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.

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.

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.