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Helping Survivors Look Forward To A Future Free Of Pain: Face Forward International

by Julie Godchaux-Linneman, Collaboration Leader at StreetLightUSA

The process of returning to normality following a traumatic experience like domestic

violence, human trafficking or other acts of violence can become even more strenuous if there are physical scars accompanying the psychological. The physical scars can range from internal issues of poorly healed and set bones, deep lacerations or damaged organs, to more external long-term scars of deep burns, loss of hair and large amounts of scar tissue.

A nonprofit based in Beverly Hills seeks to mitigate and fix these physical scars. They offer pro-bono reconstructive surgery to survivors of domestic violence, human trafficking, and other acts of violence. The majority of the patients they serve are survivors of domestic violence at 70% while survivors of sex trafficking and violent attacks comprise of the remaining 30%. The organization works with a team of Board-Certified surgeons and specialist who donate their time and skill to provide care to some of the most devastating cases from around the world.

To learn more about their organization and the issues Face Forward focuses on, I was able to interview Mandi Budd the Executive Director of Face Forward.

This is Part 1 of the interview. Look for Part 2 soon.

Julie- Thank you again, Mandi, for providing your time and expertise in this interview. We are very excited to have you here to let us know what Face Forward is and why it matters. To that end, the most important preliminary question is, what is the mission of Face Forward?

Mandi- Face Forward provides pro bono reconstructive surgery and emotional support services to survivors of domestic violence, human trafficking, and other cruel acts of crime. We created the cruel acts of crime portion of the mission, to basically serve as an umbrella to cover other acts of violence such as mass shootings, children or Veterans of war or those who have been randomly attacked.

For the cases that don't fall under the mission, such as birth defects or developed diseases, or accidental issues, we refer out to other groups and organizations. We'll take the 10-15 minutes of research and outreach time to other groups that would work with them, and usually have a good collection of contacts already sort of set. We try to help everyone that we possibly can however we can, whether that’s helping them ourselves or doing research to connect them to other resources.

Julie- The scope of what Face Forward is willing to include is very impressive, and that you do your best to never give a complete “no” to anyone. Now, are you localized to a region? I know that you are headquartered out of Beverly Hills in California.

Mandi- We were founded and started in Beverly Hills, and because of that we have a network of doctors in the Beverly Hills and greater Los Angeles area, along with doctors in several other states in the US. We also have several doctors in other countries as well, who have offered to extend their services because they want to get involved.

Who we reach out to is completely on a need basis, determined by what patients come to us, and what services are needed. Just because we have doctors in Greece or the UK or Beverly Hills doesn't necessarily mean that they are the specialists that we need for certain surgical requests that come to us. When we transitioned away from just domestic to international, we learned very quickly the importance of partnering with other non-profit organizations locally to ensure that the survivor is getting all the resources and support in their hometowns or in their home countries. We like to think that while we're providing them free reconstructive surgery, at the end of the day, we want them to have continued support.

In many ways we are the opposite of other groups, like Doctors Without Borders. Organizations like that send doctors out, spend a few weeks in a camp, do a bunch of surgeries, and then they go home and go about their lives. What we're doing is actually building relationships long term with our patients, and making sure that they're receiving as many of their surgical needs as possible. This is because, yes, there are a lot of cases where it's a one and done surgery, like a broken nose, or a cheekbone where we can repair the physical issue in one treatment. The majority of our cases, I'd say probably 70- 80% of them, are inherently more complex and require long term care, usually over the space of multiple years. And in cases where there are burns, or acid attacks, those may require lifetime care.

So, to address that issue, we have found that we work most effectively with a network of specialists who get to know and learn about our patients and also learn and develop the cutting-edge techniques and processes to help with whatever medical issues the patient may have. To give an example, let's say a patient has issues with ocular repair or repairing their vision because they've been blinded by an acid attack. So, we bring them here to our home office, from either within the States or internationally, we go through at least one consultation to get an idea of what will be needed. Afterwards, we now know that we need not only two doctors who deal with scars but also a doctor who specializes in ocular surgery to work with the planned facial and body reconstruction. The consultation meeting is crucial because some things cannot be communicated with a photo or an email, and when they physically get the consultation with a doctor, then we can see the growing list of needs. Then, we will reach out to a list of specialists that we work with. Our goal is to then provide further services to them while they're here on one visit versus having to send them to different doctors all over the country or all over the world in that capacity.

Julie- It seems that that is an incredibly holistic way to deliver patient care. And something that is fairly unique, as I believe most hospitals will do pro bono or free cost for specific procedures, not the entire service or long-term care.

