Revenue & Expenses	2018	2017
Total Revenue
Grants, donations & other income	$1,779,449	$1,296,057
Total Expenses	$1,646,203	$1,232,209
Cleft care	$994,616	$588,740
Partner Medical Training & Capacity Building	$392,823	$367,381
Administration and fundraising*	$258,764	$276,087
Excess of Revenue over Expenses	$133,246	$63,849
Balance, beginning of year	$365,240	$301,391
Excess (deficiency), revenue over expenses	$133,246	$63,849
Balance, end of year	$498,486	$365,240

Meet Nang from Myanmar

When Baby Nang* was born with a cleft in a small community in Myanmar, her mother was so afraid: Would she survive? Would she ever go to school? How would the family afford the care she needed?

Fortunately, her mom soon learned about TF’s dedicated partner, NWDF who works tirelessly to ensure that families in Northern Thailand, Laos and Myanmar have access to comprehensive cleft care.

As Nang grows up, she can count on our partners for the dental care, speech therapy and social support she needs! Today, Nang is thriving, thanks to supporters like you!

*Nang’s name has been changed to protect her privacy.

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Meet Tiago from Argentina

From the moment he was born, Tiago’s mom has been his champion.

Tiago loves dinosaurs (what 8-year-old doesn’t?), soccer (he cheers loudly for his local team) and sweets (especially the ones his mom makes). He shares a home in northern Argentina with his three siblings, one cousin and his loving mother.

When Tiago was born with a cleft, his family was shocked. But his mother was determined to fight for his future and she became his biggest advocate.

Tiago’s initial repair surgery was successful and his rehabilitation is going well. He travels with his mom to Tucumán, the provincial capital, once a week for oral health care, counselling and speech therapy.

“I have learned how to help my son improve his speech,” Tiago’s mom shares proudly. “His communication is much stronger, and he is getting over his shyness.”

The cleft team at Fundación GAVINA has been a source of support and encouragement every step of the way. With their continued support, Tiago has a very bright future ahead.

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Meet Kan Kaung from Myanmar

Kan Kaung is making tremendous strides, thanks to the loving care of his mom and the support of our partner.

In low-income contexts where specialized care is scarce, how do you support a baby who is unable to breastfeed as a result of their cleft?

This is a major concern in Myanmar, where our partner regularly meets babies who are malnourished and underweight. Families are often discouraged by neighbours, and even ill-informed local health workers, who remark that “there is no purpose for such a child.”

What’s more – without proper nutrition, a baby cannot have a safe, timely cleft repair surgery. This affects all other areas of their rehabilitation as they grow up.

Kan Kaung was the very first patient to benefit from a new feeding support program in Myanmar. Our local partner, NWDF first met him in 2015, several weeks after he was born with a cleft and a syndrome that caused many health complications. He was severely malnourished (weighing only 2 kg). His mother tried anything and everything to get her baby to successfully breastfeed, to no avail.

Our partners had the heartbreaking fear that Kan Kaung might not survive.

Thankfully, Kan Kaung and his mom were tenacious, and the local cleft team rallied to get this family the support they needed. From supplementary food and special bottles, to regular social worker visits, Kan Kaung was finally healthy enough to receive his initial cleft repair surgery by his third birthday. To everyone’s enormous relief, the surgery was a success!

Today, this smiley pre-schooler weighs 11 kg and is growing into a thriving, healthy boy! His journey to full rehabilitation will be long, but his mom reports that “everyone is so happy with Kan Kaung’s new, bright smile!” She is filled with hope for her son’s future, knowing that he will have access to the full circle of care he needs in the years to come.

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Meet Bharathi from India

At age 16, Bharathi’s new life is just beginning!

For 16 years, Bharathi faced shame and stigma at every turn. No one in her small, rural community understood what it meant to be born with a cleft. She wanted to go to school like her peers, but gave up on her education because of the relentless teasing she faced. She shares that “no one at school would talk to me.”

