The mission of the American Cleft Palate-Craniofacial Association (ACPA) is to optimize the health of persons affected by craniofacial anomalies through professional education, stimulation of research, and the promotion of interdisciplinary collaboration and team care. In addition, the association desires to improve communication and cooperation among professionals interested in craniofacial anomalies and to develop the public's understanding of, and support for, the needs of these individuals.

Towards these goals, the ACPA strongly endorses the efforts of individuals and organizations to provide professional education and clinical care for individuals with cleft lip and palate and related craniofacial anomalies in nations outside their home country. ACPA standards for international care are aimed towards assuring that international exchanges or mission-based cleft lip/palate and craniofacial care are delivered in a safe and high quality manner. In the spirit of improving international collaborations, this aspirational set of standards is set forth by the ACPA.

1. The primary objective of international clinical programs is to render appropriate service to all persons who seek care with full respect for human dignity. Visiting clinicians should respect the trust and confidence of patients in their care, rendering to each individual a full measure of quality service, safety, confidentiality and dedication.
   
   
2. International clinical programs should be conducted with the agreement of the host nation and with the cooperation of host nation health professionals. Such programs must be sensitive to the cultural practices, laws and norms of the host nation.
   
   
3. International clinical programs should seek to educate and train host nation professionals who can thereafter deliver high quality, team-based care.
   
   
4. Interdisciplinary team approaches should be utilized in providing care in international settings. Such care is best provided in venues where appropriate post-treatment and long-term follow-up can be accomplished. When possible quality assessments of care outcomes should be undertaken.
   
   
5. Clinicians participating in international treatment programs should provide only the type of care and procedures for which they have appropriate training and experience and also which they perform as part of their clinical practice in their home country. It is important that all clinicians participating in international treatment programs maintain their skills and keep their knowledge current.
   
   
6. Training and experience to perform cleft lip and palate and/or craniofacial care should be obtained only through properly supervised and monitored training programs, not through unstructured experiences outside the home country.
   
   
7. The principles of informed consent should apply in any setting where clinical care is rendered. Patients must be known by name to the medical team and parents or guardians must provide fully informed, educated, and culturally appropriate consent for any procedures performed on children. When language differences exist, professionals should utilize translators to assure informed consent exists prior to the delivery of care.

ACPA Ad Hoc Working Group on International Treatment Programs:
Linda D'Antonio, PhD
Jim Lehman, MD
Michael Moses, MD
Harlan Muntz, MD
Peter Spalding, DDS, MS
Barry Steinberg, PhD, DDS, MD, FACS
Ron Strauss, DMD, PhD(Chair)

Approved by ACPA Executive Council, April 2001

Endorsed to date by the following organizations:

American Academy of Oral-Maxillofacial Radiology
Jackson, Mississippi

Canadian Society of Plastic Surgeons

FACES Foundation
Portland, Oregon

Indian Orthodontic Society
Chennai, India

Loma Linda University Department of Surgery
Division of Plastic and Reconstructive Surgery
Operation Good Samaritan
Loma Linda, California

Operation Restore Hope
Sidney, Australia

Thai Association of Orthodontists
Bangkok, Thailand

Transforming Faces Worldwide
Toronto, Ontario, Canada