
Our Work in Bulgaria
In Bulgaria, cleft isn't viewed as a public health priority, leaving resource-constrained parents with a heavy financial burden. We partner to make Comprehensive Cleft Care accessible.
A family attends our partner, ALA’s weekly multidisciplinary cleft clinic.
Cleft Care in Bulgaria Today
Beyond surgery, cleft care services are largely funded through international NGO partnerships. The Plovdiv cleft unit, where we partner locally, is Bulgaria’s main centre supporting families born with cleft.
Bulgaria has sufficient trained specialists; the major challenge has been the lack of support for families and effective referral mechanisms to prevent newborn children affected by cleft from falling through the cracks.
Until recently, many new parents of children with cleft were given the impression that they should place their baby up for adoption, as it would be the only way for them to get the care they needed. Thankfully, advocacy and community engagement have made a difference. Our partnership in Bulgaria allows families to access care without a financial burden.
Fast Facts
- Population: 6,460,000
- Capital: Sofia
- Below Poverty Line: 22%
- Cleft Incidence: 80+/ year

Key Challenges
Community Awareness
Lack of awareness about cleft has historically led to children being under the care of state services. While this has improved thanks to our partner’s diligent awareness efforts, misconceptions about what cleft is and how it can be treated persist.
Transportation
Ongoing and full circle cleft services are only available at one centre meaning families would have to travel long distances if it weren’t for our partner, ALA’s extensive regional network of specialists.
Psychosocial Support
Many of the school-aged children our partner program supports struggle with bullying and low self-esteem. Parent support groups help to combat the feelings of shame and stigma families frequently face.
Program Successes
Patients accessed 1,978 cleft care treatments or treatment interventions at our partner hospital
Speech therapists spread across Bulgaria facilitated a total of 1,124 speech assessment and therapy sessions
Orthodontic treatments were provided by our partner via their orthodontist network this year
“In Bulgaria, only surgical treatment is covered by public healthcare; everything else would otherwise be a family’s financial obligation. It is important to give a chance for optimal treatment to por families. Children need multidisciplinary, coordinated care and follow-up until adulthood.”
- Dr. Youri Anastassov, Surgeon & CCC Team Lead, Association ALA
Stories of Success

In our impact report, we shared that, thanks to our monthly Bright Start donors, we were able to exceptionally arrange surgery for 11 children in the capital city, Yangon. Among those children, a photo of Yoon* and her father, Phyo was featured. Early in 2020, Phyo and his wife Aung learned they would be expecting…

Dan, a bicycle mechanic, and Hellen, a stay-at-home mother, reside on the shores of the swampy Lake Kyoga, along with their two children – Janet and Innocent. In mid-2021, they expanded their family and welcomed a third child, who they would name Esther. It wasn’t until the delivery day that the local health centre discovered…

Vineesh was born in 2012 to a humble family living in the village of Neriya, India near the coastal region of Karnataka. He has two siblings whom he enjoys playing with. Vineesh enthusiastically attends school each day and hopes to grow up to be a teacher. He excels at mathematics, which happens to be his…

Eight-year-old Rachel and her family live atop a lush mountain in rural Costa Rica, about 30 minutes from the nearest town – Cartago. She enjoys taking care of her pet hamster, and playing on her swing outside in the fresh air. She attends a one-roomed schoolhouse, and her favourite subject is Math. Her father operates…

We are often asked how TF came to be. As longtime friends of TF will know, our co-founder and Board Chair, Jackie, has a deep personal connection to our work, as she was born with a cleft lip and palate. We are delighted that Jackie has chosen to share some of her story. Our co-founder…

Samantha is an absolute chatterbox. She is a bubbly and energetic two-year-old, who loves meeting new people. When members of the Transforming Faces’ team visited her family in early April, we noticed this right away. She was keen to share her speech therapy homework that she enjoys doing with her mother, Jimena, and was proudly…
Our Partners in Cleft Care
TF has been supporting partners in Bulgaria since 2009.
Our Partnerships in Bulgaria
- Association ALA, Plovdiv