Kathmandu, Nepal

In consideration of the prevalence of cleft lip, palate and other craniofacial disorders in rural Nepal and out of a desire to increase the capacity and quality of their care, the National Dental Hospital proposed that Transforming Faces Worldwide provide support for their program. In February 2002, the National Dental Hospital and Transforming Faces Worldwide signed a three-year agency agreement. The overall goal of this project is to provide all the essential components of care in the management of cleft individuals - surgery, speech therapy, orthodontics, prosthetic rehabilitation and any necessary reconstructive surgery - especially for those who could not otherwise afford treatment. The first three-year phase of this project was completed in December 2004. A new phase began in November 2005.

In addition to the first three-year operational grant, Transforming Faces Worldwide made an exceptional, one-time capital grant for the completion of the third and fourth floors of the National Dental Hospital. The TFW Board was impressed by local fundraising efforts as well as the commitment of the National Dental Hospital team to remain in Nepal and provide this valuable social service. The National Dental Hospital inaugurated its new National Centre for Oral and Maxillofacial Surgery in November 2004.

The National Centre for Oral and Maxillofacial Surgery collaborates with organizations such as the Red Cross of Nepal and Safe Motherhood, using their networks to disseminate information on cleft management and the services available at their Centre. In addition, two trusted community workers in Jahpa, Eastern Nepal, identify individuals with clefts and accompany them to the Centre. These outreach efforts have encouraged families to bring their children with clefts to the centre for assessment and treatment. In addition to the rural hospital based cleft program initiated in 1998, the National Centre for Oral and Maxillofacial Surgery now provides a safe environment for conducting surgery on very young patients and more complicated cleft cases. In addition to rural based cleft camps, 235 patients received cleft surgery at the National Centre for Oral and Maxillofacial Surgery between July 2003 and

The project reports that the number of patients returning for follow-up speech sessions, orthodontic treatment or prosthetic rehabilitation is a continual challenge since many patients live in remote communities and the internal conflict in Nepal hampers movement within the country. The project leaders are investigating various possibilities to meet this challenge.