Cleft Lip and Palate One child in every 700 worldwide is born with a cleft lip or palate. Cleft lip and palate is a complex developmental problem in babies where the upper lip or palate (roof of the mouth) is not correctly joined. A cleft lip creates a opening in the upper lip between the mouth and nose, and looks like there is a split in the lip. A cleft palate creates an opening in the palate - the roof of your mouth. Babies with a cleft lip can become severely malnourished as they are unable to suckle and may be prone to choking. Left untreated, a child with a cleft may not learn to speak properly and can suffer hearing problems. Apart from the daily communication and physical difficulties, cleft children can confront great social stigma. Many individuals with a facial ‘difference’ are ostracised by their communities, and most of our young patients are denied their right to a school place. Babies who are born with a cleft condition in the UK are operated on soon after birth, but in most of Ethiopia this does not occur. Although treatment is freely available in some hospitals, the communities we work with are either unaware of the treatment or cannot access it due to distance and cost. Our research has found that fewer than half of all children born with a cleft lip or palate ever attend school unless they receive treatment. This barrier is more severely felt the more severe the disability (only a quarter of children with both cleft lip and palate have been to school and many drop out). Cleft conditions create even more barriers for rural girls, with only 30% going to school prior to surgical repair. The parents of girls most often express concerns for the economic and marriage prospects of their daughters. Project Harar has provided access to surgery for more than 8,000 children and young people with cleft lip and palate since it was founded and is now treating 1,100 patients a year. In order to expand our reach, we have trained 750 government health workers, building their capacity to identify and refer patients to Project Harar. We are fortunate that there are now many skilled Ethiopian surgeons who are able to perform life-changing surgery on our patients with allied medical professionals offering speech therapy and dental care. We currently have outreach teams in Oromia, SNNPR (Southern Nationalities), Amhara and Afar regions and have partnerships with other NGOs in Tigray.