Katrin Kandel, voluntary CEO of Facing the World.

Located in the centre of London, the home of voluntary CEO of Facing the World (FTW) Katrin Kandel is decorated with beautiful paintings, some of which are from Viet Nam, giving a feeling of closeness to the homeowner.

Katrin has compassion for Vietnamese children with birth defects and the motivation to pursue a journey that has brought about life changes for thousands of unfortunate children in Viet Nam.

In 2007, the foundation was first invited by a US charity to Viet Nam where they found a very high rate of birth defects, which is estimated by some experts to be almost ten times the regional level. Following on from this, Katrin and colleagues felt very strongly that FTW should develop craniofacial centres in Việt Nam given the compelling need across the country.

The visit marked the start of a long journey where the FTW has accompanied Vietnamese doctors to help bring smiles and a normal life to thousands of Vietnamese children with craniofacial birth effects.

A UK-registered medical charitable foundation set up in 2002 to treat children from developing countries with craniofacial defects, FTW initially brought Vietnamese children to the UK for treatment at the foundation’s partner hospitals with costs ranging from £50,000 to £1 million (US$57,100 to $1.14 mil) per child. However, since 2008, the foundation began sending multidisciplinary teams of medics to Viet Nam to join local doctors operating on complex surgical cases.

Since then, the foundation has developed a unique, clear and sustainable strategy and solutions which continues to lead to tens of thousands of children, initially in Viet Nam and then beyond, receiving the treatment they need for often horrifically disfiguring birth defects.

Katrin said the key to this viable and sustainable solution is the “teach a man to fish” approach. FTW awards international training fellowships to Vietnamese medics, having sent more than 100 doctors to top medical institutions in the UK, Canada, the US and Australia to observe and learn new techniques and approaches. The doctors are offered two to six-week fellowships which are covered by the foundation (approximately 11,000£/two-week fellowship).

Katrin said by sending Vietnamese doctors abroad for training, the foundation aims to create an opportunity for the doctors to work and establish relationships with doctors in centres of excellence throughout the world.

These fellowships are supplemented by in-country medical missions where complex surgeries are carried out by coordinated teams of Vietnamese doctors and international doctors involved in the fellowship programme. Since 2008, there have been on average two missions to Viet Nam per year, with all missions now including teaching conferences to which doctors throughout Viet  Nam are invited.

The foundation also regards telemedicine as an important part of its training strategy. FTW has partnered with a platform technology developed by InTouch Health (now Teladoc’s World Telehealth Foundation) that enables the development of a ‘hub-and-spoke’ outreach programme within Việt Nam. The platform facilitates a two-way mentoring and educational system for international partners and domestically. The foundation has collaborated with its Vietnamese partners to identify game-changing technology needs, which are met through donations.

Katrin pointed out that while the number of doctors can't be multiplied, technology like Telemedicine can help multiply their expertise. This means that doctors, nurses and health centres from outlying areas are able to access the expertise of centres in large cities. Longer term, the foundation expects that doctors will be able to assess children in all the outlying areas and determine whether they need to be brought to the centres or be given advice remotely.

According to Katrin, Viet Nam is in a strong position to roll out the approach. To date, £2.4 million worth of telemedicine equipment and technology has been donated to FTW partner centres in Viet Nam. Close to £10 million in other medical equipment has been donated to the same partner hospitals.

FTW has now partnered with three hospitals in Viet Nam: the private Hồng Ngọc General, and two leading public hospitals in Viet Nam, 108 Military Central Hospital and Việt Đức University Hospital. Their network of approximately 100 further hospitals and clinics allows the foundation’s reach to extend throughout the country, enabling treatment for the poor, primarily children, born with severe facial defects.

At 108 Hospital, the foundation opened in late 2018 the Centre for Craniofacial and Plastic Surgery, the first of its kind in Southeast Asia. So far, 26 medics from the centre have taken part in FTW’s fellowship program and two telemedicine platforms from InTouch Health have been donated to the hospital. After eight years, the centre is expected to reach and treat 60 per cent of all children born in Viet Nam with significant facial defects.

Doctors from Viet Nam and the UK perform a surgery at Viet Duc Hospital in Hanoi. — Photo courtesy of the Facing the World

Katrin said 108 Hospital was a wonderful example of how the number of children being operated on has been measured. Before the centre was established, the hospital was able to run only one mission a year into the outlying areas, but now is running one mission every month. During the COVID-19 pandemic, the centre was still working, performing operations for children even though FTW medics and Vietnamese doctors couldn't travel.

In the next five years, FTW plans to enable 40,000 operations to be performed by its trained Vietnamese doctors. The foundation expects to send at least another 200 Vietnamese doctors abroad for training. Medical equipment which is considered to be game changing will continue to be donated.

FTW’s efforts have been recognised by the governments of Viet Nam and UK. Katrin Kandel was awarded the Vietnamese President’s Medal for Friendship; the Medal for Peace and Friendship among Nations; and a Certificate of Merit for significant contributions to Viet Nam's socio-economic development in 2021 by the Vietnam Union of Friendship Organisations. Katrin was also awarded the Points of Light Award in recognition of excellence, commended in 2017 by the then British Prime Minister.

Katrin said an important goal in the longer term is for Việt Nam to be very much part of the surgical expertise at FTW, acting as a craniofacial centre in Southeast Asia. When the foundation is able to expand into one of the neighbouring countries like Laos and Cambodia, Viet Nam is expected to become part of the training scheme similar to the UK, Canada, Australia and the US.

She noted that with 108 Hospital and Viet Duc Hospital being accredited by the Royal College of Surgeons for Accreditation, the hospitals are now seen as having the expertise for training which is at a level similar to UK hospitals.

A touching memory of Katrin about a baby she had met demonstrated her determination to change the destiny of unfortunate Vietnamese children. The baby, perhaps only six months old, had severe defects that made her look horrific to any ordinary person other than a doctor. But the baby turned into an adorable child after an operation performed by FTW medics in collaboration with Vietnamese doctors.

Katrin said it was such a lovely feeling seeing the change that could make a child who is ostracised become part of society. She said the very lovely children that have horrific birth defects and the love that their families have for them have largely encouraged FTW and herself to fulfill the foundation’s mission in Viet Nam. — VNS