Her family heard that there might be a place where their daughter could access treatment, but they didn’t have the money for surgery or ongoing care. Bharathi accepted that she would never have the opportunities other children had.

But Bharathi’s aunt had big dreams for her niece’s future. She learned about TF’s partner, ABMSS and accompanied Bharathi to her first appointment at St. Joseph’s Hospital.

Our partner recalls the day they met her, sharing that “she was trembling and hardly spoke at all.” But they quickly told Bharathi the good news: her cleft was treatable! In December, Bharathi had her initial repair surgery. A second surgery has been scheduled, and ongoing care will be provided to ensure that she can fully and confidently participate at school and in her community.

Needless to say, the last few months have been life-changing for Bharathi. “I will go back to school now!” she tells the team excitedly. “I will look good and no one will tease me.”

Bharathi’s entire world has been transformed with access to comprehensive cleft care. Thanks to TF’s partner and our dedicated supporters, she is filled with hope for her future. Her new smile says it all!

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Meet Frehiwot from Ethiopia

Frehiwot (and her mom) will soon begin speech therapy, so that she can communicate clearly when she starts school!

Today, two-and-a-half-year-old Frehiwot wows everyone she meets with her radiant smile! Her mother and two older sisters beam as they share how much joy she brings to their lives.

Even though her mother had seen other children with cleft in their community, she was shocked when her daughter was born with a cleft lip and palate.

“I was feeling so guilty, thinking I caused my child to have the cleft,” her mother shares. “But coming to Yekatit 12 Hospital and receiving information from the cleft team helped me overcome the guilty feelings I had.”

The team at Yekatit 12 Hospital immediately began supporting the family through counselling and helped prepare Frehiwot and her mom for her initial repair surgery.

Today, Frehiwot’s mom has big dreams for her daughter’s future. “Seeing my child after her surgery definitely changed my life!” They continue to come back for appointments every other month, and Frehiwot’s mother is committed to the long-term treatment process.

Frehiwot is currently receiving dental treatment and will soon begin speech therapy, which will help ensure she is communicating clearly when she begins school. Frehiwot and her family will have access to the complete circle of care in the years ahead!

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Meet Jean Paul from Peru

Jean Paul and his mother know they can count on TF’s support for years to come!

Jean Paul lives in small town on the outskirts of Lima, Peru. When he was born with a cleft, his family was shocked!

“In the beginning when our baby was born, everything was chaos,” his mother recalls. “Everyone worried. We asked ourselves what was going to happen to this baby.”

His mother recalls: “When I first saw him, I was desperate. I was completely lost because I did not know anything about cleft.” She did not even know if her son would survive! “At the beginning, we were afraid of everything! We were afraid to feed him!”

But from the moment she met Jean Paul’s cleft care team, his mother says “I felt calm. I felt confident. The doctor explained to me that the baby would be fine.”

Once per week, Jean Paul and his mom make the 4 hour round-trip journey to his appointments on public bus. The family is committed to his long-term treatment plan.

Thanks to the cleft team’s support, Jean Paul was able to reach a healthy weight and have a safe cleft lip repair surgery at 8 months old.

His family is filled with hope for his future, knowing that they can count on TF’s support for years to come.

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Meet Tharaton from Northern Thailand

Tharaton and his loving family are committed to his long-term rehabilitation.

Tharaton was born in a small village near the Thai-Laos border. He has a little brother (who he adores), and loves Spiderman (as is evident from his favourite t-shirt).

Tharaton was born with a cleft lip and palate. His parents had never heard about cleft before, and were so worried about their son when he was born. They told us that they weren't sure whether their baby would ever be able to lead a happy, healthy life.

Thankfully, TF's partner, Northern Women's Development Foundation (NWDF), heard Tharaton’s story, and he was admitted into the project when he was just one day old! NWDF has supported the family ever since, and ensured they have access to comprehensive care as he grows up!

For example, NWDF provided nutritional support to help Tharaton's mom when her baby struggled to breastfeed, and helped him reach a healthy weight for safe cleft lip and cleft palate repair surgeries. They also provided family counselling, hearing and dental assessments, and are providing regular speech therapy sessions to help Tharaton learn to communicate clearly.

