in the education of the families. Because the priority is to teach local surgeons (attendings), US residents may scrub in and assist, and will be treated with similar supervision as they are within cases performed within the US.

Ecuador Global Health Initiatives - GSF

The MUSC Department of Otolaryngology's outreach trip to Ecuador.

Faculty Members: Krishna G. Patel, M.D., Ph.D., Phayvanh P. Pecha, M.D., MPH

Host Organization: Global Smile Foundation (non-profit)

Location: Comprehensive Cleft Center at Hospital León Becerra, Guayaquil, Ecuador

Summary of Activities: Patients are treated at the Comprehensive Cleft Center at Hospital León Becerra. Global Smile Foundation (GSF) provides a full range of integrated and interdisciplinary cleft care throughout the year, at no cost to all patients and their families. The center is managed by Fundación Global Smile-Ecuador, established in 2012 to ensure the sustainability of GSF’s humanitarian work. Supplies are donated as part of the humanitarian effort.

Potential Involvement of Students and Residents: Students will learn the importance of establishing trusting relationships with the host professionals in the Hospital Leon Becerra. They will accompany peers on rounds and assist in the education of the families. Because the priority is to teach local surgeons (attendings), US residents may scrub in and assist, and will be treated with similar supervision as they are within cases performed within the US.

Domestic Clinical Activities

Dream Center Clinic (Free Clinic)

The MUSC Department of Otolaryngology's Dream Clinic. — Faculty from the MUSC Department of Otolaryngology (and other departments) volunteer at the Dream Center to provide care for patients without insurance.

Faculty Member: Rod J. Schlosser. M.D.

Host Organization: Dream Center Clinic (Affiliated with Seacoast Church)

Location: North Charleston, SC

Summary of Activities: A monthly ENT clinic is conducted on Tuesday evenings from 6 to 8 pm. Usually, two to six patients are seen. There is limited equipment and resources, such as medications and imaging, that can make care challenging, but patients are very appreciative.

Potential Involvement of Students and Residents: Residents have conducted some independent clinics in other specialties (internal medicine). Students will generally shadow MDs and APPs or assist with taking vital signs, rooming patients, etc.

Head and Neck Cancer Screening Clinic

Faculty Member: Ashton Getchell, PA

Host Organization: MUSC

Location: Charleston, SC

Summary of Activities: Medical students, residents, SLPs, APPs, nursing staff, and MDs attend a variety of community events to provide free screening for head and neck cancer.

The MUSC Department of Otolaryngology's head and neck screening. — Members of the MUSC Department of Otolaryngology volunteer at a recent head and neck screening event.

MUSC CARES (Community Aid, Relief Education & Support) Clinic

Host Organization: MUSC

Service: MUSC CARES

Location: Mount Pleasant, SC

Summary of Activities: Medical student initiated free clinic, typically six patients per night, usually Monday, Tuesday, Thursday, and some Wednesdays from 6 to 9 pm.

Potential Involvement of Students and Residents: Licensed providers volunteer time while teaching medical, pharmacy, and PA students.

Barrier Islands Free Medical Clinic

Host Organization: Barrier Islands Free Medical Clinic

Location: Johns Island, SC

Summary of Activities: Monday to Friday 9 am to 4 pm by appointment.

Potential Involvement of Students and Residents: Licensed providers in the clinic, also appear to be opportunities for other volunteers as well for admin or operational support.

Educational Activities

Many educational activities are integrated into the domestic and international activities described above, including teaching local healthcare providers how to perform surgery and care for patients. Additional opportunities abound including efforts such as online instructional videos.

Rhinology Worldwide Textbook

This series of videos are free to access on Youtube, and have accumulated more than 35,000 views. Click here to access all videos.

Faculty Members: David Gudis, M.D., Nicholas Rowan, M.D., Rod J. Schlosser, M.D., Zach M. Soler, M.D., MSc

Summary: This is a compilation of 39 videos given by international experts on the entire spectrum of rhinology topics. It was the product of the Humanitarian Initiative of the American Rhinologic Society to provide education to practitioners around the world with limited educational resources.

Research Activities Addressing Healthcare Disparities

MUSC Department of Otolaryngology – HNS has conducted a wide variety of research into healthcare for underserved populations both in the US and abroad. Below is a sample of such research with MUSC Otolaryngology members in bold. Many opportunities are available for students and residents.

Van Swol JM, Wolf BJ, Annan NB, Hamdan US, Patel KG. Association of Patient Factors and Follow-Up in an International Volunteer Cleft Lip and Palate Repair Clinic in El Salvador. J Craniofac Surg. 2022;33(8):2477-2481.

Patel KG, Eberlin KR, Vyas RM, Hamdan US. Use of safety measures, including the modified world health organization surgical safety checklist, during international outreach cleft missions. Cleft Palate Craniofac J. 2014;51(5):597-604.

Kantar RS, Ramly EP, Almas F, Patel KG, Rogers-Vizena CR, Roche NA, Zgheib E, Munoz-Pareja JC, Nader MK, Kummer AW, Flores RL, Van Aalst JA, Hamdan US. Sustainable Cleft Care Through Education: The First Simulation-Based Comprehensive Workshop in the Middle East and North Africa Region. Cleft Palate Craniofac J. 2019;56(6):735-743.

Kantar RS, Breugem CC, Keith K, Kassam S, Vijayakumar C, Bow M, Alfonso AR, Chahine EM, Ghotmi LH, Patel KG, Shetye PR, Santiago PE, Losee JE, Steinbacher DM, Rossell-Perry P, Garib DG, Alonso N, Mann RJ, Prada-Madrid JR, Esenlik E, Pamplona MDC, Collares MVM, Bennun RD, Kummer A, Giugliano C, Padwa BL, Raposo-Amaral CE, Tse R, Sommerlad B, Flores RL, Hamdan US. Simulation-Based Comprehensive Cleft Care Workshops: A Reproducible Model for Sustainable Education. Cleft Palate Craniofac J. 2020 Oct;57(10):1238-1246.

