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Patient Story Madagascar

Two Lives Transformed by One New Smile

Patient Story Madagascar

Two Lives Transformed by One New Smile

Twelve-year-old Sandra before cleft surgery. Photo: Zute Lightfoot.

Our promise of improving health and dignity during the COVID-19 pandemic endures. Once again, we’re providing surgery and in-person care while taking stringent measures to keep families safe. Hope is on the horizon. And we remain focused on what cleft care makes possible for children, helping them to better breathe, eat, speak and live with confidence. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

From Sandra’s Madagascar village where she’s lived her entire life, the nearest hospital is a 5-hour walk away.

This is the reality for many families living in areas of the world where access to safe and timely medical care is not only limited but oftentimes nonexistent altogether. 

Geographical and financial barriers, and sometimes a fear of the unknown, can prevent patients like Sandra from accessing the life-changing care they need early in their lives. 

Sandra lived the first 12 years of her life with an unrepaired cleft lip. Her family knew that care was possible, but their limited income and a strong stigma that deepened their fear of doctors and hospitals made it seem like Sandra’s surgery would remain out of reach. 

Sandra's grandmother, Manuelle. Photo: Zute Lightfoot.

It wasn’t until her grandmother, Manuelle, learned about Operation Smile and its global community of trusted medical volunteers that everything began to change.

With only two weeks before the surgical program was scheduled to start, Manuelle was determined to get her granddaughter the care that she deserved despite any fears she had. 

When it finally came time for their journey to Antananarivo, the capital city of Madagascar, love and perseverance motivated Manuelle to walk the five hours to their nearest hospital where an Operation Smile bus was waiting to transport her, Sandra and many other families to the mission site. 

Ten hours later, they stepped off the bus feeling both eager and nervous.

Sandra and her grandmother, Manuelle, arrive to screening during a 2015 Operation Smile surgical program in Antananarivo. Photo: Zute Lightfoot.

After a day filled with comprehensive health evaluations from anesthesiologists, pediatricians and more, Sandra was told news that would forever change her life.  

She was scheduled to receive free cleft surgery.

Sandra spent time in our child life area with volunteer psychosocial care provider Cynthia Fitchpatrick of the U.S. who helped prepare her for surgery. Photo: Zute Lightfoot.
Manuelle remained by Sandra's side during every step of her cleft care journey. Photo: Zute Lightfoot.

Upon arriving home to their village following the mission, they were greeted by family and friends who were anxiously awaiting to see Sandra’s new smile.

It was through this journey with her granddaughter that Manuelle learned just how impactful free cleft surgery can be, and she wanted to do more for the people of her community.   

Manuelle once passed a child with a cleft condition from a neighboring community walking down the road. She felt in her heart that she had a responsibility to inform the child’s family of the opportunities that existed. 

She wanted more families and grandparents to see the same incredible changes in their children that she saw in her own granddaughter.

During a follow-up visit to her village, Sandra smiles wide while surrounded by friends and family. Photo: Zute Lightfoot.

Before surgery, Sandra enjoyed school but constantly dealt with teasing by other children who would tell her that she had a broken lip.

Operation Smile visited Sandra at her home six months after surgery. They were greeted by a new Sandra, one who skipped happily around her village surrounded by friends and a beautiful smile on her face. 

With the burden of painful bullying seemingly lifted from her shoulders, Sandra now lives a happier and healthier life as an outgoing 12-year-old who loves to play and study her favorite subject Malagasy. 

Sandra sits beside a friend drawing. Photo: Zute Lightfoot.

With every smile and sound of laughter from her granddaughter, Manuelle became more determined to share her Operation Smile experience with as many people as she could reach. 

From house to house, Manuelle reassured families by describing the process of a mission, helping quell any fears they might have and urge them to reach out to Operation Smile.

“I’m happy to recruit for Operation Smile, and I will work hard to find more patients because of the work that they do,” Manuelle said.  

During one trip, she walked nearly five miles, crossed a river and hiked another mile to reach a boy named Gino and a girl named Nordine. Both children were recruited for a later Operation Smile surgical program in Madagascar. 

When asked what motivates her to find more children, Manuelle said, “My grandchild once suffered from cleft lip. My grandchild Sandra was teased, dropped out of school, and was a shy girl. Now I can’t keep her in the house. She has many friends and is constantly smiling. She is beautiful. 

“I would like to give that gift, the gift of smiling to others like Sandra.” 

Help us keep our promise to patients like Sandra amid the COVID-19 pandemic. Your support today means we can continue to help them through these uncertain times and provide them with the surgery they deserve when it's safe to resume our work around the world.

Sandra, after surgery. Photo: Zute Lightfoot.


It takes as little as $240 and as few as 45 minutes to provide life-changing surgery and a bright, beautiful new smile to a waiting child.