Ready to Meet the Challenge in Madagascar

Neilsen helped a mission organization that flew doctors into Madagascar to provide cleft care, but he knew local doctors were as capable as those flying in. 

Smile Train Africa staff member Neilson

Michael Nielsen Andrianomenjanahary has dedicated his life to building a better Madagascar. As his home is one of the most diverse — and most fragile — ecosystems on earth, he intimately understands the threat climate change poses and has long been determined to do something about it. So, he earned a Master’s in Sustainable Energy from the University of Antananarivo, then got to work writing grants for a rural electrification project funded by USAID’s Power Africa. Still driven to do more, he spent much of his spare time in 2019 getting active in a youth workshop against climate change.

A child with an untreated cleft lip from Madagascar

But Nielsen knows change happens through personal relationships as much as through big movements. That’s why he spent many years volunteering with a Western mission trip-based organization that flies into Madagascar a few times each year to perform cleft surgeries. He helped set up their mission hospitals, arranged logistics and lodging for the visiting American medical teams, liaised with the health ministry and local hospitals, and so much else. It was a lot of work for a volunteer, but it was worth it for him to see children who had been so sick leave the mission tent with new smiles. Yet he noticed that once the American doctors flew home, the children they operated on were left with nowhere to turn; if they needed additional help, they had no choice but to try to hold out until the organization decided to fly back. Some went to local hospitals for help, but they either couldn’t afford the care, or the hospitals weren’t equipped to handle the care they needed without outside help. It broke Nielsen’s heart to see so many children suffer as they waited for the Americans to return.

It also frustrated him. He knew from his volunteering that Madagascar’s doctors were as capable and as passionate as any. They didn’t need to be dependent on others; they just needed a boost. Thankfully, he soon learned that an organization called Smile Train was looking to offer just that boost — and that they were hiring in Antananarivo. Smile Train is the opposite of a mission group. Instead of importing outside doctors to provide care to a few lucky individuals while doing little to solve the problems that made them feel the need to fly in to begin with, Smile Train uses a combination of rigorous local training programs, strategic investments in local healthcare infrastructure, and constant evaluation to empower medical professionals in 70+ countries to provide cleft surgeries and other forms of essential cleft care for free in their own communities. This model makes high-quality cleft care available to people in need 365 days a year while also creating a high tide that lifts all regional healthcare.

Nielsen wasted no time in applying, and when Smile Train’s staff met him, he instantly wowed them with his ability to focus on the big-picture while never losing sight of the real people before him — a skill they knew would prove exceptionally valuable in his new role as Smile Train’s first-ever Program Manager for Madagascar.

“The entire Smile Train Family is so excited to have Nielsen on board,” said Dr. Esther Njoroge, Smile Train’s VP and Regional Director for Africa. “He is a bright and determined young man dedicated to doing good, and I can’t wait to see him use his gifts to help build up Madagascar’s healthcare system and spread smiles across the country he loves.”