Project Harar

Editors-In-Chief: Martin I. Newman, M.D., FACS, Cleveland Clinic Florida, [mailto:Newmanm@ccf.org]; Michel C. Samson, M.D., FRCSC, FACS [mailto:samsonm1@ccf.org]

Overview
Project Harar, also known under the working name Project Harar Ethiopia, is a UK registered charity working in Ethiopia to help children affected by facial disfigurements. Since 2002 Project Harar has secured treatment and aftercare for over 500 children and young patients living in poverty and isolation.

Project Harar works in collaboration with Ethiopian and foreign plastic, oral and maxillofacial surgeons and other specialists to treat children affected by a variety of conditions and give them normal facial function and a chance to live dignified lives, included in their home community.

History
Project Harar was founded after Jonathan Crown, a London-based Chartered Accountant and businessman on a photography vacation,encountered two young boys with facial disfigurements, Fhami and Jemal, begging in the town of Harar, eastern Ethiopia, in 2001. Moved to do something to help, Jonathan Crown spent months organising the trip that would bring Fhami and Jemal to The Gambia, where they received highly complex surgery on board of the M/V Anastasis operated by the charity Mercy Ships.

Since that first trip, Project Harar has collaborated with other charities and the Ethiopian health system, so that patients now receive treatment within Ethiopia, carried out by Ethiopian and volunteer foreign surgeons in hospitals in the capital Addis Ababa.

In 2006, the English actor John Hurt became Project Harar's first patron.

In autumn 2007, Project Harar was featured in two BBC World Service programmes on noma and the treatment of patients from remote regions. In November 2007, a documentary film made by BBC Inside Out featured a group of severely-affected patients from the Hararghe and Somali regions of Ethiopia who underwent treatment by a team of UK medical volunnteers, organised by the noma charity Facing Africa.

Operation
Project Harar is a health outreach charity functioning as a bridge between those who could benefit from facial reconstructive surgery and the centralised Ethiopian health services. Its Ethiopian staff work in remote rural areas, liaising closely with local health administrators and extension workers, to locate and support children with facial disfigurements, who often face stigma and social exclusion.

The children and their families are informed about the possibilities of professional medical care and, if they decide to be assessed further for surgery, Project Harar covers all costs related to reaching and staying in hospital in the capital city, as well as the cost of prescription medicines and other after-care costs. Project Harar always arranges for a guardian to accompany the young patients and support them through their recovery process.

After surgery, Project Harar promotes the full integration of children back into community and family life, carrying out follow-up visits and playing a role in the reduction of stigma against people living with a facial disfigurement. With the restoration of facial functions (chewing and swallowing, speech, salival continence, facial expression) and improved appearance, Project Harar children are often given for the first time the opportunity to attend school.

Through its close collaboration with Ethiopian health services and foreign specialists, Project Harar contributes to training opportunities for local health professionals and, in this way, helps to advance the surgical capacity of Ethiopia.

Project Harar operates mainly in the Oromia Region, including the zones of Misraq (East) Hararghe and Mirab (West) Hararghe which take in the towns of Harar and Asebe Teferi. The charity also covers parts of the Somali Region, including Jijiga, and the chartered city of Dire Dawa.

In 2008, Project Harar secured the treatment of 290 patients with an income of £ £114,856.

Conditions treated
Project Harar helps children and other individuals living with a treatable facial disfigurement, which can be caused by a number of conditions. These include:
 * cleft lip and palate
 * noma - a devastating form of gangrene that attacks the tissue of the face
 * tumour and ameloblastoma
 * animal attack injuries and bite wounds
 * burns and other accidental injuries