An early indication of the extent of Elana Ho Tsao Yuk-lan's devotion to children came in her mid-20s. The wife of a lawyer, and with two children of her own - including a daughter with special needs - Ho adopted her sister's three children. They all lived together in a 600 square foot flat. "We had to change all the beds to bunk beds," says Ho. "I was 26 at the time. My husband, Dennis, had just qualified. My sister divorced and neither side wanted to take on the children." So she did. Since then, Ho's work with orphanages on the mainland has resulted in hundreds of babies with cleft palates being given surgery and the chance of a much more positive future. Shockingly, babies with cleft palates are still abandoned by their families or left to starve to death, despite this being a straightforward medical process. "In 2003, I went to see an orphanage in Fuzhou ," says Ho. "It was so sad and pitiful. More than 200 babies were all sick. I remember looking at an eight-month-old baby and she was telling me so much from her eyes. I felt so restless." Ho looked around to provide fundraising for organisations already working in this area, "but their accounts were messy. With Starfish, there is zero management costs." Ho, with other committed Christians, formed the Starfish Charitable Foundation in 2006 to raise funds and provide medical expertise for operations for orphans on the mainland. Surgery is not restricted to cleft palates; conditions such as spina bifida have also been treated. If you take a look at some of the babies on the Starfish Charitable Foundation website, it's easy to see the impact that Ho's work has had. Babies with cleft palates have startling faces pre-operation, but afterwards they have a simple scar - and a much brighter future. "Orphans often have a very bad start," says Ho. "But they can end up in the same place as you and me, if they have help in the beginning. They don't need our sympathy." She cites the example of nine-year-old Jonathan, who was one month old when Starfish took up his case. "We thought he only had club feet, but then he had a similar virus to Sars when he was three months old," she says. "He walked at the age of three and is so smart. He stayed in a foster home in Shanghai and last week an American family adopted him. His case would have been diagnosed as hopeless - but we have a lot of miraculous cases like that." Ho and her team now work with more than 20 orphanages on the mainland. "I fly every month, sometimes twice a month," she says. "I have to thank my husband, children and helpers for supporting me. We really serve as a team. Without them I wouldn't be able to travel so frequently." There are four doctors on the Starfish team and a committee, which discusses and approves each medical process. "So far we have taken on some 250 medical cases," says Ho. Among the doctors is Dr Edward Sitt Wing-hung. "It's so encouraging to work with these people," says Ho. The cleft palate surgery takes about 40 minutes at different hospitals on the mainland. "Every year we have about 40 cases. We work with another charity, HIS Foundation. The whole team goes to the mainland for a week and they operate on 20 to 25 kids on one trip. "We organise all the patients and then the doctors do [the operations] for free. We pay for the medical fees for the hospital and the transport and caring fees." More serious problems such as congenital heart disease and spina bifida are sent to Shanghai, says Ho. "So every month, six orphans from different parts of China come to Shanghai for different kinds of surgery." There's no doubt that the surgery for the children absolutely changes their lives and prospects for the future, but Ho says the experience of going on this journey with these children through Starfish has also been life-changing for her and the team. "I'm just an ordinary mum. I never thought Starfish would go that far. I just thought if I could help five or 10 babies …"