Mandi- Correct. And we do have a very strict no therapy, no surgery policy with our patients as well. When we are bringing in patients who have not had any sort of emotional support therapy, we'll bring them to our site far in advance of their surgery, and start therapy services immediately.

A surprising development with COVID- 19 is that we have developed the capacity to be able to do them virtually. Now, we can start sessions with patients through Teladoc, or Zoom, or with whatever their individual doctors prefer and get ahead of our therapy/surgical schedule.

The therapy is a crucial aspect of our service, we give them the free surgical care, yes, but we also ask them in return to pay it forward and be advocates in their own lives to seek mental health and personal success however that looks. The therapy we provide seeks to arm them with all the resources to make that possible.

We also focus on aligning with groups in their own communities in their hometowns on even in California. Here in LA we are lucky that we are a true melting pot of cultures, so when we are working with someone internationally, we'll reach out to the local communities in LA. For example, I've had three patients who have come to us from Kenya, so we communicated with the local Kenyan community in LA, and we have found that they will really just step up to the plate in a beautiful way. They really come in together to work as a support system while the patients are in town for treatment. For us that is crucial: to make sure that their healing is as positive an experience as possible.

Julie- I am curious as to how this system works; it sounds like there is an incredible number of people who volunteer their time and expertise to work with your patients, from community members to surgeons. You also listed a variety of specialists earlier as well, ocular surgeons as well as facial reconstruction doctors. Do they do this all pro bono? What about nurses and anesthesiologists?

Mandi- The surgeons and community members are the ones donating their time and services. The surgeons are the ones really working on this; they bring in their nursing staff, their employees, etc. because they are in charge of their day to day operations. They donate their time and services. For operating rooms and recovery, we have relationships with local surgery centers, so we receive special pricing and discounts. But we do pay for the surgery center fees, the anesthesiologist, and any medical equipment that's needed. Sometimes we're able to get those donated just from the distributors, or at least discounted, based on the representatives that we work with. But at the end of the day, our surgeons really are the heart and core of our program.

Julie-The work your surgeons do to make these operations work is impressive in how much work they do and how big of an impact they have. What brought these surgeons into your organization?

Mandi- Most of them come with some sort of personal story of what brought them to us wanting to help. Stories focused on the patients they may have treated in the past who were survivors of deep traumas, or they may have had family members who've been affected. However, many also were just looking to do something positive. They thought, I have the skills and talents to do this, and I can do something good for people who need help.

Many of our doctors have been with us longer term, and it's exciting to see them face the challenges of figuring out new creative surgeries to be able to help, especially in extreme cases like acid attacks, burns and more severe issues. Because of the variety of issues they see with Face Forward, many of our surgeons even created new processes to help reduce visible scarring and different techniques that aren't quite so invasive.

There used to be a standard of using laser treatments for scarring and burns. But since laser treatment is in essence re-burning the skin, it can be a traumatic process for someone who has been a victim of an acid attack. So originally, we couldn’t do anything to lessen that process for the patient besides preparing them with psychological and emotional support. Well, one of our doctors brought in a new technique called nano fat transfer where they actually take body fat from another portion of the body, treat it and then inject it into the scarring under the skin. The process uses the body’s natural cells to regenerate and heal, so it’s a much less traumatic way of healing the body. And we have seen amazing success with this procedure.

Our doctors are always looking for techniques that have higher levels of success and involve a less traumatic process for the survivors. I don’t have as much of a medical background as these surgeons but it is just as exciting a process for me as an outsider as it is for the doctors.

Working at Face Forward seems to be an adventure every day for them, yes because it's a challenge to them but it is also more. I often hear them say, ‘this is why I got into medicine in the first place.’ The goal of getting into medicine for surgeons is to make a difference. So, for plastic reconstructive surgeons, they do Botox, breast implants and fillers all day but working at Face Forward allows them to change lives in a more moving way. Being able to help change the life of someone who has suffered severe trauma is rewarding to them in so many different ways because they can develop new processes, work on technically difficult procedures and change a life.

This is the end of part 1 of our interview with Mandi of Face Forward. Part 2 of our interview will cover more information about Face Forward, including why it was founded, and the effects of COVID 19 on the patients of Face Forward and the business itself. Thank you, Mandi, again for the interview, and I hope that this interview has been interesting for our readership at StreetLightUSA. If you are interested in learning more about Face Forward please read part 2 of the interview and check out Face Forward’s website at

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