Hanoi (VNA) - When Facing the World (FTW) began its work yearsago, its modus operandi was to bring children needing complex facialsurgeries from all over the world to the UK.
“We then saw a very high incidence of children being brought over from Vietnam;and we were then invited to go to Vietnam by another charity to see what thesituation was,” FTW CEO and Trustee Katrin Kandel said.
The occurrence of birth defects inVietnam is estimated to be ten times higher than in neighbouring countries.
“So it became clear to us that thiswould be the first country where we would roll out our programme,” Kandel said.
Over the years, the programme hassucceeded in transforming the lives of many children and youth.
Finding new look
“My wife broke out into tears when she saw Chinh for the first time aftergiving birth to him.”
Pham Duc Dung, Chinh’s father, remembersthe moment vividly, almost three decades on.
“She grieved for him and forherself.”
Pham Duc Chinh, 28, was born to a poor farmercouple in a small village in the northern province of Thai Binh.
He was born with Treacher CollinsSyndrome, a rare genetic disorder characterised by craniofacial abnormalities.In Chinh’s case, this included down-slanting eyes, absence of cheekbones,underdeveloped ears and a cleft palate.
“His condition was so severe that hestayed at hospitals more often than home during his first three years,” thefather told Vietnam News Agency. “I remember his being at emergency rooms allthe time.”
When Chinh turned five, his parentsdecided he should have a normal life and must go to school like other kids do.They took him to hospital after hospital in Hanoi, only to learn that there wasnothing much doctors could do about his condition.
The young boy’s facial differences madeschool a difficult place to be. “Absent ears made it particularly hard for meto listen in open spaces like classrooms or halls." But it was not the onlyproblem.
“I was bullied by classmates and youngerkids ran away from me in fear,” Chinh recalled.
As time went by, Chinh began to face upto the fact that his facial deformities would be with him forever.
Then, out of the blue, he got a callfrom a doctor at Hanoi’s 108 Military Central Hospital three years ago. Thecompassionate doctor offered to sign him up for a charity project run by FTW so that he couldreceive free reconstructive facial operations.
Katrin Kandel, CEO of Facing the World, (sixth from left), Britain's Prince Andrew, Duke of York (fifth from right), and Mai Hong Bang, director of 108 Military Central Hospital (fourth from right) at the inauguration of the Centre for Craniofacial and Plastic Surgery in 2018. (Photo courtesy of 108 Military Central Hospital)Chinh went through three plasticsurgeries in just one year to reconstruct his eyelids, nose bridge andcheekbones. The surgeries were done at the Centre for Craniofacial and PlasticSurgery established in the 108 Hospital with FTW support in 2018.
“It has been more than a blessing tous,” his father said. They had been waiting for this opportunity for so long.
Now he is finally able to face the world with a lot more confidence.
Sustainable shift
FTW began running medical missions in Vietnam in 2008, during which amultidisciplinary team of medics operated jointly with their Vietnamesecounterparts on complex surgical cases like that of Chinh.
Moving away from the model of treatingone or two children a year at astronomical cost, the UK-based charity is now able to operate onthousands of children by providing continuous training for Vietnamese doctors.
FTW has so far awarded more than 100international training fellowships to Vietnamese medics who were sent to topmedical institutions in the UK, Canada and the US to observe and learn newtechniques and approaches. A further 140 fellowships are currently in theplanning.
“We went together as a team of medicsfrom different specialties – anaesthesiology, resuscitation and emergency,neurosurgery, and others – to major hospitals in the UK and Canada, allexpenses covered,” said Doctor Vu Ngoc Lam, Director of the Centre forCraniofacial and Plastic Surgery. He was one of the awardees who joined3-4-week training courses with his colleagues from 108 Hospital about two yearsago.
They were instructed in how to perform a numberof specific medical techniques neither popular nor done properly in Vietnam,and given the opportunity to meet top experts in different fields.
“It is not difficult to access generalinformation about these techniques from Vietnam, but the main point is that thecourses allow Vietnamese doctors to observe, with their own eyes, how thetechniques are effectively done,” Lam said. “This is very hard to understandjust from reading documents."
