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Global Grant Proposal Form for Project G-3331 Last updated by Malena Bennet <emailmalena@gmail.com> on 25-Sep-24 Project Title Tecate Craniofacial Smiles Type of Project [X] Humanitarian [ ] VTT [ ] Scholarship Primary Host Partner Information
Primary International Partner Information
Grant Host Committee
Grant International Committee
Do any of these committee members have potential conflict of interest? If so, please briefly explain. No Tell us a little about your project. What are the main objectives of the project, and who will benefit from it? 1. The direct beneficiaries of this equipment project will primarily be the elementary schools located in Tecate ,Mexico as well as the population affected with facial differences associated with Cleft lip and Palate deformities. They will be able to use the equipment throughout the year providing education and training as well as be able to provide it for use with the Rotary Surgical Missions for children not otherwise having access for care for Facial Cleft deformities. Training of equipment use and maintenance will take place during these clinics. 2. The secondary beneficiaries for the provision of this equipment grant equipment are the hundreds of children and their families in the Baja Mexico regions who, otherwise, have no access for the diagnostics and surgical care which would be made possible with this project. 3. The main objective of this project is to further provide care for cases having limited access to professional and technological corrections of their facial cleft deformities, and to help give their communities sustainable continued care following project conclusion. 4.Children and young adults from the ages of 10 weeks to 17 years of age will be the focus of this project's treatments. Equipment purchased and utilized by established (18Years) Rotary-Smiles mission projects. Speech-Language Surgical treatment planning via Endoscope diagnostics, and further reconstructive facial procedures such as Cranio-Orthognathic reconstructions will be made possible with this project. 5.Sustainability will be achieved, in part, by working side-by-side with local specialists demonstrating the equipment's usage and maintenance and having them use the equipment throughout the year. This will serve double purpose of catching patients up with their therapeutic treatments as well as provide the communities with sustainable care provided by the ongoing surgical clinicians associated with this charitable and educational clinic. Which area of focus will this project support?
Which goals of this area of focus will your project support? - How will you measure your project impact?
Do you know who will collect information for monitoring and evaluation? -
Humanitarian Project Primary location: Tecate, MX 11/01/2024 through 05/18/2025
Cooperating Organization (Optional)
Why did you choose to partner with this organization and what will its role be? - Partners (Optional) List any other partner that will participate in this project. Dra. Macrina Bustos, CSL, MaxiMed, CSL, BajaSur, Mx Rotary Club of Tecate, BajaNorte, MX Rotary Club of Los Cabos, Los Cabos, BajaSur, MX Rotary Club of Carlsbad, Carlsbad, CA, USA H. Clinica Azul, Colonia Hindu, Tecate, BajaNorte, MX H. de Especialidades, CSL, BajaSur, MX Volunteer Travelers (Optional) Provide name, email of traveler(s). - Describe this person's role in the project. - Rotarian Participants Describe the role that host Rotarians will have in this project. Host sponsors will participate with advertising of the educational and clinical opportunities to the community, provide lunches for the volunteers and patient families at the clinic, and host overnight arrangements for the families and patients traveling long distances, coordinate with DIF for the governmental transportations of patients coming from distant towns, and provide community clinician interface for collegial education using grant computers purchased, and help provide introductions of community clinicians coming with their patients to work side-by-side for collegial interface directly participating in the surgical procedures as well as the screening and follow-up for the treated children. Describe the role that international Rotarians will have in this project. International sponsors will provide additional anesthesia equipment, medications, surgical equipment and sterile nursing supplies for the clinics. The visiting volunteer Surgeons, Dentists, Anesthesiologists, and Nurses will directly participate in the surgical procedures as well as the screening and follow-up for the treated children interfacing with the community clinicians for computer-based education of the specialty project procedures as well as providing instructions on children's educational benefit maintenance. What is the budget for this grant?
Tell us about the funding you have secured for your project.
