Impact Report 2022

Local Leadership, Global Results

Comprehensive Cleft Care

Solutions, Together

Local Leadership, Global Results in 2022:

Reflections from the Executive Director

At Transforming Faces’ founding in 1999, we embraced some ideas that were considered radical for an international cleft NGO. Among them:  

1) That local health professionals in Asia, Africa and Latin America were best positioned to provide care, and;  

2) That a comprehensive approach best supports children toward demonstrating full inclusion in their homes, at school, and in the community.  

We’re grateful and humbled to see our ‘radical’ passion reflected by our donors and supporters. Thanks to you, we were able to significantly increase our support for children and families, all while limiting non-program spending. Good stewardship is a core responsibility in making a sustainable impact 

We’re inspired daily by the commitment of our partners to pioneer new models of care and of the resilience of families who overcome many barriers to ensure that their child born with cleft leads a full life.  Through this brief report, I’m delighted to invite you to journey through the Circle of Care that informs everything we do.    

Along the way, you’ll meet children like Johari and Linda and learn more about the joys, as well as the challenges, of pursuing a vision for Comprehensive Cleft Care for all. 

On behalf of our team and partners worldwide:  Thank you. 


Hugh Brewster
Executive Director

One year ago, we planted a renewed mission and vision. Now firmly rooted, we reflect on the initiatives that have furthered access to Comprehensive Cleft Care, while acknowledging the challenges we face.  

Behind it, all are leaders - local partners delivering team-based care, caregivers rallying for awareness, children affected by cleft supporting each other, a dedicated staff and board at Transforming Faces, and you. 


We partner locally and innovate globally so that children and families in under-resourced communities access Comprehensive Cleft Care. 


Our vision is for all children affected by cleft lip and palate to experience full rehabilitation and community inclusion with the support of a trusted local health team. 

Comprehensive Cleft Care
Solutions, Together

Graphics-annual Report_treatment

Cleft Treatments*

Treatments in 2022

( 13%)

Treatments Since 1999

Graphics-annual Report_impact

Multiplying Impact


(↓ 9.2%)

Avg. yearly Cost/Patient


The pandemic-sparked shift to virtual care (in Latin America & Asia) has proven cost-effective, decreasing our overall average cost from 2017-2019.

Graphics-annual Report_children-support

Children Supported

New Patients in 2022
( 26%)

Families Helped in 2022
( 8%)

*A cleft treatment includes any element of Comprehensive Cleft Care such as counselling, nutritional support, speech therapy, surgery, and more.

Comprehensive Cleft Care Solutions, Together

⬤ Local Impact

Our local partners, represented in orange, have strengthened their ties with their communities to deliver more ongoing cleft care. The map below highlights the number of families accessing care through TF programs in 2022. Click the icons to explore their stories.

⬤ Global Network

TF is a founding member of the Circle of Cleft Professionals (CoCP), a network dedicated to furthering Comprehensive Cleft Care, highlighted in blue. In 2022, the CoCP grew to over 700 members who share a passion to see children achieve full rehabilitation in Low and Middle-Income Countries.

Journey Through the
Circle of Care ->

The Circle of Care places the child at the centre of the planning process.

Comprehensive Cleft Care (CCC) is the treatment pathway that is most likely to be helpful, appropriately timed, and suitable for the child’s diagnosis and context.

Explore the circle that you help to complete.

Explore - Click the Circle

Click on a cleft care service to learn how it contributes to the full circle of care. You will also discover stories of CCC.












Dental Care

Meet Janani & Her Teacher

Janani was born with a cleft lip and palate in Tamil Nadu, India. She has been receiving CCC since she was only 17 days old. In this 2-minute video, see how speech therapy has built her confidence and meet the teacher who has become an advocate for community-based cleft care!


You + TF’s
Circle of Care

Find out how you are a part of TF’s Circle of Care & read the story of Aina’s new beginning with her daughter Johari.


Community Engagement

Did you know?

Many parents have never met a child with cleft until the moment their child is born with the condition. Some assume that affordable care would be impossible, while others believe that a surgery is the only treatment that can help their child thrive.


Newborn Nutrition & Transportation Assistance

Did you know?

Children who are not yet a healthy weight cannot access surgery until this nutritional challenge is addressed. Significant delays in surgery are costly, as they can limit a child’s rehabilitative progress for the rest of their lives.


Speech Therapy & Hearing

Did you know?

Speech therapy at the time of a child’s first words can improve their long-term outcomes. TF’s partners work closely with parents so they can support their child’s progress. 


Surgical Care in Myanmar: A Part of the Circle

Did you know?

Children born with cleft often require multiple surgeries. This can include the initial surgery on the lip, multiple surgical interventions in cases of cleft palate, ear surgery to correct cleft-related hearing challenges, and surgery to align the nose for corrected breathing.  