Kantar RS, Esenlik E, Al Abyad OS, Melhem A, Younan RA, Haddad M, Keith K, Kassam S, Annan B, Vijayakumar C, Picard A, Padwa BL, Sommerlad B, Raposo-Amaral CE, Forrest CR, Gillett DA, Steinbacher DM, Runyan CM, Tanikawa DYS, Chong DK, Fisher DM, Mark H, Canter HI, Losee JE, Patel KG, Hartzell LD, Johnson AB, Collares MVM, Alonso N, Chen PK, Tse R, Mann RJ, Prada-Madrid JR, Kobayashi S, Hussain SA, Kummer A, Sell DA, Pereira VJ, Mabry K, Gonsoulin CK, Persson M, Davies G, Sethna NF, Munoz-Pareja JC, Kuijpers-Jagtman AM, Grayson BH, Grollemund B, Garib DG, Meazzini MC, Kharbanda OP, Santiago PE, Nalabothu P, Batra P, Stieber E, Prasad D, Brewster H, Ayala R, Erbay E, Akcam MO, Don Griot JPW, Vyas RM, Flores RL, Breugem CC, Hamdan US. The First Hybrid International Educational Comprehensive Cleft Care Workshop. Cleft Palate Craniofac J. 2023;60(10):1189-1198.

Kantar RS, Breugem CC, Alfonso AR, Keith K, Kassam S, Annan B, Chahine EM, Wasicek PJ, Patel KG, Flores RL, Hamdan US. Perceived Barriers to Comprehensive Cleft Care Delivery: Results From A Capacity-Building Educational Initiative and Implications. Ann Plast Surg. 20211;87(2):194-198.

Asitha D L Jayawardena, Ashley M Nassiri, Dylan A Levy, Vienna Valeriani, Alison J Kemph, Charissa N Kahue, Nathaniel Segaren, Robert F Labadie, Marc L Bennett, Carl A Elisée, James L Netterville. Community health worker-based hearing screening on a mobile platform: A scalable protocol piloted in Haiti Laryngoscope Investig Otolaryngol. 2020;5(2):305-312.

Gutierrez JA 3rd, Durrant FG, Nguyen SA, Chapurin N, Schlosser RJ, Soler ZM. Association between Social Determinants of Health and Allergic Fungal Rhinosinusitis: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg (in press).

Liebowitz A, Spielman DB, Schlosser RJ, Stewart MG, Gudis DA. DemographicDisparities in the Federal Drug Approval Process for Allergic Rhinitis Medications. Laryngoscope 2023;133(4):755-63.

Mehta NK, Ma C, Miglani A, Gudis DA, Nguyen SA, Schlosser RJ. Impact of federal mandates on demographic reporting in rhinitis clinical trials. Int Forum Allergy Rhinol 2022;12(1):116-119.Title: Association between social determinants of health and AFRS: A systematic review and meta-analysis.

Ma C, Mehta NK, Nguyen SA, Gudis DA, Miglani A, Schlosser RJ. Demographic Variation in Chronic Rhinosinusitis by Subtype and Region: A Systematic Review. Am J Rhinol Allergy 2022;36(3):367-77.

Spielman DB, Schlosser RJ, Liebowitz A, Sharma R, Overdevest J, Mattos J, Gudis DA. Do Federal Regulations Affect Gender, Racial, and Ethnic Disparities in Chronic Rhinosinusitis Research? Otolaryngol Head Neck Surg 2022;166(6):1211-18.

Sharma RK, Schlosser RJ, Beswick DM, Suh JD, Overdevest J, McKinney K, Gudis DA. Racial and ethnic disparities in paranasal sinus malignancies. Int Forum Allergy Rhinol 2021;11(11):1557-69.

Jungbauer WN Jr, Zhang K, Melvin CL, Nietert PJ, Ford ME, Pecha PP. Identifying barriers to obstructive sleep-disordered breathing care: Parental perspectives. Int J Pediatr Otorhinolaryngol. 2023;171:111621

Atherton KM, Poupore NS, Clemmens CS, Nietert PJ, Pecha PP. Sociodemographic Factors Affecting Loss to Follow-Up After Newborn Hearing Screening: A Systematic Review and Meta-Analysis. Otolaryngol Head Neck Surg. 2023;168(6):1289-1300.

Yan F, Pearce JL, Ford ME, Nietert PJ, Pecha PP. Examining Associations Between Neighborhood-Level Social Vulnerability and Care for Children With Sleep-Disordered Breathing. Otolaryngol Head Neck Surg. 2022;166(6):1118-1126

Mullen MC, Yan F, Ford ME, Patel KG, Pecha PP. Racial and Ethnic Disparities in Primary Cleft Lip and Cleft Palate Repair. Cleft Palate Craniofac J. 2023;60(4):482-488.

Yan F, Levy DA, Wen CC, Melvin CL, Ford ME, Nietert PJ, Pecha PP. Rural Barriers to Surgical Care for Children With Sleep-Disordered Breathing. Otolaryngol Head Neck Surg. 2022;166(6):1127-1133

Pecha PP, Chew M, Andrews AL. Racial and Ethnic Disparities in Utilization of Tonsillectomy among Medicaid-Insured Children. J Pediatr. 2021;233:191-197.

Pecha PP, Hamberis A, Patel TA, Melvin CL, Ford ME, Andrews AL, White DR, Schlosser RJ. Racial Disparities in Pediatric Endoscopic Sinus Surgery. Laryngoscope. 2021;131(4):E1369-E1374.