Chapter Three

Operation Airway

The first sustainable, multidisciplinary pediatric airway surgical mission — built in Quito, so that a local team could one day care for its own children.

A Mission That Stays

Not a Visit — a Program

Many surgical missions arrive, operate, and leave. Operation Airway was designed to do something harder: to build a sustainable program in which Quito's own surgeons, anesthesiologists and intensivists could independently care for children with the most complex airway problems — long after the visiting team had gone home.

Dr. Ernesto Quiñones anchored it in Ecuador, in partnership with the team at Massachusetts General Hospital and Harvard Medical School in Boston.

What It Set Out to Do

Four Goals

The mission was built around four aims, pursued together rather than one at a time.

01To help children with aerodigestive abnormalities — the airway and swallowing conditions that are hardest to treat.
02To create a sustainable program in which the local team could independently care for its own patient population.
03To develop an educational curriculum and training program for the local team.
04To cultivate a collaborative, multidisciplinary approach to caring for each child.
The First Four Missions

In Numbers

The published study followed the first four Operation Airway missions in Quito. Across them, the team cared for twenty children — from infants to young adults — and carried out the procedures below.

20
Children treated, ages 4 months to 21 years
23
Bronchoscopies
6
Laryngotracheal reconstructions
5
Salivary procedures
2
Tracheostomies
2
Open granuloma excisions
1
T-tube placement
1
Tracheocutaneous fistula closure
The Partnership

Quito and Boston

Operation Airway brought together a multidisciplinary team — otolaryngology, anesthesiology, critical care, nursing and respiratory therapy — from Massachusetts General Hospital and Harvard Medical School, working alongside Dr. Quiñones and his colleagues in Quito.

The aim was never dependence but the opposite: to leave behind a trained local team, a curriculum, and a way of working together — so that the program could continue on Ecuadorian hands. It became a model for what a medical mission can be.

For the Record

The mission was documented in the peer-reviewed literature.

Operation Airway: The First Sustainable, Multidisciplinary, Pediatric Airway Surgical Mission. Annals of Otology, Rhinology & Laryngology — May 2014 (Vol. 123, No. 10, pp. 726–733). Co-authored by Dr. Ernesto Quiñones with the Operation Airway team.