SURGICAL NEWS

40 YEAR ANNIVERSARY
The Australian Craniofacial Unit 1975-2015
DAVID DAVID
South Australian Fellow
This stand-alone Craniofacial
Unit has been operating
for 40 years as a multidisciplinary,
patient centred, national
and international organisation
for the management of severe
Craniomaxillofacial deformity.
In the early 1970s a group of surgeons
and other health professionals in
Adelaide banded together to implement
the principles laid down by the
French surgeon, Paul Tessier for the
An Indonesian patient managed over
a 25 year period now married with a
family and employed as a manager
management of severe craniofacial
deformity. The stimulus was the
absence of any adequate treatment for
these problems in the region. Initially
patients were referred from around the
country by word of mouth, mostly from
plastic surgeons and neurosurgeons.
The management programs, and
particularly the surgical interventions,
were at that time, difficult, however
successful outcomes brought the
group to the attention of the then State
Premier, Mr Don Dunstan, who was
impressed by the concept of a patient
centred solution where highly skilled
professionals who had ambitions to
work in a co-operative way and wished
to establish a more formal unit.
Professionals from Plastic Surgery,
Neurosurgery, Oral & Maxillofacial
Surgery, Ophthalmology and all of
the principal Dental specialities,
Anaesthesia, Speech Pathology and
Neuropsychology were incorporated
into a “stand-alone” Craniofacial Unit,
not under the formal banner of any of
the silos of specialist surgery.
This concept fitted into the vision
that the premier had for the state of
South Australia and Australia at large
and he formalised the then South-
Australian Craniofacial Unit, facilitated
the necessary adjustments to the
standard employment processes and
barriers between hospitals and sought
to establish relationships with our
near neighbours in South East Asia to
partner with them in providing health
care to these very complex conditions.
The delivery of healthcare to the
craniofacially deformed was considered
to be a new discipline and a new
department was structured to focus
on a multi-disciplinary, patient care
extending from birth to maturity. The
South Australian Craniofacial Unit
became well established, and as a result
of the inflow of work from Australasia
and South-East Asia and the success
of this system, a significant number
of medical experts were attracted
from around the country and overseas
and patients were referred from far
and wide, fulfilling the necessary
case load laid down by the Founder
of Craniofacial Surgery, Paul Tessier,
when he said that a Unit treating major
deformity needed to serve “at least 15-
20 million people”.
In the early 1980s due to the
generosity of an Australia wide
campaign undertaken by the Apex
Clubs of Australia, which raised
nearly $1 million, the Australian
Craniomaxillofacial Foundation
was formed. and acts to this day as a
support and charitable arm of the now
Australian Craniofacial Unit.
At the same time as the Foundation
was formed, the State Minister of
Health, together with the Premier gave
a specific undertaking to support the
research of the Unit and an amount of
money was made available to establish
a Research Unit which was initially
headed by Professor Tasman Brown,
Anthropologist and Professor of
Dentistry at the University of Adelaide
and today is headed by Professor
Peter Anderson. Outreach clinics were
established in Malaysia, Indonesia,
Thailand and Hong Kong, Auckland
and Christchurch. From the outset
the South Australian Government
facilitated the treatment of patients
from neighbouring countries who were
unable to afford this care on a pro bono
basis.
In 1988, at the Combined State and
Federal Health Ministers Conference,
following the initiatives of the then
Minister of Health in South Australia,
the South Australian Craniofacial
24 SURGICAL NEWS AUGUST 2015