In January 2025, a team of six UK-based clinicians travelled to Kirtipur Hospital in Kathmandu, Nepal, for an inspiring and productive week focused on delivering cleft care. The group included two surgeons, an orthodontist, a dentist, a speech and language therapist, and a psychologist. Together, they demonstrated the results achievable through a multi-disciplinary approach, reinforcing the importance of teamwork in cleft care.

Kirtipur Hospital, nestled on the outskirts of bustling Kathmandu, is a dedicated centre for cleft and craniofacial care. The hospital provided an ideal setting for the team to engage with local clinicians and share expertise. A hallmark of the visit was the seamless integration of specialities, where each professional contributed their unique skills to achieve a unified goal: providing holistic care to patients with cleft lip and palate.

Collaborating Across Borders

The collaborative spirit of the visit was palpable from the very start. Whether in the operating theatre, dental suites, or therapy rooms, the UK team worked hand in hand with their Nepali counterparts. The orthodontist and dentist formed part of a vibrant dental team that even sang while working, creating a warm and welcoming atmosphere for patients. This sense of camaraderie underscored the ethos of multi-disciplinary care, where shared knowledge and mutual support are key to success.

One of the most rewarding aspects of the trip was the cross-cultural exchange of skills and ideas. For instance, the orthodontist described learning new techniques from the Nepali team, who impressed everyone with their resourcefulness and multi-talented approach. This exchange exemplified how collaboration enriches all participants, ensuring the ongoing improvement of care standards worldwide.

Inaugurating the Cleft Fellowship

A significant milestone during the visit was the inauguration of the new Cleft Fellowship. This initiative will enable Dr Bipulesh, a talented Nepali surgeon, to perform cleft surgeries across five outreach centres in Nepal. The programme, funded by CLEFT with the generous support of donors Lord and Lady Stevens, marks an important step in expanding access to specialised cleft care in remote areas. In a memorable ceremony, David Sainsbury presented Dr Bipulesh with a yellow scarf (below), symbolising this new chapter of service and collaboration.

Case Studies: Changing Lives

The team’s work had a profound impact on individual patients, many of whom travelled great distances to receive care. One such patient was Surag, age 9, from Chitwan, a 5 hour trip from Kathmandu. He is looked after by his grandmother as his father works in India. He came to the Kirtipur Hospital and was seen by the team after having previously had a cleft repair elsewhere which had unfortunately not healed. Peter Hodgkinson, cleft surgeon, re-repaired his palate and is pictured below left, post surgery, making good progress.

 

Another case involved Aarab (above right), also 9 years old. Like Surag, Aarab had to travel a long time to reach the hospital. He impressed the team with his extensive knowledge of Mount Everest! He had surgery to help improve the clarity of his speech, a procedure that had not previously been done at the Kirtipur Hospital so this was a great opportunity for the surgeons to demonstrate how it is done.

Comprehensive Patient Care

Each clinician brought invaluable expertise to the table, ensuring that every aspect of patient care was addressed. Surgeons performed life-changing procedures to correct cleft conditions, while the dentist and orthodontist ensured optimal dental alignment and oral health. Meanwhile, the speech and language therapist worked with patients to improve their communication abilities, supported by the psychologist, who provided essential mental health support to patients and their families.

Kate Le Marechal is pictured above giving a well received talk on 'The role of the Clinical Psychologist in UK Cleft Team' and 'Personal and Team Psychological Wellbeing'. Both talks prompted a lot of discussion and there are plans to introduce a clinical psychologist in their speech and language therapy sessions.

This holistic approach ensured that patients received comprehensive care, addressing not only their medical needs but also their psychological and social well-being. 

A Memorable Journey

The week in Nepal wasn’t all work and no play. The UK team had the opportunity to attend a traditional Nepali wedding, experiencing the rich cultural heritage of the country. These moments of connection added depth to the trip, fostering lasting friendships and a deeper appreciation of the shared humanity at the heart of their work.

Reflecting on the visit, one team member said:

The experience at Kirtipur Hospital was truly exceptional. The dedication and talent of the Nepali team was inspirational. It was a privilege to work alongside them and see the direct impact of our collaboration on patients’ lives.

The Power of Teamwork

This visit to Nepal underscored the vital role of multi-disciplinary work in cleft care. By pooling their expertise, the UK and Nepali teams achieved outcomes far greater than any single discipline could accomplish alone. The trip not only improved the lives of countless patients but also strengthened the global cleft care community, setting the stage for future collaborations.