Comprehensive Care Beyond Surgery Alone for Medically Isolated Cleft Lip/Palate Patients Utilizing Internet Connectivity

Comprehensive Care Beyond Surgery Alone for Medically Isolated Cleft Lip/Palate Patients Utilizing Internet Connectivity

Organization type: 
nonprofit/ngo/citizen sector
Project Stage:
$100,000 - $250,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Our mission is to model comprehensive, high-quality care for indigent, medically isolated patients with cleft lip and palate deformities beyond surgery alone.

About Project

Problem: What problem is this project trying to address?

Surgery alone is not enough for cleft lip and palate patients. After cleft lip and palate surgery, speech does not come naturally, but requires intensive therapy to teach patients the sounds and patterns of speech. If you cannot speak understandably, you cannot function well in your society. Our goal is to target the most difficult to reach population - indigent and medically isolated patients and families. However, their geographic location (often in mountainous regions, days away from even the most basic medical facilities) and financial restrictions make it nearly impossible for face-to-face interaction with a local therapist (of which there are very few, and are not inclined to treat indigent patients).

Solution: What is the proposed solution? Please be specific!

Our solution is the FACES wireless cellular and Internet Connectivity Model. We are addressing the challenge of medical isolation by staying connected with patients post-surgery using Internet connectivity. FACES' expert bilingual (Spanish/English) speech-therapists based in the US connect with cleft lip and palate patients on Internet conference calls (iChat or Skype), which allows them to provide the highest quality speech evaluation and therapy through live-time video conferencing. Although our rural patients may be days away from an adequately trained in-country speech therapist, the majority do have cell phones, even in areas with limited or non-existent electricity. Internet sites are also more available. This connectivity helps patients learn how to speak clearly and understandably. FACES is committed to local sustainability and we work with local community groups to achieve this goal. Wireless technology is changing the world. Utilizing it within our model is changing lives.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

The FACES model begins with surgery: a team of surgeons and nurses travel to northern Peru and provide cleft lip and palate surgery to previously screened patients from our target population free of charge. Regional hospitals donate space for the team to operate in and local community members, such as the Lions Club, assist with the periosurgical process. During the surgical trips the surgeons select and enroll a number of cleft lip and palate patients into the FACES Speech Therapy Program. After the team returns to the US and the enrolled patients recover, the speech therapy begins. Patients come to an Internet site with the help of an in-country coordinator to connect with the bilingual speech therapists in the US utilizing live-time audio and video capability. Through a series of virtual sessions, the FACES speech therapists work with the patients via wireless technology to teach them how to make the proper sounds and patterns of speech. Even before the virtual therapy sessions are complete, patients are often able to enroll in school, communicate more effectively with others, and begin to shed the burden of their deformity and make meaningful contributions to their communities.

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

Operation Smile and Smile Train are similar to us from a surgical perspective. There are other groups doing cleft work, but none have reported a similar level of follow-up care to the target population. We are different because we provide more than surgery. No other group provides follow-up with speech-therapy or post-operative evaluations, which we view as an essential component of comprehensive cleft care. Our model differentiates us because we work to close the gap of geographic isolation using technology, as well as collaborate with local resources to try to achieve local sustainability. These groups do not pose challenges to our growth. This new model can and should be adopted by larger groups, and we are committed to the academic and educational efforts to make this happen.

Founding Story

The end of an exhaustive, but fruitful surgical trip was nearing in Peru. Dr. Albert, FACES President and Founder, was there as part of a traditional cleft team in-country to operate on facial deformities. As Dr. Albert was packing up and reflecting on the trip, he was struck by a thought: the team would have no idea what would happen to their patients after the doctors left. Dr. Albert reached for his cell phone, and the seed idea for the FACES Speech Model hit: using modern technology and Internet connectivity, the doctors could offer a new level of comprehensive care and post-operative therapy never before available to indigent, medically isolated patients anywhere in the world. If e-mail and cell phones were so easy to connect to, why not translate this to benefit the people most difficult to reach? Dr. Albert realized that with simple, off-the-shelf technology the FACES Connectivity Model would be possible and attainable.
About You
FACES Foundation
About You
First Name


Last Name


About Your Organization
Organization Name

FACES Foundation

Organization Country

, OR, Multnomah County

Country where this project is creating social impact

, LY

How long has your organization been operating?

More than 5 years

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How long have you been in operation?

Operating for more than 5 years

Which of the following best describes the barrier(s) your innovation addresses? Choose up to two

Access, Quality.