Today, Tharaton is six years old - and his family says he's thriving! He even practiced some of his speech therapy lessons for us to prove it! Your support makes a life-changing difference for families like these, and we are so grateful.

Tharaton is learning to communicate clearly through regular speech therapy. Here he is practicing his name!

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Peru

Patients Treated in 2018: 179

Partner: Universidad Peruana Cayetano Heredia
Location: Lima
Partner Since: 2016

In collaboration with Universidad Peruana Cayetano Heredia and Smile Train, TF is helping ensure that cleft care is accessible to low-income families in and around the capital, Lima. In particular, this project focuses on providing early care for newborns and infants (and their families) and on expanding awareness about the importance of comprehensive cleft care in Peru.

Partner: AVODILSIN Breña
Location: Lima, Peru
Partner Since: 2016

With a focus on building the capacity of cleft professionals in Peru, AVODILSIN is collaborating with the Dental Department of Breña's Children Hospital to train dentists across the province in using Nasoalveolar Moulding (NAM), technique using to reshape a baby’s nose, gums and lips prior to surgery, for better surgical outcomes. In particular, this project supports low-income families and ensures they now have access to early care for their newborns.

Partner: ADAVOL San Borja
Location: Lima, Peru
Partner Since: 2018

This partnership has supported San Borja's Children Hospital in setting up a Comprehensive Cleft Care Program. With TF’s support, the hospital now has a multidisciplinary team of cleft professionals who are providing care to children from birth to 18 years old.

TF’s partner has created educational video content to raise awareness about cleft care in the country.

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Our Mission

We equip local teams to provide comprehensive cleft lip and palate care that is accessible for all. Together we are building happier, healthier lives for children and families in Asia, Africa and the Americas.

Our Vision

Our vision for children with cleft lip and palate is full inclusion into their community, so they can pursue their hopes and dreams.

Our Approach

1	Provide comprehensive care to children born with cleft, so they can thrive at home, at school and in their communities
2	Support families to help every child realize their full potential
3	Build the capacity of local cleft teams worldwide

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Completing the Circle of Cleft Care through:

Newborn Nutrition

Babies with a cleft often struggle to breastfeed. TF supports newborns and moms, to ensure babies reach a healthy weight and can have a safe repair surgery.

Surgery

A cleft lip repair surgery can take place as early as 3 – 6 months, and a cleft palate repair usually follows at 9 – 12 months. More surgeries may be required as the child gets older. Many children will need years of holistic support beyond their cleft repair surgery.

Speech Therapy

Children born with a cleft often have trouble pronouncing certain sounds. Regular speech therapy helps children learn to communicate clearly so that they can thrive at home, at school and in their community!

Community Engagement

Mobilizing our partners to do outreach in communities, in schools and at local health centres helps ensure cleft is understood and children are referred to comprehensive care centres. This includes advocacy and awareness campaigns to combat shame and stigma, and is an important part of ensuring that every child born with cleft has access to the treatment they need to thrive.

Hearing

Many children with a cleft are at risk for fluid buildup in the middle ear, which can lead to hearing problems. Children with a cleft should have their ears checked once or twice a year.

Dental Care

Children with cleft often have more dental problems than other kids – including small teeth, missing teeth, extra teeth or teeth out of position. Cavities are a problem too. Regular visits to the dentist and good oral hygiene are essential as the child grows up.

Orthodontics

Children with cleft may begin post-surgical orthodontic treatment as early as age 6. This may involve expanding the palate or using braces to position the teeth.

Parent Support

Shame and stigma still surround the condition in many communities. Providing social support to family members is essential in ensuring everyone is on board with a child’s treatment plan, and feels supported throughout the rehabilitative journey.

Transportation Assistance

Many families we work with live in remote, rural areas – often far away from treatment centres. Attending appointments can be costly and time consuming (sometimes involving up to 3-4 days of travel). TF supports families like these in accessing essential rehabilitative treatment.