Humanitarian Projects - Project Planning Describe the community needs that your project will address. Clinicians based in both the fields of Dentistry and Medicine who practice at various hospitals and clinics around the Tecate, San Jose Los Cabos and Cabo San Lucas areas, as well as their extended surrounding communities which have governmental provided transportation, have all indicated that currently there are minimal treatments available to these patients*, minimal computer equipment availability, and no current training availability for the doctors and patient educators to help as well. With the help of this project, patients who have not been able to obtain treatment for their disorders will now be better able to obtain their care on a longitudinal and sustainable basis and to provide their community education leaders with computer access and programs for the necessary education for this. *Reference Wikipedia: Mexico's medical infrastructure is highly rated for the most part and is usually excellent in major cities,[336][337] but rural communities still lack equipment for advanced medical procedures, forcing patients in those locations to travel to the closest urban areas to get specialized medical care.[179] Social determinants of health can be used to evaluate the state of health in Mexico. State-funded institutions such as Mexican Social Security Institute (IMSS) and the Institute for Social Security and Services for State Workers (ISSSTE) play a major role in health and social security. How did your project team identify these needs. Over 67 previous Rotary surgical mission trips treating children with cleft lip and palate deformities (over 700 cases recorded) physically identified that these children are presently lacking access to advanced services and education at their schools for better comprehension of the incidence and support needed in their family structures. In preparation for deciding on a global grant focus, we performed longitudinal follow-up of their clinical charts, and found that, despite having multiple surgical staged surgical procedures, they have all reached an impasse for their final stages and had limited computer educational access at their schools for necessary education of classmates and family members due to the unavailability of equipment necessary for these processes. This grant is designed to provide these patients with access for this. National and international data base literature review shows that the incidence of CLP in Mexico at a rate of 1:600 live births. The birth rate is listed at 15.7 live births/1000 inhabitants in Baja-Mexico. The entirety of Baja Mexico had a population in 2021 of 3.8m persons with 800,000 living in Baja California alone. This makes the patient population for benefitting from this equipment to be 800 babies in Baja California alone with this clinic in Cabo San Lucas able to be a focus treatment region. Many more will benefit from the project in the regions of Baja California, with Tecate able to become the focus treatment area with the outreach performed in November of 2024 & May of 2025. How were members of the benefiting community involved in finding solutions. Members of both the institutional and private sector medical/dental community who knew members of the local Rotary Clubs, all asked for help for patients who could not be cared for by their governmental hospitals or schools sufficiently due to lack of resources and expertise availability. They became involved with the Rotary mission efforts and asked assistance after exhausting their local and governmental resources enquiries. The projects were initiated to involve these clinicians so that follow-up and evaluations of needs could be continued at the local level and future provision of care eventually achieved. How were community members involved in planning the project. Local clinicians and health care professionals all were involved in the planning of the project and are "onboard" with the implementation plan with their individual and collective participation. Private Practice as well as hospital institutional clinicians are all involved in order to provide their professional community this enhancement for patient care. Humanitarian Projects - Project Implementation Summarize each step of your project's implementation.
