Newsletter 2023
Building Faces Building Futures
Message from the CHAIRMAN
2023 has been a hugely successful year for the Future Faces. We have continued to provide training and developing expertise for surgeons in low resource settings so they can achieve best outcomes for their patients and ultimately practice independently as cleft and craniomaxillofacial surgeons. We have also been able to offer training fellowships to a number of people both from low- and middle-income countries as well as from the UK for those who want to better understand the demands of global surgery and gain further surgical experience.
During the year, we expanded our centre in Janakpur, Nepal and have entered into an agreement with a like-minded Spanish NGO FECS to enable training for surgeons at the Bugando Medical Centre in Mwanzi, Tanzania, on the shores of Lake Victoria.
All this has been made possible by continued significant donations for which we are extremely grateful.
With our best wishes for a very happy new year
Professor A F Markus FRCS FDSRCS FDSRCPS FFDRCSI
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Craniofacial Centre Nepal
Further work has been carried out at the CFC hospital. On the ground floor, completely surrounding the main entrance, on one side basic living facilities have been created for parents and carers whilst their children or other relatives are undergoing treatment. On the other side, outpatient consulting facilities have been built. This has freed up space within the original outpatient and reception areas to accommodate the new CT scanner and essential offices for support workers including our hospital manager.
An area on the third floor has been designated as living quarters for Santoshi, who now has three nursers/carers providing full time care and support.
On the fourth floor, the accommodation for visitors has been further upgraded, including installation of air conditioning. The top floor has been covered over and transformed into a lecture theatre.
The outside of the hospital has been covered with weatherproofing, and given a rather smart and colourful covering, which looks especially spectacular when lit up at night. All in all, the facilities are now quite spectacular, making this centre one of the most outstanding in the whole region.
Story of Santoshi
Santoshi Saville, the baby born with a severe craniofacial deformity, amniotic band syndrome, will be two years old in January 2024. She had been at the very beginning of 2022. She was taken into the hospital where they cared for her prior to being transferred a few weeks later to the Craniofacial Center. deposited in a dustbin a day or two after birth by her troubled parent.
As previously mentioned, her name “Santoshi” was given by nursing staff in the hospital and her last name “Saville” in honour of Danuta Saville, a very kind English lady who had heard of her plight and who has most generously undertaken to provide for all her care till she comes of an age when she can be independent.
She has had primary surgery at the CFC and major secondary surgery at the GSR Hospital in Hyderabad, India, a centre Future Faces have supported for the last 20 years, and which has become well known for expertise in cleft and craniofacial surgery.
She will be returning to Hyderabad for further surgery early in 2024.
The Ambulance
The new -ish ambulance has proved a great boon to our outreach health programmes, as well as being a very effective way of advertising our facility.
The ambulance has enabled us to carry out regular outreach health camps as well as transport for our patients to the centre and transport for our personnel on official duties.
CT Scanner
The new Cone beam CT scanner was donated to Future Faces. It is the first in the province. This amazing machine was purchased from New Street Dental Centre in Andover. The senior partner, Julian Chen, offered it to us at a price much lower than if we had purchased it on the open market. It was made possible with a magnificent donation from Mrs Danuta Saville. We are enormously grateful to both for their great generosity.
At the end of 2022, this machine arrived, in several boxes, at the Centre. It has been installed in a dedicated room on the ground floor next to the consulting rooms and the boxes have been recycled to form the base for all the seating in the new outpatients.
Using this 3D scanner, we will be able to provide all sorts of additional services as well as bring in some income.
Outreach health programmes in Province 2
The camps are now established on a regular and firm footing, covering the entire province. On each, a surgeon, a dentist, a nurse and our liaison officer/social worker spend a day, or if they are at a greater distance from Janakpur, two days, working. We have developed a simple database, which collects demographic data, records activities carried out and identifies people who need more specialised treatment at the centre.
The arrival of the new ambulance has made a great difference to our service. Our outreach programme has improved, to find more patients with cleft lip and palate and cranial facial disfigurement. Craniofacial Centre has started free dental services to patients at leprosy hospital and their staff on a weekly basis.
School Screening Programme
In addition to camps, we also conduct school screening programmes in the nearby schools in Jankapurdham. Through this we aim to screen children for any craniofacial anomalies at a very young age so that they get the much-needed attention at soon as possible.
Surgical camps in 2023
We started regular cleft surgeries at our new centre in 2022. We are very grateful to cleft/maxillofacial surgeons, for providing this service. It was a great start to this year. We have managed to provide care for 144 cases with cleft and craniofacial disfigurement. Most of the treatment given was free of cost including accommodation, food, and a few patients with transportation. We are hoping to have support from Smile Train early in 2024. This would cover the costs related to cleft surgery and enable us to increase the number of cleft patients to over 200 cases or more during 2024. The craniofacial centre would then become one of the largest treatment and training centres in Nepal.
We have followed-up all our patients since 2017 on a regular basis. Cleft patients who require further surgery or revision are identified by our door-to-door screening process and will be operated on in 2024.
Craniomaxillofacial Unit, Mwanza Project, Tanzania New collaboration with FECS (Spanish Foundation for Health Cooperation)
The aim of the project, the brainchild of Professor Fernando Marcia Garin, an eminent maxillofacial surgeon in Madrid, is the development of a first class fully coordinated multidisciplinary Craniomaxillofacial Unit in Bugando Medical Centre, to provide comprehensive and accessible treatment to people with cleft and craniofacial anomalies and associated problems. Bugando Medical Center is a tertiary referral specialist care centre for eight regions and serves a catchment population of over 14 million people. These aims are consistent with those of Future Faces.
