Our longest-running partnership has been with the cleft team in Plovdiv, Bulgaria where we have been working to reduce the number of babies born with clefts being sent to orphanages. A survey we conducted for UNICEF in 2009 showed that nearly 40 per cent of parents of children with clefts were advised to put their newborn in care – this advice in most cases came from health professionals. We plan to re rerun the survey in 2015 to see whether our interventions have made a difference. The key outputs so far have been ⦁ Tentative agreement by the Health Ministry in Bulgaria that Plovdiv should be designated as a centre of excellence in cleft care and the main referral point for all babies born with clefts ⦁ The establishment of a national network of specialist, trained, cleft nurses ⦁ The establishment of a national network of trained parents who can offer support to new parents, particularly in the period immediately post diagnosis ⦁ The inclusion on the cleft team of a psychologist show can look out for those families – and children – who may be experiencing psychosocial difficulties. For more information about Bulgaria, visit the patient group website, http://ala-bg.org/?lang=en