A complex facial disfigurement can range from facial trauma, such as burns or animal attacks, to large tumours. There is huge stigma attached to facial disfigurement in rural areas, individuals are often excluded from their communities and are the subject of bullying. Strong religious belief can lead some communities to believe the facial disfigurement is a punishment and subsequently individuals are hidden away from others and will drop out of education. Some complex facial disfigurements are life threatening and the majority cause pain, discomfort and problems with eating, drinking, breathing and speaking. Patients who receive treatment during the Complex Surgical Programme are from the most remote and developing areas of Ethiopia. Often there is a lack of awareness in rural communities that treatment is available for complex disfigurement, consequently disfigurements, such as tumours can escalate hugely because of limited health monitoring. Families in rural Ethiopia also encounter food shortage, due to environmental and financial implications, this can escalate complex conditions such as Noma, a rare facial gangrene which can be caused from malnutrition.
Throughout the year, Project Harar's outreach team proactively engage with rural communities to identify individuals with complex facial disfigurements. This involves travelling far and wide in often difficult-to-reach areas and keeping in regular contact with health facilities.
The surgical side to the programme begins with two weeks of pre-surgery assessments, two weeks of surgery and up to two months of recovery. During the pre-op stage, patients receive initial assessments from a team of doctors, nurses and dieticians to assess suitability for surgery. Full medical histories, tests, scans, and oral hygiene investigations as well as nutritional assessment are also carried out.
After an initial two weeks of assessments a larger medical team arrive in Addis Ababa and an intense two-week operative stage takes place. The team comprises of surgeons, doctors, nurses, dieticians and anaesthetists from Yekatit-12 Government hospital in Addis Ababa and also a team of international medical volunteers who are specialists in the field of plastic, maxillofacial surgery and head and neck cancers. The majority work in the NHS in the UK, but we are proud to have medical volunteers from all over the world, including France, Germany, Brazil, Hong Kong and Ireland.
Post-surgery, patients recover at Cheshire Services, just north of Addis, where they receive support from nurses and doctors before they are discharged. The care at Cheshire ensures patients stay infection free and recover properly from their surgery before returning home, it is also an opportunity for our patients to relax and play.
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Volunteer on our annual Complex Surgical Programme
Throughout the year, Project Harar Programme Officers conduct remote follow up of patients treated during the Complex Surgical Programme, in 2017 we were also able to conduct a more thorough review of patients treated by Project Harar