Will you work in coordination with any related initiative in the community? If yes, briefly describe the other initiatives and how they relate to this project. If no, please explain. Are local initiatives not addressing these needs? Or, if they are, why did you decide not to work with them? Yes. We will be working with several children's charities that have been working with the Rotary Club for vocational directions and guidance, as well as several Casa Hogar (Orphan facilities) for helping patients and families that would travel from rural communities via the DIF governmental transportation assistance to house them overnight nearby the quarterly mission clinics before and after their care. Please describe the training, community outreach, or educational programs this project will include. Training will take place during the performance of the mission months by one-on-one education with the local doctors as well as with the children's families through the local school system's use of the computers provided by the grant. This is planned to take place over the span of the project dates. The dates for the training and computer education, as well as maintenance will be in the months of November 2024, February 2025, May 2025 at a minimium. with primary focus location in Tecate, B.C., Mexico with additional outreach projects in Cabo San Lucas, Baja California, MX. How were these needs identified? The needs assessment was initially performed through identification of patients lacking access to care during previous mission visits as well as a chart review of 700 treated patients taken from 67 surgical mission projects arising from the years 2005 until February 2024. Additionally, new patient populations who will benefit from this project arise from the epidemiological national and international data base and literature review showing that the incidence of CLP in the continents of America, including Mexico is at a rate of 1:600 live births*. At this rate, without taking into account people migrating to the northern border town of Tecate of BajaNorth, Mexico, and to the employment rich region of Cabo San Lucas, BajaSur, Mexico from other locations, the birth rate is listed at 15.7 live births/1000 inhabitants. The entirety of Baja Mexico has a population in 2021 of 3.8m persons with 800,000 living in BajaSur alone. This makes the patient population for benefitting from this equipment to be and with 800 babies in BajaSur alone with this clinic in Cabo San Lucas able to be a focus treatment region during the February and August projects. Importantly, many more than this will benefit in the regions of BajaNorte during the project's outreach, with Tecate BajaNorte able to become another treatment area with the projects in May and November. Clearly the need exists, and opportunity for them to obtain this type of specialty care is low. While the governmental system does generally provide citizens with medical care, these rural areas and regions such as the peninsula of Baja, recently advanced to statehood from frontier status, are lacking resources and trained professionals for this type of care. Patients have to travel many miles to gain access for care if it available at all. This project utilizes the governmental rural transportation buses provided by DIF, (desarros integral de familia) to bring distant cases to one of the two clinic areas in either Cabo San Lucas for the south, and Tecate for the north. *REFERENCE: Cleft lip and/or palate is a congenital abnormality that is seen frequently around the world. On average, about 1 in every 500-750 live births result in a cleft (Hardin-Jones, Karnell, & Peterson-Falzone, 2001). Furthermore, in the U.S., the prevalence for cleft lip with or without cleft palate (CL +/- P) is 2.2 to 11.7 per 10,000 births. Cleft palate alone (CP) results in a prevalence rate of 5.5 to 6.6 per 10,000 births (Forrester & Merz, 2004). Cleft of the lip, palate, or both is one of the most common congenital abnormalities and has a birth prevalence rate ranging from 1/1000 to 2.69/1000 amongst different parts of the world (McLeod, Saeed, & Arana- Urioste, 2004). What incentives (for example, monetary compensation, awards, certification, or publicity), will you use, if any, to encourage community members to participate in the project? No incentives were found to be needed for this project. List any community members or community groups that will oversee the continuation of the project after grant-funded activities conclude. The project has identified several Rotarians, and past Rotarians who have been working and volunteering for the mission cleft clinical projects for the prior 12-19 years in Cabo San Lucas and in Tecate Mexico. These individuals will serve as interface for the project oversight after the grant-funded activities conclude. All have served as Rotary Club officers with a variety of positions including the roles of president in the Clubs in Tecate and Los Cabos. Budget Will you purchase budget items from local vendors? Explain the process you used to select vendors. yes. We reviewed pro-forma invoices from several vendors and selected purchases from best priced quality equipment having best post-purchase support. Did you use competitive bidding to select vendors? If no, please explain. Yes. Please provide an operating and maintenance plan for the equipment or materials you purchased for this project. This plan should include who will operate and maintain the equipment and how they will be trained. Primarily, the project began operations at the Hospital de Especialidades, located centrally in Cabo San Lucas, C. Adolfo López Mateos entre leona vicario y morelos, Ejidal Chamizal, 23470 Cabo San Lucas, B.C.S., Mexico, is operating as an active specialty hospital providing services 24h/7d/week with staff on site year round. It is privately owned by