The future of cleft care

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Future Faces Autumn Newsletter 2014

Report from UK trainee surgeon Serryth Colbert at the GSR Institute

GSR Institute of Craniofacial Surgery

Serryth Colbert receives training at the GSR Institute in Hyderabad

Serryth Colbert first met the founding Director of Future Faces in 2010 whilst working as a Specialist Registrar at Poole Hospital in Dorset. Serryth has since engaged with much of the work of Future Faces and recently travelled to Hyderabad to learn a range of surgical techniques that can only be learned at the GSR Institute, led by Professor Gosla Srinivas Reddy. Since the GSR Institute specialises in cleft and related surgeries, trainee surgeons are able to learn skilled techniques firsthand, an opportunity not available elsewhere. Serryth accompanied Gosla to the Sri Sai College of Dental Surgery in Vikarabad where Gosla teaches the postgraduate students.

Serryth not only gained a unique training opportunity, but he met children at the Cleft School Project. These children have all benefited from the skilled surgeons working at the GSR Institute and they also have tailored healthcare plans which include a range of further surgeries, post-surgical care, speech therapy and orthodontics, where necessary. Serryth clearly enjoyed these opportunities to better understand how these children integrate into their communities with a view to gaining the education they need so that they can pursue a career of their choosing.

Here are a few excerpts from his report: I have just returned from my visit to Gosla and have had the most brilliant time working with him in Hyderabad. I would like to say a very big thank you to Future Faces for helping fund my visit to Gosla last month… Gosla has travelled to the leading cleft centres in Europe to learn different philosophies on cleft from world leaders in cleft care. He has also brought many of them over to Hyderabad to operate in his institute! Gosla has combined the skills he learned from these experts with his own knowledge and experience to design a protocol of treatment that delivers world class outcomes. Gosla has performed more than 20,000 cleft procedures since 1996. He taught his cleft philosophy to me and explained why he does what he does!

Serryth (in blue), Gosla (in pink) and Raj (in grey)

They have combined aspects of all of the different techniques of cleft repair to help design their own unique methods. Gosla and Raj taught and explained their techniques of cleft lip repair, cleft palate repair, septorhinoplasty, bone grafting and craniofacial surgery to me. Gosla taught me how to perform his Afroze Cleft Lip Repair. I heard Gosla lecture on this technique at BAOMS in Edinburgh, and one month later I had the privilege of performing the repair in Gosla’s institute under his supervision. Everything I previously read about the technique made much more sense after performing the surgery and discussing it with Gosla.

It was clear to me that Gosla is a very thoughtful cleft surgeon – this was evident from his technique, style and approach to cleft care. In between cases, I would sit with Gosla and Raj in the coffee room and discuss the pros and cons of all techniques of cleft repair and controversial topics in cleft care. We would also plan research and publications that we are going to do together.

Cutting the Happy Teachers Day Cake!

I performed a secondary cleft procedure in theatre with the postgraduates, followed by two 4 hour teaching sessions on cleft lip and palate, head and neck oncology, surgical dermatology, maxillofacial trauma and orthognathic surgery. One of the days that I taught on also happened to be “Happy Teachers Day” – and the students presented me with a cake to celebrate the occasion. This wasn’t the only time that I was given some cake – I was invited to a party at Gosla’s School for Cleft Children. There are over 70 children with cleft lip and palate in the school who had been abandoned by their parents at a young age due to their cleft. Not only has Gosla repaired the clefts on all of these children, he also provides the children with full time education, full time care and attention, food, clothing, facilities…and yoga lessons first thing in the morning! There was a party to celebrate the birthdays of three of the children at the school while I was there…and we all had cake!

Future Faces is proud to have seen Serryth grow from strength to strength and we hope to hear more from him in the near future.

Ensuring that surgical expertise grows

Cleft surgeon - Gosla

As you can see from Serryth’s report, in order for individuals with cleft conditions to obtain the best repair possible, the surgeon needs to be skilled in a diverse range of surgical techniques. Cleft conditions occur and present in what seems to be ever-increasing variants, so the procedure needs to be assessed for the best possible outcome and then carried out with demanding precision. This means that more surgeons need training and where possible, international collaboration regarding the entire surgical process will benefit future patients.

Future Faces acknowledges that it is extremely difficult for surgeons to develop these skills in the modern economic climate and that funds need to be allocated for this core learning. If doctors in India are to be able to give the greatest benefit to their patients, they need training which is available in very few places across the world. Future Faces actively engages with these surgeons internationally, so that we can assess the skills and help promising surgeons to not only become experts in their field, but to nurture a commitment to provide the most needy and often isolated patients with the benefit of recovering from this disability. Future Faces needs core funds to support this collaborative decision-making process so that this becomes a reality for many, not just a few.

Reaching out to the most isolated areas to help people with cleft conditions

Reaching out to the most isolated areas to help people with cleft conditions

Whilst Future Faces recognises that surgical skills are critical, in order for individuals to recover completely, they often need intensive speech therapy in order to develop clear and intelligible speech. Cleft palates present a range of difficulties to patients, due to the gap between the roof of the mouth and the nose. Clear speech demands the ability to articulate sounds, many of which are made in the roof of the mouth, such as ‘d’ and ‘t’. Think of the American pronunciation of ‘better’ as compared to the British pronunciation, and you can start to see how readily this tiny variant of articulation can be heard. Speech therapy is therefore critical in order to ensure that patients can achieve the most beneficial result of such demanding surgeries.

