In poor communities, patients may suffer from health problems requiring special management that cannot be provided locally because of lack of equipment and/or expertise. Children with craniofacial anomalies represent one of these challenging problems. Visiting medical missionary teams have attempted to address these issues for a long time. This article highlights healthcare difficulties in one of the third-world countries with personally based trials for providing free surgeries in tough situation and with hardly available diagnostic and therapeutic facilities. During 15 years, >5000 surgeries were performed in repeated missionary visits. The majority of operations were to correct post-burn complications or to repair cleft lip and/or palate. Of 33 cases of rare craniofacial anomalies, 14 patients were treated with simple soft tissue reconstruction without interference in the underlying bone deformities. This may not be optimal; however, it can give good results even with the limited resources.