Times of crisis bring new plans for craniofacial medical care

Cleft Palate–Craniofacial Journal — Medical care for cleft lip or palate is typically offered in stages, with carefully timed surgeries and long-term comprehensive care provided by a team of professionals. When a crisis occurs, such as a natural disaster or political unrest, this standard of care is disrupted. There is a need to establish standards for continuing care for children with craniofacial anomalies during times of upheaval.

Several articles in the November 2011 issue of Cleft Palate–Craniofacial Journal address issues surrounding this topic. One article centers on craniofacial care in locations where disaster and unrest have created difficult conditions. Another addresses an emerging trend of a higher incidence of craniofacial anomalies after a disaster. A third article suggests that guidance is needed for domestic and global crisis relief programs.

When Hurricane Katrina struck New Orleans, La., in 2005, Children’s Hospital housed one of the two craniofacial teams in the city. Lessons learned during the hurricane’s aftermath have led to new policies for the hospital. When evacuating its facility became necessary, the hospital set up a temporary location at a Baton Rouge, La., clinic 80 miles away and a satellite clinic in Lafayette, two hours away. The hospital has continued to work with these locations as satellite sites in case future evacuations are required.

Communications with patients were found to be lacking after Hurricane Katrina. Hospital staff were unable to contact many patients’ families to inform them when and where they could expect medical care for craniofacial anomalies. Before this disruption, the mail had served as the primary means of communication. Now mobile phone numbers and email addresses are collected as part of routine patient information.

Researchers report in another article that the number of new cleft cases showed an increase in greater New Orleans about nine months after Hurricane Katrina. This study found that the increase, particularly among African-Americans, could be attributed to higher levels of teratogenic agents or elevated stress levels following the hurricane.

Hurricane Katrina and other catastrophic events in recent years have shown a need for guidance in crisis relief programs. No such standards currently exist for cleft and craniofacial care. As presented in another article in this issue, principles set forth by the American Cleft Palate–Craniofacial Association may provide precisely such guidance. The authors recommend using this document as a template for international clinical care programs. This would provide standards for examining the conduct of relief programs and ensuring that medical teams are effective, ethical, and culturally sensitive.

Full text of “Flood, Disaster, and Turmoil: Social Issues in Cleft and Craniofacial Care and Crisis Relief,” and other articles in this issue of Cleft Palate–Craniofacial Journal, Volume 48, Number 6, November 2011, published by Allen Press, are available by clicking here.

The official publication of the American Cleft Palate–Craniofacial Association (ACPA), the Cleft Palate–Craniofacial Journal is a bimonthly international, interdisciplinary journal on craniofacial anomalies. The journal explores and reports on the study and treatment, including experimental and proven surgical procedures, of cleft lip/palate and craniofacial anomalies. It also keeps readers in touch with the latest research in related laboratory sciences. To learn more about the society, please click here.