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Bangladesh Project Update - Visit to GOSH

I'm Dr. Moumita Talukder and have worked in the National institute of Burn & plastic surgery, DMCH, as an anaesthesiologist from 2007. I perform all kinds of operations like cleft lip, cleft palate, craniofacial deformities, and all kinds of plastic surgery, including emergency burn care also, but my direct involvement has been with the Comprehensive Cleft care team of DMCH for the last 2 years.  I'm thankful and grateful to Prof Abul Kalam who has assisted me & also inspired me to do this job.

Before anything to say about my visit to GOSH, I want to share my personal experiences.  I have a daughter who was born on August, 2003 with cleft palate & bifid uvula. Then I had just completed my MBBS. My family and I became so frustrated and felt like we had lost everything. We just went through lots of suffering and pain with my baby.  She was operated on in DMCH in November, 2004, at the 15th month of age which was too late.  After that we faced another problem regarding her Speech therapy.  I was just in a phobia about her nasal intonation.

In Bangladesh complete care of cleft lip & palate patients is still inadequate and not synchronised.  So as a mother, I have the experience of what kind of sufferings a family has to deal with in Bangladesh.

All my gratitude to Almighty God that I have been given the opportunity to do something for cleft lip and palate patients.  I'm also thankful to Dr Brian Sommerlad, Dr Samonto Lal Sen, Prof Abul Kalam Azad, Prof Sazzad Khondokar, Prof Rayhana Awal, CLEFT charity and to Emirates Airlines Foundation who have given me such a wonderful opportunity.

As you may know Bangladesh is a developing country and lots of babies are born with congenital abnormalities.  In Dr Rabiul Karim Papon reports you may already have an idea about the real situation in Bangladesh. You may also know how much Dr Brian Sommerlad is trying to establish a complete comprehensive cleft care in Bangladesh.  Not only treating people,  he also tries to establish a team who are working to rehabilitate the patient and to provide social support, family education and long term follow up of the patient.  We are very grateful to Brian, the CLEFT charity and Emirates Airlines foundation for helping us to establish such a centre in DMCH.

In my visit to GOSH, they arranged a very good programme schedule for me.
Dr Kar Binh Ong was my observer. He did a lot to make my visit fruitful.  I went through not only the cleft lip and palate team but also all kinds of paediatric surgery.  I also visited PICU, NICU, POW, Pain clinic and emergency operation.  I learnt how they deal with a baby and their parents so cordially. Really it was an art.  Every day in the morning before starting an operation there was a team briefing about all patients going to operations and what every team member needed to do for their best outcome.  At the end there was another briefing to consider what else could be done to further the best outcome.  I think it was a good practice to overcome any difficulties.  It was just wonderful that every body was working so synchronously and properly, the best outcome is obvious.

In GOSH almost every baby has a multisystem problem and I have a clear view how a multidisciplinary approach to a cleft patient provides comprehensive care.

The anaesthetist of GOSH are doing an amazing job.  They are dealing with very complicated situations so smoothly and confidently that it was a great learning for me.  I also attended some tutorial and scientific session which helped me further.

Another thing that impressed me was that they are keeping records of each patient. They are doing lots of paper work at the same time.

One thing I would like to mention is that GOSH is much richer, both instrumentally and technically.
It was my observation that our skills and knowledge are not in proper use due to lack of facilities we have in Bangladesh.

So while a visit can improve our views and skills, to implement these skills we need proper working equipment and other facilities in our comprehensive cleft centre in DMCH.  It is important to mention that every cleft patient has difficult airways and most have cardiac problems.  However we have no difficult airway management trolley or any cardiac monitoring systems.  We are using an anaesthetic machine which is old with no ventilator or sevoflurane vaporizer.

So I would like to request to Brian, the CLEFT charity and Emirates foundation to arrange a good and safe working environment for us. If we get a proper working environment, I think our devotion and dedication will help create a much better outcome.

As a member of the cleft care team and also as a mother of a cleft palate baby, I would like to provide my skill and dedication to every cleft patient and I shall try my best to improve our team work to reach the goal of a comprehensive cleft care, at DMCH. I will also ensure that I shall share my experience which I gathered from GOSH with each member of our team for the best outcome.

Again my thanks and regards to all member of the CLEFT charity. I feel honoured to be a part of a cleft charity.

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