“Many children have such complexproblems that you cannot fix them with a simple operation,” Kandel explained.“It requires a whole team of doctors including non-surgeons, such as anesthetists, speech therapists, psychiatrists andpsychologists… the whole support system has to work together.”
“Our focus is very much on enablingdoctors from Vietnam to go all over the world to top medical institutionsand observe how these teams work together,” she said, adding that this helpsthem “establish a relationship and then ultimately bring back or utilise inVietnam what is most appropriate for Vietnam.”
The foundation expects that in thelonger term it can go to another country with Vietnam taking part as thetrainer, she added.
‘Learned a lot’
Nguyen Hong Ha, head of the Departmentof Maxillo-facial, Plastic, Aesthetic Surgery at the Hanoi-based Viet-Duc UniversityHospital, confirmed that FTW’s approach not only reduced costs, but alsoimproved the professional skills of Vietnamese doctors.
“Instead of bringing some childrenneeding surgeries to the UK, the foundation sends a medical mission to Vietnam.It can take advantage of local health care infrastructure while the mission canconduct operations for many children,” he said, adding that Vietnamese doctorshave learned a lot from them.
Ha said he could never forget the firstengagement between FTW’s experts and a local team seven years ago. They decidedto perform surgery on an 11-month-old baby who had facial differences and arespiratory problem.
It took about 7-8 hours to perform theoperation and it was a success in terms of facial improvement. However, the babydeveloped complications several days after the experts left.
Doctors at the Viet-Duc UniversityHospital consulted with the experts and agreed that another surgery must bedone right away. This was done with consultation of foreign experts via thetelehealth platform. Ten days after the three-hour second surgery, the baby wasdischarged from the hospital. Now she attends school and can speak normally.
“In the past, we didn't dare to conductoperation on such complicated cases, but after working together with foreignexperts, we gained confidence and can now handle up to 90 percent of thesurgeries,” he told VNA.
Facing the World experts and doctors from Viet-Duc University Hospital examine a child. (Photo courtesy of Viet-Duc University Hospital)He said that with the availabilityof sophisticated equipment, his department can perform “single stage auricularreconstruction by pourous polyethylene frame using single incisionendoscope-assisted for temporoparietal fascia harvest…”, in other words, earreconstruction, one of the most difficult plastic surgery techniques.
“The Plastic and Aesthetic SurgeryCentre of Viet-Duc University Hospital is one of a few centres in the world that cansuccessfully carry out the technique”, he said, adding that the advantage ofthe method is that the patient only needs one surgery at a very early age (4-5years) and can benefit from better aesthetic results than other methods.
Equipment support
Apart from providing correctivesurgeries, the foundation has worked with its Vietnamese partners toidentify medical equipment needed during the COVID-19 pandemic and facilitatedthe donation of 28 advanced monitors worth 308,000 GBP (530,000 USD) to thecountry.
“We identify truly game changing equipment. We don'tdonate consumables (things used once and then thrown away). We have donateditems like microscopes, ultrasound machines and endoscopy towers,” Kandel said.
Since the latest phase of the FTW programme was launched,more than 2 million GBP of medical equipment has been donated, includinginTouch telemedicine to Hong Ngoc, Viet Duc, K (Cancer) and 108 MilitaryCentral hospitals as part of expanding national and international links andtreatment capabilities.
FTW has collaborated with the RoyalCollege of Surgeon of England in granting global accreditation to the Viet DucUniversity Hospital and 108 Military Central Hospital.
“It was important for thefoundation that the approach be assessed by an outside body. The accreditationhas given the hospitals a standing within the international medical community,”Kandel said.
Talking about future plans, she said thefoundation is hoping that international travel resumes and that doctors willbe able to travel freely once again.
“We want to resume taking doctorsfrom Vietnam for fellowships to all our partner hospitals in the USA, Canadaand the UK.”
A surgery conducted by a Canadian mission at the 108 Military Central Hospital in 2018. (Photo courtesy of Facing the World)For his part, Chinh, now a university researcher, is hoping to have one or two more surgeries to make eating and communicating easier.
"It is a test of my inner strength and destiny," he said./.
