Over 4.8 million died and 4 lakh children were born with birth defects believed to be due to exposure to Agent Orange.


In June, the UK, US and the EU moved a special session of the Chemical Weapons Convention in The Hague to address the threat of chemical weapons use. 82 states out of 106 voted to condemn the use of chemical weapons and to seek to identify the perpetrators or sponsors thereof.

This is significant as since the end of the Vietnam War (1971) the legacy of the dioxin from Agent Orange is thought to have caused a mutation in the genetic make-up of Vietnamese DNA and some studies show the effects are carried from one generation to the next, defects that will never go away. The Vietnam Red Cross recorded over 4.8 million deaths and 400,000 children born with birth defects believed to be due to exposure to Agent Orange. Today, the occurrence of severe facial birth defects in Vietnam is estimated at 10 times higher than in neighbouring countries. Each new generation carries forward the craniofacial defects and the rate of birth defects does not decrease. The lives of children with severe facial disfigurements and their families are bleak. Most are unable to attend school or become productive members of society. All suffer psychological trauma as a result of living with the stigma of severe facial disfigurements. The rest of the family is often blamed or excluded, and many children are abandoned. The majority of children with severe facial disfigurements also have the risk of further medical complications including difficulty in breathing, eating, speaking or seeing. Many live with the possibility of life-threatening complications.

Facing the World (FTW) is a UK-registered medical teaching charity with a goal of treating children from developing countries who have craniofacial defects. Since 2008, FTW has focused resources on international education and training of physicians, nurses and other medical staff involved in the treatment and care of children with craniofacial birth defects, in the first instance in Vietnam. The project is ring-fenced—all funds raised are clearly tracked directly to the project. The aim is to achieve a sustainable solution through the establishment of surgical centres of excellence that can be replicated in other areas—Africa and the Middle East—over time.

FTW’s approach is to bring local Vietnamese doctors to UK to practice new techniques learned from specialist consultants in the UK. The UK medical teams donate all their time, as do all the Vietnamese doctors and the charity’s CEO and staff. The consultants, a multidisciplinary team and the local doctors then deliver in-country practical training during two-four medical missions per annum to partner hospitals in Vietnam. In 2018, FTW has completed two missions and two more are planned for October and November. Medical equipment needs are identified in collaboration with the charity’s partner hospitals in Vietnam and grants are sought by FTW to enable donations; just one modern microscope can enable a surgeon to complete an additional 100 complex microsurgeries a year. Just recently, the US foundation Direct Relief has earmarked a potential £100million for medical supplies and disaster relief. Many of the operations are challenging and require the combined work of craniofacial reconstructive surgeons, neurosurgeons, oculoplastic surgeons and anaesthetists to reconstruct the entire bony anatomy of a face and skull.

In the past two years, 40 doctors from Vietnam have come to the UK, at least a further 75 are expected over the next five years. It is hoped this will enable 35,000 life-changing operations back in Vietnam allowing children a lifetime of facing the world without inhibition.


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