From March 23 to 26, 2026, your support made it possible for Operation Smile to host the fifth edition of the MEPA training course at CHUJRA Antananarivo, the capital of Madagascar. This program brought together anesthesia providers from across the country for four days of rigorous, hands-on learning. Together, we helped them sharpen the skills that matter most when a child’s life depends on a fast, confident response.
What the MEPA Program Looks Like on the Ground
More than 139 providers applied to participate. Twenty-one were selected. Those 21 anesthesia providers traveled from five regions across Madagascar to take part in training that goes well beyond a classroom.
Because of you, MEPA uses high-fidelity simulation, the same technology used in leading medical training centers worldwide, to replicate real pediatric anesthesia emergencies. Participants practice managing critical scenarios in conditions that mirror actual operating rooms, building both the technical precision and the non-technical judgment that emergency care demands.
Non-technical skills, communication under pressure, clear decision-making and team coordination are as central to the curriculum as clinical technique. When seconds matter, how a team works together is just as important as what each individual knows.
Why Simulation-Based Learning Changes Outcomes
Safe surgery depends on providers who can respond calmly and competently when the unexpected happens. For pediatric patients, the stakes are especially high. A child’s body responds differently to anesthesia, and a mother’s worst fear can escalate quickly.
High-fidelity simulation gives providers the opportunity to experience those moments in a controlled environment, make decisions, correct mistakes and build confidence, before a real child is on the table. Your partnership ensures a care team has already practiced the hardest scenarios and knows exactly what to do.
MEPA structures this experience deliberately. Each simulation is followed by debriefing sessions that reinforce learning, surface gaps and develop shared mental models among team members. Because of your kindness, participants leave not just with sharper skills, but with a deeper understanding of how to function as a cohesive unit in high-pressure moments.
The Power of Bringing Five Regions Together
The diversity of this cohort matters. Participants arrived from five different regions of Madagascar, each bringing local knowledge, distinct professional networks and varying clinical contexts. That mix is intentional.
When providers from different regions train together, they learn from each other as much as from the curriculum. They exchange approaches, build relationships and carry those connections back to their home hospitals. The professional networks formed during a four-day course can shape how teams communicate and collaborate for years.
This peer learning model reflects a core belief at Operation Smile: strengthening health systems means investing in the people who lead them. You are ensuring those people are connected to one another.
Building Emergency Preparedness That Protects Children
The direct impact of MEPA is measured in readiness. Providers who complete the course return to their hospitals better equipped to prevent anesthesia-related complications, recognize warning signs earlier and respond to emergencies with greater speed and accuracy.
For pediatric surgical patients, including children receiving cleft care, your support translates into safer operations and better outcomes. Improved anesthesia management reduces the risk of complications during and after surgery, supports stronger recoveries and expands the range of procedures that local hospitals can perform safely.
Patient safety is not a single intervention. It is a system. You are strengthening one of the most critical links in that system.
A Long-Term Commitment to Local Expertise
This was the fifth time your generosity allowed Operation Smile to deliver the MEPA course in Madagascar. That continuity is significant.
Sustainable health care is not built through one-time training events. It is built through your repeated investment in local providers, expanding the base of skilled professionals who are permanently embedded in their communities. With each iteration of MEPA, you equip more anesthesia providers across Madagascar to deliver safe pediatric care. More children benefit from that expertise every day, not just during surgical programs.
This is what long-term commitment looks like in practice: showing up again, going deeper and building something that lasts.
Madagascar already has one of the most comprehensive integrated care models in Operation Smile’s global network, combining nutrition support, surgical care and community health systems. Programs like MEPA strengthen the clinical foundation that makes that model work. You are the reason this foundation is strong.
Impact Beyond Surgery: From the Field is a content series from Operation Smile Canada that shares real stories from programs around the world. Each piece is told through the perspectives of the local teams and communities at the heart of this work, because the most important measure of impact is what happens on the ground, in the hands of the people who show up every day to care for their communities.
