Asia
Chennai, India
TFW and Sri Ramachandra University
TFW has partnered with some of India's top Speech and Orthodontic specialists to provide rehabilitation for cleft lip and palate. The project is housed at Chennai's Sri Ramachandra University and performs monthly outreach to the rural areas of Thiruvannamalai District.
Focus on Rehabilitation
Even after having surgery for cleft lip/cleft palate, many children continue to experience health problems. A child with CLP is at greater risk of developing ear infections, hearing loss, and speech disorders. Dental problems - such as missing, extra, malformed, or displaced teeth, and cavities - also are common.
The SRU project team travels each month to a rural community district to provide the following services:
- Identification of speech and hearing disorders;
- Referrals to ENT specialists;
- Speech therapy, using trained community-based rehabilitation (CBR) workers;
- Dental and orthodontic work.
To date, over 1000 rural children have received Speech & Language therapy and Dental/Orthodontic treatment through the program.
Rehabilitation helps to ensure that these children will go on to have normal speech and hearing, giving them a better chance of performing well in school.
What's New: Telemedicine
In 2008, the SRU is bringing the innovation of telemedicine to rural communities. The telemedicine van is equipped with basic medical facilities and electronic connectivity with the SRMC. This allows children with CLP in rural areas to receive speech and hearing assessments without having to travel outside the community.
Hengshui, China
Home to a rich millenary culture and the world's largest population of 1.3 billion, China is poised to regain its place as a dominant world power. However despite rapid growth, free and universal health care is not yet a reality. Instead, health care in China remains highly uneven, especially in smaller communities.
Cleft lip and Palate in China
Every year, over 50,000 children are born with cleft lip and palate (CLP) in China. The majority of these children do not have access to comprehensive treatment.
Our Local Partnership
In response to this need, TFW has partnered with the Amity Foundation and Harrison International Peace Hospital in order to increase access to comprehensive treatment for cleft lip and palate.
The Amity Foundation is a Chinese voluntary organization that was created in 1985 to promote education, social services, health, and rural development.
The Harrison International Peace Hospital was founded in 1946 and belongs to the network of National Red Cross Emergency Medical Aid Centers. The Hospital is named in honour of Dr. Tillson Harrison, a Canadian surgeon, who, like Dr. Norman Bethune, is highly respected for his medical humanitarian work in China during the 2nd Sino-Japanese War (1937-1945).
The Project
In 2008, TFW, Amity and Harrison Hospital launched a one-year pilot project to provide treatment for 40 children with cleft lip and palate, with most coming from rural areas in Hebei province.
In addition to CLP surgery, the team will also provide:
- Assessment by a multidisciplinary team of local health professionals;
- Basic oral health and dentistry in preparation for future orthodontic treatment;
- Counselling for mothers on breastfeeding newborns with CLP;
- Monitoring and treatment for ear infections; and,
- Education about CLP and the benefits of comprehensive care
Next Steps
The project aims to build a multidisciplinary model of care in China. After the pilot period, TFW and our partners will gradually expand rehabilitation services for CLP. Within 3 years, the team plans to provide comprehensive treatment to 100-150 children annually.
The team will also promote the project in the surrounding hospitals and health clinics, so that more people will understand the causes of CLP and the importance of multi-disciplinary care.
As this project develops over time, the model of multidisciplinary care will then be replicated in other regions of the country.
Chiangrai, Thailand
In 2000, the Northern Women’s Development Foundation of Thailand (NWDF) initiated the Cleft Lip, Cleft Palate Repair and Rehabilitation Project in the cities of Chiangmai and Chiangrai. Since the project’s inception, Transforming Faces Worldwide (TFW) has provided funding for reconstructive surgery and comprehensive rehabilitation for cleft lip and palate, as well as training for the project’s local medical staff.
The project originated as a response to the need for cleft lip and palate surgery for children from tribal groups in Northern Thailand. Often, people from these groups cannot afford to pay for the costs of surgery and rehabilitation. Many do not hold Thai identity cards and therefore do not benefit from public health care. To date, at least 45% of the project’s patients are members of these tribal groups, among them migrant workers from neighbouring Laos and Myanmar.
Project Organization
A local advisory board is responsible for the overall planning and coordination of the project. The project’s local medical team consists of 12 members from the disciplines of plastic surgery, otolaryngology, social work, speech pathology, orthodontics, and nursing.
The medical team meets monthly to discuss referrals and patients’ progress, and a coordinator organizes patient referrals from the social welfare unit of the hospital, the sub-district health centres and the local district hospitals.
Progress to date
As a direct result of this project, 152 patients have received full treatment for cleft lip and palate. Over 1,280 interventions have been performed, in the form of reconstructive surgery, speech therapy, orthodontic treatment, hearing tests, and social work to enable reintegration into community life.
Patients come from 40 districts within six provinces of Thailand, and most patients are between the ages of 1 to 5 years old, although some adults have also received treatment. Approximately 10% of the project’s patients cross the border from Laos and Myanmar to seek assistance, and it is foreseen that the patient load from these countries will increase.
TFW has also provided valuable training opportunities for the project medical staff. In 2002 and 2006, Cindy Guernsey, Co-ordinator of the Cleft Lip and Palate Department at Toronto’s Hospital for Sick Children, conducted an assessment of the project and gave recommendations to strengthen the team approach for cleft treatment. In addition, several local staff members participated in a Cleft Congress held at the Khon Kaen University in Thailand.