Family & Psychosocial Support

Did you know?

Psychosocial professionals can help children to address teasing and bullying by developing a ‘script’ to respond to questions about cleft. Similarly, they can support parents to effectively address questions by members of their extended family, or in the community, in a way that firmly challenges stigma.  


Dental & Orthodontics

Did you know?

Aesthetic concerns may be high on the list of priorities for some families affected by cleft. However, without oral care, children with cleft are at greater risk for caries and periodontal disease, in addition to the functional challenges of dental anomalies. 

Sante Plus team observes CCC at CoRSU Hospital, a long-term TF partner in Uganda
Sante Plus team observes CCC at CoRSU Hospital, a long-term TF partner in Uganda

Building Madagascar’s
First CCC Centre

Historically, cleft in Madagascar was treated by foreigners via the fly-in-fly-out model – an infant with a cold during the “mission” dates may be excluded from surgery for a year or more! Clinique Santé Plus, in partnership with Transforming Faces and USA-based NGO Smile Train, has built the first CCC centre in Antsirabe, Madagascar and is working to inspire change nationally.  

This is their story. 

The Madagascar Mission: A New Model of Care

In this podcast, we discuss the first Comprehensive Cleft Care centre in Madagascar, the challenges the CCC team have faced in changing perceptions of local, ongoing care, and the hopes and dreams for cleft care in Madagascar. 

Global Innovation and Professional Development

TF’s Circle of Care requires the heart and soul (not to mention the on-the-ground legwork!) of an interdisciplinary team. We invest in local teams so that they may provide quality ongoing cleft care closer to home. Working and learning together improves children’s outcomes! 

International Cleft Congress (Cleft 2022)

Members of the Transforming Faces staff and board were delighted to convene in Edinburgh for the 14th Cleft Congress in July 2022.

TF’s 40 delegates, made up of local partners from around the world, spent 5 days learning from and with each other.

Delegates presented research and discussed ways to enhance Comprehensive Cleft Care in Low and Middle-Income Countries.

A Collaborative Spirit
for Cleft 2022

Prior to the Cleft 2022 Conference, TF’s global CCC leaders explored the strengths and challenges facing their centres, and offered one another solutions to common concerns. 

Comprehensive Cleft Care Workshops

Transforming Faces works with our partners to advance and refine CCC approaches.  Facilitating these strategic conversations helps develop care plans for the children and families that need it most.


Madagascar Knowledge Exchange

Dr. Nirina Mandrano and 3 nurses & midwives from the Santé Plus team in Madagascar visited two of TF’s long-term partners in Ethiopia and Uganda. These conversations, observations, and learning have redoubled the team’s efforts in growing  Madagascar’s first CCC centre

Thank You, Retiring Board Member Dr. Ronald Zuker

Dr. Ron Zuker is a paediatric plastic and reconstructive surgeon who served as the Medical Director of SickKids Cleft Lip & Palate program for over a decade. He recently completed his tenure on TF’s Board of Directors, a position he’s held since 2015.

Thank you, Dr. Ron, for your wisdom and inspiration service to TF and our partners around the world.

Dr. Zuker with TF partner Dr. Bowornsilp of Thailand
Dr. Zuker with TF partner Dr. Bowornsilp of Thailand

Financial Statements

This year we made our largest investment in cleft care to date, thanks to our generous donors. The TF staff and our partners work closely to ensure resources are well used with global results in Comprehensive Cleft Care in mind. 

Total Revenue
Grants, Donations & Other Income $2,050,543 $1,604,118
Total Expenses $2,134,770 $1,541,920
Cleft Care $1,243,678 $807,786
Partner Medical Training & Capacity Building $455,947 $432,634
Administration and Fundraising $324,907 $278,188
Excess of Revenue over Expenses ($84,227) $62,197
NET ASSETS 2022 2021
Balance, Beginning of Year $406,252 $344,055
Excess (Deficiency), Revenue over Expenses ($84,227) $62,197
Balance, End of Year $322,025 $406,252

Your Donations at Work


*A private charitable foundation covers TF’s administrative and fundraising costs. This means 100% of your donation goes toward our CCC programs.



This life-changing care is made possible by you.



This expense is covered by a private charitable foundation.



This expense is also covered by a private charitable foundation.

Our Gratitude

Transforming Faces Staff

Thank you for helping to fulfil the Circle of Care and supporting Comprehensive Cleft Care in under-resourced communities. We are grateful to our donors, partners, staff, board, advisories, and supporters.

transforming faces logo
transforming faces logo

Thank you to TF staff, partners and volunteers for photos featured in this report and to Sahil Ali for additional film and photography. Visual design by Jessica Orduz.

Edited by Kristian Wykes


© 2023 Transforming Faces | Charitable Registration # 86720 4034 RR0001