Social Impact
Please describe the goal of your initiative; outline what you are trying to achieve

The goal of FACES is to develop a model of high quality, truly comprehensive and locally sustainable care for indigent, medically isolated cleft patients. We want these patients to be able to function effectively and fully in their local communities. The objective in Peru is to work to perfect the model in a sustainable fashion. This requires multiple levels of work: the surgery itself, follow-up utilizing wireless connectivity, educational efforts for the target population, as well as in the US. The FACES model aims to make city, country and international borders inconsequential. Although we focus in Peru, we know that a well-developed model holds immense power because it can be leveraged anywhere. Our goal is to continue fine-tuning our telemedicine model and educate other medical teams

What has been the impact of your solution to date?

The FACES surgical team has completed over 165 surgical procedures, with the target population being indigent, medically isolated cleft lip and palate patients. Since the Speech Model was created in 2009, FACES has provided over 200 speech therapy sessions. Preliminary results show that the tele-therapy model is nearly as effective as sitting face-to-face, a finding that is immensely promising for geographically isolated patients around the globe. The surgeries and subsequent Internet speech-therapy sessions have had a profound impact on each and every FACES patient. Patients who go through the entire FACES program are able to communicate and be understood – this vastly improves quality of life and makes it possible for these individuals to enroll in school, get a job and be productive members of their communities. For example, one of our first patients, Milagros,

What is your projected impact over the next five years?

The goal is to fully develop the local sustainability of our model in Peru by partnering with local community service groups, training village works as health promoters and to utilize connectivity to improve direct patient care. We'd like to double our surgical volume and match that with the ability to reach more patients more effectively post-operatively.
The impact of the expansion of the project will be an improvement in the quality of life for all of the FACES patients. In addition to shedding the burden of their cleft lip and palate deformity, they will be able to communicate and speak clearly.
Additionally, we expect to continue to gather the necessary data to demonstrate the efficacy of this model with academic publications and presentations to pertinent groups.

What barriers might hinder the success of your project? How do you plan to overcome them?

The main barrier is staying connected with our target population, geographically isolated people, who have little access to modern technology. Given the nature of their living situation, often high in the Andes mountains, these patients can be difficult to track after they receive a surgery. But, the connectivity is essential to the FACES program, as this is how we deliver high quality post-operative speech therapy. We plan to overcome this barrier using our strong local network of people. We will continue to develop local sustainability by providing technology training to the community, as well as to key community members who can help us stay connected with patients, many of whom are children.

Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact

Increase the therapeutic speech sessions by 25%.

Identify three major tasks you will have to complete to reach your six-month milestone
Task 1

Work with our local network of people to enroll patients in the speech program after surgery.

Task 2

Train local point people to help track patients once they return to their villages.

Task 3

Increase weekly time dedicated to speech therapy sessions in the US so more patients can receive therapy.

Now think bigger! Identify your 12-month impact milestone

Gather validated data of results to allow for publication in peer reviewed journals and present findings locally and nationally.

Identify three major tasks you will have to complete to reach your 12-month milestone
Task 1

Purchase new off-the-shelf devices (laptops, cell phones, WiFi enabled devices, iPads) to loan to medically isolated patients.

Task 2

Training of local Speech Promoters and Health Promoters to improve local effectiveness and sustainability.

Task 3

Implement newer speech therapy methods which allow for concentrated instruction up front and home-based work with parents.

Tell us about your partnerships

Lions Club - Our partnership with the Lions Club in Lambayeque, Peru, has been invaluable in enhancing local sustainability. The Lions Club publicizes our program through media, word of mouth and other channels, which brings in patients from all over the region who we would not be able to connect with alone.

Cafe Femenino – Cafe Femenino, a fair-trade coffee importer, has a strong infrastructure and network set up in Peru. Improved health for children is a particular goal of Cafe Femenino and allows FACES to collaborate with them in training local representatives.

Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?

Our goal is to educate others about the utility of this connectivity system. We believe the power is in an easily replicable model. We are working on strengthening the FACES Connectivity Model and presenting it in different forums – locally, through research papers and in academic presentations. The model was recently present at the American Cleft Palate Association conference at Harvard Medical School and at Oregon Health and Science University. This is a multilevel effort to 1) develop the model and, 2) educate people about its power.

What type of operating environment and internal organizational factors make your innovation successful?

FACES Foundation believes in collaborative efforts locally and internationally. Local efforts are pursued in Portland, OR, with the parent organization for Cafe Femenino, as well as Oregon Health and Science University. We have a dedicated and innovate Board and Advisory Board. The strategic plan for FACES is focused on sustaining the programmatic aspects of our mission. As is well known, a non-profit must also be a successful business. This is a reality that is being addressed with great vigor by the Board.

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