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The Effectiveness of an International Cleft Mission Model in Asia

An Update

Mao, Shih-Hsuan, MD*; Ajiwe, Tochi, BS; Wang, Rebecca, MS; Wong, Fen-Hwa, PhD§; Chou, Pang-Yun, MD; Lo, Lun-Jou, MD

doi: 10.1097/SAP.0000000000001730
Reconstructive Surgery

Background Cleft lip/palate is a congenital craniofacial anomaly affecting patients physically and psychosocially and has contributed to the global burden of surgical disease, especially in underprivileged areas. For 20 years, Noordhoff Craniofacial Foundation (NCF) and the Chang Gung Craniofacial Center (CGCFC) have carried out missions to these areas. Rather than implementing short-term missions that lack proper follow-up care, the team has provided an effective, long-term, and multidisciplinary approach for the treatment of patients with cleft lip/palate. In this study, we evaluate the sustainability and effectiveness of the cleft mission model implemented by NCF and CGCFC.

Methods Data from the years 1998–2017 were retrieved from the NCF database. All local centers were evaluated by a 3-stage categorization, levels 1 to 3, based on 4 criteria: (1) capacity to carry out independent missions, (2) diversity of cleft-care professionals, (3) diversity of surgical service offered, and (4) collaboration with local hospitals. Support and training of personnel were provided based on deficiency in these criteria. Noordhoff Craniofacial Foundation made close collaborations and partnerships with several organizations that shared its mission for comprehensive cleft care in developing countries.

Results In all, 19 partner cleft teams in 9 different countries were established. In coordination with these teams, NCF and CGCFC have treated 1846 patients across 78 mission trips. To date, 158 personnel from 19 different countries have been successfully trained to provide cleft care in local centers. Most partner cleft teams centers have progressively reached category level 3, including those in the Philippines, Cambodia, and Mongolia.

Conclusions In order to establish and maintain sustainable cleft care in developing regions, commitment and compassion toward those who lack essential resources are necessary. Noordhoff Craniofacial Foundation and CGCFC have achieved a successful and practicable model through seeding medical personnel in order to provide effective and sustainable cleft care to the regions in need.

From the *Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan;

University of Texas Southwestern Medical Center, Dallas, TX;

Noordhoff Craniofacial Foundation; and

§Noordhoff Craniofacial Foundation, and Department of Life Sciences and Institute of Genome Sciences, National Yang Ming University, Taipei; and

Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.

Received September 7, 2018, and accepted for publication, after revision October 5, 2018.

Conflicts of interest and sources of funding: none declared.

Authors' Roles/Participation: S.H.-M. and T.A. were responsible for data collection and writing of manuscript; R.W. and F.-H.W. instructed and supervised the data management; P.-Y.C. and L.-J.L. were responsible for data analysis and editing of manuscript.

Reprints: Pang-Yun Chou, MD, Division of Trauma Plastic Surgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan. E-mail:; or Lun-Jou Lo, MD, Plastic & Reconstructive Surgery, Chang Gung Memorial Hospital. 5 Fu-Shin Street, Kwei Shan, Taoyuan, Taiwan 333. E-mail:

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