Mission

Identification of Need:

The identification of a problem or project that is worthy of consideration for support can come from several sources. Local Taiwanese businessman who knew of our capabilities in the field of craniofacial surgery recognized a need for help and presented us with a request for help. This was the situation in both Cambodia and Vietnam. In the Philippines, it was Mr. Samuel Paul Noordhoff who recognized a possible means of helping the Pilipino provide adequate care of their own people. This came through his business contacts with a Philippine Hospital and its director in General Santos.

Other mechanisms for identifying need exist through government channels and personnel. Persons assigned to government posts upon getting to know the people and the land in which they are living can identify needs such as agriculture, industry, medicine etc. Further conversations with the local people help clarify these needs and even possible solutions for help.

Now that we are recognized for our contributions, we get more specific requests from other countries such as India and Bangladesh. On receiving these requests, we need to evaluate each one to see how and whether we can be of assistance.

Assessment of need:

Each individual countries needs would be different and assessed on that basis. In our situation, we were aware of the difficulty in developing comprehensive care for the cleft lip and palate child since we have already progressed from nothing to our present center. It is very rare in developing countries or even advanced countries to have well established craniofacial centers. We recognized the need to provide help but did not have an understanding of the magnitude of the problem. It became imperative to make a first hand evaluation of the situation.

The evaluation was facilitated with the cooperation of the local sources in that country and with some Taiwanese businessmen interested in providing help. Arrangements were made for a team of individuals to work visit the country, provide medical care to indigent patients and to evaluate the local conditions.

The following important points were noted:

1. Level of interest: We needed to know if the local people, in particular the doctors, nurses and hospital personnel, were interested in improving their skills and providing better care for their own people. In some instances there was a negative response. In these situations it is useless to try and help as they are not interested. It is very important to find a place that wants to improve and provide better care.
2. Level of education and training: The care of the cleft lip and palate child requires special skills and training. In these situations it became apparent that although the surgeons, anesthesiologists were trained in their profession they did not have the special skills needed for the care of the cleft lip and palate patient. It is very difficult to improve one’s skills; unless there is a teacher. It became readily apparent that they all needed further experience and education and the best place to provide this was the craniofacial center at the Chang Gung Memorial Hospital back in Taiwan.
3. Quality of medical equipment: In certain instances the anesthesia equipment, monitoring equipment for postoperative care and surgical instruments were inadequate. Some used medical equipment such as anesthesia machines were reconditioned and sent to the hospital free of charge as a donation from Chang Gung and the cost of refitting by the Noordhoff Craniofacial Foundation. Other instruments were purchased and given to the institution as a gift. It is impossible to do this kind of work without good monitoring equipment during and after anesthesia to prevent mortalities from occurring.
4. Cost of medical care: In almost all instances the cost of providing this kind of extensive care to the patient is prohibitive. We have there cooperated with several other foundations to meet these needs. The Smile Train in the USA helps provide for the cost of surgery in Cambodia and the Philippines. In addition, the Noordhoff Craniofacial Foundation also provides additional financial assistance when necessary. Further support is provided on occasions by donating surgical supplies such as sutures that are very costly. Providing only the training and equipment is frequently not enough. Further financial support is needed to provide this care. It is difficult to ask these physicians and personnel to work for nothing when there salary already is minimal.

Developing a plan of Service:

It is imperative that any kind of help or service must be of the highest quality without restrictions. It would be extremely poor judgment to send personnel that are not experts with excellent skills and experience. Sending incompetent incompletely trained residents for them to get surgical experience would be a mistake. Any service for even the poorest individual must be of the highest quality.

The most important concept to understand is that we are there to help and to train the local personnel to do their own work in their own country. Only then will we have a lasting impact on our work. Therefore, everything is directed to accomplishing this goal. Love Makes Whole.

1. Education must include a period of special training in a major cleft center
2. Continuing education programs must be instituted.
3. Evaluation of the treatment and complications is necessary to insure quality control and safety of the patient.
4. Continued conferences and evaluations are done on a periodic basis.

Instituting the plan of service:

Periodic times of visitation to the newly established center are imperative. These serve as educational opportunities. Complicated difficult patients problems are discussed. This increases their knowledge and skills. Usually two or three visits are made each year.

Evaluation of Plan:

This includes the evaluation of cases done, charts, records and complications. It also provides for the team doctor to see first hand the postoperative results and discuss further possible improvements.

Working ones way out of a job:

It is our objective to help these centers develop their skills and expertise and gradually become totally self sufficient and independent. They in turn can train others.