The Unit will facilitate training for young surgeons, orthodontists, speech therapists and other health workers.
The project will also collaborate with EACMFS (European Association of Craniomaxillofacial Surgeons) recently established MAXTRAIN training programme. This collaboration will include:
- Exchange of professionals between Bugando and reference Hospitals and Universities in Europe and India
- Visit of international accredited specialists to Bugando to participate in the training of specialists.
- Scholarships for Bugando young surgeons for training periods in reference international centres. These have already been established thanks to a very generous donation from Paul and Helen Allen.
- Funding for the access of patients to the treatment in the Craniomaxillofacial Unit in Bugando
European Association for Craniomaxillofacial Surgery Scholarship and MAXTRAIN programme
Funding for this was agreed by the Council of the Association, primarily for development of services in Nepal, providing opportunities for Nepali trainees to spend time in European centres of excellence as well as to facilitate visitors by European surgeons to the Craniofacial Centre for the purpose of teaching. So far, no suitable candidate has been identified but we are ever hopeful and the funds will be used for our other projects.
BRANNGO Conference at the British Embassy, Kathmandu 22nd November
Britain and Nepal NGO Network (BRANNGO) held a successful conference at the British Embassy in Kathmandu on 22nd November with the theme ‘Strengthening collaborative links so UK NGOs can better help those in need in Nepal’.
Our Trustee, Prof. Sunil Sah, attended the conference and gave a presentation on our work in Nepal. The conference was chaired by His Excellency the Ambassador, Mr. Rob Fenn, who spoke about the importance of civil society as the basis for development and paid tribute David and Joanna Thomas for founding BRANNGO. The Development Director of The British Government Aid Programme in Nepal and the Deputy Ambassador, British Embassy Kathmandu, Pippa Bird, spoke briefly about ‘multi-dimensional fragility’ of Nepal in terms of its economy, geography, climate and societal structures. She stated that UK is helping develop the security and justice institutions in Nepal. She emphasised the need for a great deal of evidence and knowledge to support development decisions in Nepal. UK NGOs represents a huge pool of soft power who can help by sharing their knowledge. Speakers from various NGOs in Nepal and members of BRANNGO also presented their work during their conference.
Free dental service at Leprosy Hospital
LALGADH LEPROSY HOSPITAL is one of the world’s busiest leprosy hospitals. At times it has an annual patient-flow of over 1,100 NEW leprosy patients, and over 12,000 total leprosy consultations (new and returning), and over 110,000 outpatient consultations of all types (skin diseases, tuberculosis, typhoid, cholera, malaria, elephantiasis, parasitic diseases etc) including 20,000 children.
LLHSC has 100 inpatient beds and an awesome Community Outreach programme with 120 Self-Help Groups. LLHSC runs the leprosy programme on behalf of the Nepal Government with a catchment area that includes the entire Province-2, all 8 Districts, with a population of 6.01 million, adjacent to the border with India. It has 45% of all new cases of leprosy in Nepal.
The Nepal Leprosy Trust, established 35 years ago, is a Christian organization and a British NGO. It has served people affected by leprosy, as well as other ill, needy, marginalized, disabled and poor.
It was our pleasure to link up with Leprosy Hospital in 2023 to provide a dental service as well care for other problems in the maxillofacial region.
Stigma Project, Face Equality International
Earlier this year, we provided some funds for Phyllida Swift, the CEO of Face Equality International, a British charity, to carry out further work on the Stigma Project.
Face Equality International (https://faceequalityinternational.org) works to build capacity for a growing Alliance of charities, NGOs and support groups around the world to advocate for face equality.
The vision of this Alliance is for people with facial differences to live freely, without discrimination or indignity. With a strategic focus to position face equality as a human rights issue, consultation with member organisations delivering services in low- and middle- income countries (LMICs) revealed anecdotal evidence that the most extreme examples of stigmatising behaviours included human rights violations, such as abandonment, abuse, infanticide or being banned from attending school often occur in a low-income context. consultation revealed that these occurrences were not being spoken about publicly, let alone recorded or addressed.
Prof Ram Kewal Shah
It is with great sadness we report the untimely passing of Professor Ram Kewal Shah. Through his vision and support, we established the Craniofacial Centre, 6 years ago, at his Janakpur Trauma and Orthopaedic Hospital where we worked collaboratively until moving to the present building. Professor Shah continued to support us throughout the development of our project and will be sorely missed.
Visitors to the Craniofacial Centre 2023
We would like to thank all our visitors who have supported us.
Miss Phyllida Swift, CEO Facial equality international
Miss Laura Hutchings, student nurse, Bournemouth
Miss Kasia Dragan, Area manager B-Braun
Noa Nussbaumer, Holly Attenborough, Harman Sondh and Jake Wills, 4th year dental students, University of Sheffield
Mr Michael Nussbaumer, Consultant ENT surgeon, UK
Dr Andrea Nussbaumer, Consultant Paediatrician, UK
Dr Jayanth Kesave, Bangalore, India
Dr Mahendra Maharjan and his team from Kathmandu.
Dr. Philip Holmes OBE MSc, Lt Col (retd), Founder/CEO Pipal Tree
Mr. Nick Hinton, Chairman, Britain-Nepal NGO Network (BRANNGO)
THANK YOU
To ALL our supporters
• European Association of Craniomaxillofacial Surgeons
• Mrs Danuta Saville
• Helen and Paul Allen
And to very many generous individuals who donate significant amounts.
Happy New Year 2024