a legally formed Mexican Professional Corporation and is managed by their governing body consisting of owner physicians. They are open for services at all times which include emergency medical and trauma care, orthopedics, birthing center, OBGyn, Otolaryngology, Dermatologic/Plastic Surgery, and Hyperbaric Oxygen therapy. Their staff is privately supplied by their private practice governing body business model. Specialty Maxillofacial/Dental center, MaxiMed, owned privately and operated year round, will host the surgical mission via their connection with the H. de Especialidades and participate with patient screening, surgeries, equipment demonstrations and maintenance education, and patient post operative follow-up and care as well as project measurements of success documentation. Additionally, the added-purchased computer equipment will be utilized in local school systems for professional and patient family education of the various stages of children's treaments, outcomes, and necessary community support and owned by the Review of cases at each mission clinic will determine sustainable success rates for these processes. The equipment will initially be used just for charitable purposes during the mission months mentioned in paragraphs above in this application, and training of the local professionals in the use, diagnostics, and maintenance of the equipment will occur during these clinics allowing use for sustainability of patient access for the community thereafter. This will provide care for both the current and future patients afflicted with their facial cleft deformities throughout their growth and development. The grant purchased-equipment will be owned by professional corporation (MaxiMed) and stored appropriately between its local use and intermittent-cooperative project-outreach use at the H. Cerro Azul, BajaNorte, Tecate Facility. Equipment transportation/shipping will be via Arnian Freight logistics, a private company having cargo offices located in Cabo San Lucas and in Tijuana, B.C., Mexico. who has offered donated service for this project. Outreach for the northern part of the Baja-Mexico is provided in this project through use of the Hospital Clinica Cerro Azul, located in Colonia Hindu, Tecate, BajaNorte, Mexico. This clinic operates year-round and is owned by the Mexican Governmental Social Medical hospital system. They provide onsite staffing which is available for emergency care 24/7, dentistry by appointment, community health clinics including vaccinations, maternal care and parasite control clinics, and emergency transportation referrals to the larger general hospital in Tecate-Central. The global grant provided equipment will be used for charitable purposes during the mission efforts in the months outlined above, and the equipment will be transported for project use at each of these two sites, alternating with 3 month intervals to the BajaSur, Cabo San Lucas H. de Especialidades via the donated services of : Arnian Freight Logistics 9948 Via De La Amistad San Diego, CA 92154 which has cargo offices located in Cabo San Lucas and Tijuana, B.C., Mexico. Describe how community members will maintain the equipment after grant-funded activities conclude. Will replacement parts be available? The equipment will be used for charitable purposes during and after the mission efforts. Then, a percentage of private care patients see in conjunction with their community doctors during the project will continue to be seen following the conclusion of the grant-funded activities. Thereafter, the equipment will be available for private community use and fees generated on these select patients will afford upkeep expenses allowing community patients to access specialized care. Replacements parts are available for order from the manufacturer and these locations have access for delivery. However, the chance for this being necessary is very rare with this particular type of medical equipment. If the grant will be used to purchase any equipment, will the equipment be culturally appropriate and conform to the community's technology standards? If yes, please explain. If no, describe how the project team will help community members adopt the technology. Yes. The regions of both BajaSur and BajaNorte are sufficiently economically and industrially developed to have the grant equipment work within their technological standards. All electrical and back up power systems have been identified to be suitable for the overall sustainability of this equipment. Engineering standards have been verified to assure compatibility for the computer equipment, and the power operated surgical handpieces. After the project is completed, who will own the items purchased by grant funds? No items may be owned by a Rotary district, club, or member. The equipment will be owned by MaxiMed, a professional corporation staffed year round with a specialist Maxillofacial Surgeon and other specialty Dentistry professional, all connected with the H. de Especialidades who has been providing care in the community for many years. A verification letter is presented in this GG uploaded documents. Funding Have you found a local funding source to sustain project outcomes for the long term? If yes, please describe this funding source. The equipment will be used for charitable purposes during the mission efforts and a percentage of the patients seen following the conclusion of the grant-funded activities. Thereafter, the equipment will be available for private use and fees generated on these select patients will afford upkeep expenses. Will any part of the project generate income for ongoing project funding? If yes, please explain. No. Is your economic and community development activity a microcredit project? If yes, upload your microcredit supplement file. No. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||