Historically, cleft in Madagascar was treated by foreign volunteers via a fly-in-fly-out surgical 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. In this podcast, we discuss the first Comprehensive Cleft Care centre in Madagascar, the challenges the CCC team has faced in changing perceptions of local, ongoing care, and the hopes and dreams for cleft care in Madagascar.