Future Faces is committed to helping as many individuals as possible and this means that this complete care is accessible to people everywhere, even in the most remote areas. The Millennium Development Goals, MDGs, are a series of achievements which need to be obtained in order to make a real difference to world poverty, equality and health. The question is how do we ensure that the most disadvantaged people are able to benefit from procedures which require lengthy training and high-tech equipment?

The answer lies in using advanced technologies to reach the most remote areas, engage the volunteer support of communities and to develop the skill-sets of those volunteers so that they can widen their opportunities for learning and employment.

Communication is progressing rapidly in today’s global culture and it is now increasingly possible to consult with patients and train volunteers to carry out procedures and therapies with visual aids. Internet-based communication applications are increasingly improving visual and audio interaction and this presents the key opportunity in this project. In a recent update on the MDGs, it was noted that people living in remote areas are more likely to have a mobile telephone than a toilet. This project will help people to understand a range of healthcare issues including addressing maternal mortality, child poverty, sanitation in addition to identifying individuals who would benefit from surgery. Healthcare issues are discussed alongside post-surgical follow ups, like suture removal and speech therapies. The possible impact of a lack of folic acid in the first eight weeks of pregnancy upon cleft conditions can be discussed as well as ensuring that patients about to undergo surgeries get the best nutrition available.

This project has the potential to achieve more than its objectives, and they are objectives which call for everyone’s support, everyone’s financial donation so that so much more can be realised.

Goals of Cleft School

Many children with cleft conditions suffer discrimination, isolation and even rejection by their families. Their families are often blamed for the appearance of a cleft condition and as a result, families will often keep a child out of view. This means that many, especially girls, do not receive an education or develop skills to employ themselves. Instead, they are made to work in the home, away from children their own age and living an isolated and unhappy life. Parents struggle with these difficult circumstances and in some cases, it becomes possible for a child to attend the Cleft School Project, which ensures that the children receive as many surgeries as are needed. Not only this, but an entire healthcare plan is developed for each child, good nutrition is provided, clothing and accommodation is of a high standard and children are able to attend a prestigious mainstream English-medium school where they learn many skills, including English, so that they can have the best opportunities in life. Donations to the Cleft School Project ensure that Future Faces can open out this opportunity to another 30 children. There are many more children who would benefit, but between the outreach programme and the School, Future Faces is ensuring that the best options are available to as many children as possible, helping to improve the lives of children, in line with the MDGs.

Appointment of Project Development Fundraiser

Cynthia Walsh

Future Faces is pleased to announce that we have appointed a Project Development and Fundraiser, Cynthia Walsh. Cynthia comes from a strong disability-rights background and has personal experience with disability and discrimination. Her experience includes funding for disability as well as environmental causes. You’ll be hearing from Cynthia with updates and calls for funding. We hope that she can encourage you to help Future Faces make a difference and also share the funding support we plan to achieve from a range of grant-giving organisations.


Getting your online shops to donate to Future Faces through Easyfundraising- at no cost to you!


Easyfundraising is sponsored by the Institute of Fundraising and it enables a small charity like Future Faces to earn much needed money from its sponsors. It is remarkably easy to help Future Faces get cash from the online shopping you already do- just follow this link and register Future Faces as your benefiting charity.

Easy FundraisingFuture Faces will then receive a percentage of your online shopping as a donation from websites such as Great Plains (great clothes and the outlet prices are amazing) Waitrose, Sainsbury’s, BT and even Amazon (Amazon donations are now processed differently, but we can help you with that). Once registered, you’ll be prompted to claim donations for Future Faces before you shop online. This prompt will appear automatically (except for Amazon) whenever you visit a website which is linked to the programme. It costs you nothing at all, and you’ll receive updates about the donations made to Future Faces through your day-to-day shopping. This works for business purchases as well as personal shopping.

You’ll know that with Christmas approaching, you could make a huge difference to the work of Future Faces without any direct cost to you. Please register and take the few moments (literally a click or two) to benefit Future Faces when you shop. We’re proud to say that all of us here at Future Faces are using Easyfundraising; please join us!

Making donations to Future Faces

This is a crucial time to donate to Future Faces and unfortunately, it is a tough economic environment for charities. Grant-giving organisations are running out of money and are being chased heavily by a large number of charities. You’ll know that government funding is increasingly tight by the numerous cuts to healthcare and the impact it has on services. Imagine how this impacts the middle developing countries like India, where the patient-doctor ratio is already very low.

Help Future Faces to kick-start its projects with a donation and you’ll be not only taking a stance on the dwindling healthcare levels in this country, but you’ll be making an enormous difference to individuals who don’t even know their lives can be improved. Why not give a donation as a Christmas gift, and we’ll send you a hand-made acknowledgement of the gift which you can give to your friends and family?