A Landmark Patient
Make a DonationVolunteer

Editor’s Note: In August, we covered Operation Smile in Madagascar’s first-ever surgical training rotation at Centre Hospitalier de Référence Régionale in Antsirabe. Since then, we have conducted five out of the six rotations scheduled for 2017. Building on Operation Smile’s commitment to strengthening health systems where it works, international teams of medical volunteers provide training to Malagasy health care professionals by providing safe surgery for children suffering from cleft conditions. Throughout the rotations, we’ve been receiving informative and inspirational field updates from Charlotte Steppling, the project manager for Operation Smile in Madagascar. In this two-part “From the Field” series, Charlotte shares the compelling stories of two patients who received surgery during the fourth rotation, which took place Sept. 23 through Sept. 29. This is the first story.

Tsifoina was born with a cleft lip in 2016. On Tuesday, Sept. 26, the 9-month-old boy became the 2,500th patient to be operated on by Operation Smile in Madagascar.

“When I gave birth to Tsifoina, I was so surprised – shocked to see his cleft. The doctor and midwife took him to the neonatal ward and came back to comfort me,” said Tiavina, Tsifoina’s mother. “They explained to me that cleft can be repaired. Yet, I couldn’t hear anything they said – my mind was blank. I was so surprised and could only imagine, ‘How could this happen to us? What did I do? What did this child do to deserve this?”

Tsifoina’s parents had seen television advertisements and heard from word-of-mouth that there were options for surgery, among them Operation Smile. First, they searched the internet and found the Operation Smile Facebook page. They contacted Operation Smile through direct message and spoke with Mamy Ramamonjisoa, country manager for Operation Smile in Madagascar.

“Two weeks after Tsifoina’s birth, we received an appointment to meet with Mrs. Mamy,” said Tsitohaina, Tsifoina’s father. “She explained to us that there are many different possibilities and she shared the information about the next international medical mission in Antsirabe in May.”

When the mission arrived in Antsirabe, so did the family with the hope that their then-4-month-old son would receive surgery.

Unfortunately, Tsifoina was not chosen for surgery at the mission. Due to the overwhelming patient turnout – more than 500 arrived for screening – older children were given priority over infants like Tsifoina, who could wait for a future program and still be within ideal age range for surgery.

“I still kept hope. I knew that one day Operation Smile would call our family and we would have our turn to receive surgery,” Tiavina said. “I was impressed when I saw all of the children, all of the mothers, waiting to be chosen. There were hundreds. I told my husband, ‘One day it will be our turn. We must believe.’”

“We were told that there will be another international mission in November, but we were very surprised that we were called to come in September because there would be a mini-mission in Antsirabe,” Tsitohaina said of the opportunity for his son to receive surgery at the fourth of the six surgical training rotations being conducted in 2017.

“I could barely sleep – the days couldn’t go by any slower! We could not wait until September to go to Antsirabe,” Tiavina said.

The rotation arrived and Tsifoina received surgery from surgeon educator Dr. Mwepu of the Democratic Republic of the Congo and his mentees Drs. Ravaka and Briand of Madagascar. His mother and father patiently waited for him to come out of the operating room.

Once reunited with their son, tears of joy spread across the parents’ cheeks.

“Since the beginning, we were confident that if he receives surgery from Operation Smile, the results would be extraordinary,” Tiavina said. “And we are also so pleased to hear that Tsifoina is the 2,500th patient operated on in Madagascar!”

“What an honor,” Tsitohaina said. “We are so grateful to Operation Smile for having offered smiles to 2,500 patients in Madagascar. Thank you!”


“I just wanted to play with the other kids, but they only stared at me and laughed.”


& Thirst

“We did not know how to give her milk. I was worried she would die of thirst.”

-Marceline’s Mother

Speech Inpediment

“Even if I think I know the answer, I don’t raise my hand. I don’t want to be called on.”


After 48 Years, A New Future

After 48 Years, A New Future

Domingos has an indomitable spirit with a physique to match: calloused hands, muscled arms and shoulders that look like they could carry the weight of the world. In a sense, they have. Domingos carried the weight of living with an untreated cleft lip for 48 years....

read more
Braving the World Together

Braving the World Together

Noemia and her mother, Bendita. Photo: Zeke du Plessis. Children like Noemia possess a special form of bravery. It’s a courage that can often be concealed by shyness and vulnerability. This courage endures teasing and mockery with a sense of dignity that many struggle...

read more
A Life-Changing Journey for Two Sisters

A Life-Changing Journey for Two Sisters

When we first met Vaviroa and Nambina on our medical mission to Tamatave, Madagascar, the six- and two-year-old sisters shyly hid behind their parents and barely said a word. Years of bullying taught these young girls that the world didn’t want to see their smiles....

read more