When Elisa was born, her parents’ joy lasted only for a fleeting moment before they saw her cleft lip and cleft palate.

In an instant, their hopeful excitement gave way to overwhelming sadness.

Jean consoled his wife, Sidonie, encouraging her to be strong and that they would do everything they could to help Elisa. Though the parents were heartbroken, they held fast to their faith. They believed that their daughter’s condition was an obstacle sent by God for them to overcome.

Indeed, their faith would be tested.

The midwife who helped deliver Elisa told her parents that surgery could repair their daughter’s cleft lip and cleft palate, but the procedure would come at a steep cost for the poor farming family from Madagascar.

Undeterred, Elisa’s parents began seeking out surgical care for their daughter.

Sidonie and Jean were referred to a local doctor to see if he could help. However, the doctor didn’t have the equipment nor the training needed to perform surgery on the newborn. When Elisa was 6 weeks old, the family traveled to the capital city of Antananarivo to see a plastic surgeon, who then explained that Elisa was too young to receive surgery and asked them to return in about five months for another evaluation. 

Meanwhile, Elisa’s cleft lip and cleft palate made it difficult for her to breastfeed and she soon became underweight. Desperate for her daughter to gain weight, Sidonie spoon-fed milk to Elisa, but it wasn’t enough for her to thrive. By the time the family returned to the surgeon when she was 6 months old, he delivered more bad news. Elisa had become malnourished and was not healthy enough to receive surgery. 

Devastated by the diagnosis, Sidonie and Jean returned to their village uncertain about their daughter’s future. Still, they remained hopeful that she would one day receive surgery. Fortunately for Elisa, spoon feeding ensured that she would survive until she could begin eating solid foods, which helped her return to better health.

Though Elisa was too young to realize it, Jean and Sidonie dealt with cruel treatment from some members of their community. Some even seemed to take pleasure in the family’s suffering and blamed Sidonie for Elisa’s condition. Turning to superstition, certain neighbors said that Elisa’s cleft was caused by Sidonie using a shovel or wearing a key as jewelry during pregnancy. While it’s difficult to determine the exact cause of an individual cleft case like Elisa’s, Operation Smile is leading the way in cleft research with its partners in the International Family Study.

All the while, the family continued to pray that Elisa would get the surgery she desperately needed as the odds for her future continued to worsen. In the most resource-poor, poverty-stricken places like rural Madagascar, as many as 93 percent of children with an unrepaired cleft condition die before their 20th birthdays.

When Elisa’s parents finally learned that Operation Smile provides free, safe cleft surgeries and would be conducting a medical mission in Tamatave, their prayers were answered.

Unlike Sidonie and Jean’s previous attempts at providing cleft surgery for their daughter, this time Elisa would not be turned away.

A comprehensive health evaluation determined that Elisa was healthy enough to receive surgery to repair her cleft lip – she would have to return to a future mission for her cleft palate procedure. Her parents were overjoyed to learn that her life would soon be forever changed.

Sidonie and Jean waited nervously as the Operation Smile medical team performed Elisa’s surgery. After her successful procedure was completed and Elisa awoke from anesthesia, the family poured out emotions when they were reunited in the post-operative room. After so much hardship, Elisa’s smile was finally whole.

When the family returned home, their neighbors were shocked by the difference in Elisa’s appearance. Children who once kept their distance from Elisa now became her playmates. Slowly, Elisa’s sweet personality began to shine through – she loved pretending to cook for her family and neighbors.

Sidonie told everyone in the village how well Operation Smile cared for them, and she began reaching out to find other families who had children with cleft conditions. A few months later, when Sidonie and Elisa made the journey to the next Operation Smile mission for Elisa’s cleft palate surgery, they did not come alone. Sidonie brought two other families with her. Each child was cleared to receive surgery after passing their health evaluation.

A few days later, after their children received successful surgeries, the three families returned home to their communities full of hope for brighter futures.

“She doesn’t have trouble eating anymore. She is healthy and looks like all the other children,” Sidonie said of her daughter. “She’s normal now.”