Cleft palate patients require extensive multidisciplinary care. International volunteer groups that provide cleft lip and palate surgery have to date been largely unsuccessful in accomplishing this due to a variety of obstacle. The Hopkins based volunteer / research group has partnered with a Nicaraguan foundation to provide multidisciplinary cleft palate care. The project has started to use a variety of innovative strategies, including the use of telemedicine, to address the lacking resources. The goal is to create a model of care that approaches that provided in the US. Introduction to one component can be found at: http://www.youtube.com/watch?v=Jzx3x2OHsjg&feature=relmfu