The future of cleft
and craniomaxillofacial care

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Continuing the Fellowship in Tanzania

Drs Fidelis and Emmanuel write:

After completing our clinical rotation at QVH on December 9, 2024, we returned home for the Christmas and New Year holidays. On January 25, 2025, we embarked on another enriching journey from Dar es Salaam, Tanzania, toHyderabad, India, via Qatar, to participate in the Craniofacial Surgery training program at the GSR Institute of Craniofacial and Facial Plastic Surgery. This program offered unparalleled exposure to advanced surgical techniques, international collaboration, and professional growth.

Upon arrival in Hyderabad, we were warmly welcomed by Dr. Merlyn Moosy, a trainee Fellow at GSR Institute. Onour first day, we underwent an introduction and orientation to the hospital, followed by time in the outpatient department, where we interacted with patients and familiarized ourselves with the clinical environment.

The surgical component of the training began the next day, with opportunities to observe procedures such as cleft lipand palate repairs (both unilateral and bilateral) and alveolar bone grafts. By the second week, under the guidance of Professor Srinivas Gosla Reddy, we progressed to assisting in various surgical procedures. Throughout our stay, we actively participated in numerous cleft lip and palate repairs and alveolar bone graft surgeries, gaining hands-on experience in these specialized techniques.

Our training was enriched by several high-impact educational events:

  1. Velopharyngeal Dysfunction Workshop; we attended a workshop on the management of velopharyngeal dysfunction at Basavatarakam Endo American Hospital, organized by Smile Train India. This provided valuable insights into speech-related congenital anomalies challenges and their surgical management.
  2. Three-Day Craniofacial Surgery Camp: In collaboration with Professor Fabio (Craniomaxillofacial Surgeon)and Carlos (Neurosurgeon) from Monza, Italy, GSR Institute hosted a three-day Craniofacial Surgery camp. We observed complex procedures, including facial bipartition, distraction osteogenesis, and Le Fort III osteotomy, broadening our understanding of advanced craniofacial techniques.
  3. Two-Day Coblation Master Class Workshop at AIG Hospital: Participated in an advanced training program focused on Coblation technology, enhancing skills in precise, low-temperature radiofrequency surgical techniques for ENT procedures
  4. Three-Day Ear Reconstruction Camp: Toward the end of our training, we participated in a three-day camp focused on ear reconstruction using rib cartilage. This was a highlight, as it was our first exposure to this intricate procedure, deepening our appreciation for reconstructive surgery.

The program fostered meaningful connections with fellow trainees, including Dr. Abu from Israel and Dr. Ulli from Germany. Their support made our time in Hyderabad enjoyable and memorable. On our final day, Professor Gosla hosted a farewell dinner for the staff, marking a heartfelt conclusion to our training.

This 10-month training was a transformative blend of surgical excellence, mentorship, and cultural immersion. Madrid’s La Paz and Ramón y Cajal hospitals provided a strong foundation in complex reconstructions and subspecialties. QVH in East Grinstead further developed our earlier experiences in Madrid and introducedadvanced technologies like

3D planning and interdisciplinary collaboration, microvascular and local flap reconstruction for major head and neck problems and the possibilities of virtual reality training.   Hyderabad, with its unique clinical and culturalcontext, likely tested and refined our skills in new ways. Working under mentors like Dr. Fernando, Professor Acero, Dr. Cebrián, Professor Markus, Dr. Gulati, and Professor Gosla was a privilege, as was collaborating with skilled teams across three continents. The surgeries we observed from Free Flap Reconstructions to Facial Paralysis Management, Thyroidectomy, Cleft Lip and Palate Repair, Facial Bipartition, Distractive Osteogenesis and Ear Reconstruction Surgery highlighted the artistry and precision of Craniomaxillofacial Surgery. Our travels, fromMadrid’s plazas to London’s landmarks and beyond, added joy and perspective to the  journey.

Finally, and most importantly, we are immensely grateful to FUTURE FACES, whose generous financial support made this all possible. We will take this experience back to Mwanza where it will be the inspiration for the newly developing Craniomaxillofacial Centre at the Bugando Medical Centre.