Dear friends and supporters, 

We recognize that the work we accomplished last year simply wouldn’t have been possible without your unwavering commitment and passion to help us make our world a more caring and compassionate place for all. 

For 37 years, we’ve provided access to the highest quality of surgical care for patients and families living in resource-poor communities. And it’s through the persistent loyalty and ambition of our volunteers, partners, staff and supporters that we’ve been able to continue restoring the dignity of patients affected by cleft lip and cleft palate with safe surgery, while simultaneously evolving to strengthen health systems where we work through building trust and fostering relationships. 

Children possess an extraordinary power. Unifying people, cultures, families and governments, children inspired an alliance between two countries at a time when trust and friendship were effectively nonexistent between them. In 1989, Operation Smile became the first U.S. nonprofit organization welcomed back into Vietnam following the destructive and divisive conflict that ended decades before. 

It was through a chance encounter at my 25th high school reunion that we reconnected with the late John Connor, a Vietnam veteran who became involved with some of the first acts of goodwill between the U.S. and Vietnam. John knew that Operation Smile’s life-changing work could serve as a conduit for healing years of strain and distrust.  

We took a chance and soon learned that he was absolutely right. 

At our first medical mission in Hanoi, there was no room for hatred nor dwelling on the past. Our team worked side by side with Vietnamese medical professionals to change the lives of more than 100 children. We haven’t looked back since. Within four months of that first mission, the missing in action began their return to the United States.  

As we work toward our vision of a future where the health and dignity of all are improved through safe surgery, we’re utilizing our 37 years of expertise in treating cleft lip and cleft palate to create solutions that deliver safe and comprehensive care to people where it’s needed most. 

Addressing some of the world’s most pressing problems demands that we work in some of the world’s most impoverished and challenging environments. 

Mozambique is one of those places. 

In places like Mozambique, our patients and families face seemingly insurmountable barriers to accessing and receiving surgical care. It’s one of the world’s poorest and most impoverished countries with more than 46 percent of its 27 million people living in poverty. For nearly all of them, the cost of cleft surgery is impossible to afford. Compounding the economic barriers are the physical, with more than 63 percent of the population living in rural and remote areas far away from hospitals where surgery can be performed.  

While Operation Smile medical missions aim to increase access to cleft surgery for Mozambicans who need it, there’s also a need for potential patients and their families to learn that surgery is available through these programs. Many may not know that surgery can repair a cleft condition at all.  

Part of the ramp-up to the July 2018 Quelimane mission were the patient recruitment efforts of then-volunteer Carlos Mahalambe. Inspired by a poster promoting a medical mission back in 2014, Carlos was moved to help. He helped patients and families access care at both of Operation Smile’s 2014 missions in Mozambique and enthusiastically volunteered to support the July 2018 Quelimane mission. Carlos brought 18 patients to that mission before joining our staff full-time as a patient coordinator. At the following mission in Nampula in August 2019, he recruited 89 potential patients to Operation Smile’s care.  

Operation Smile’s commitment to patient recruitment and advocacy has helped thousands of patients access cleft care and fuels the growth of successful medical programs around the world. From the dedication of volunteers like Don Alex Guerrero in Honduras to Operation Smile Ghana patient coordinator Clement Ofosuhemeng, we’re building networks of like-minded people who understand the value of having their boots on the ground and engaging in face-to-face conversations and growing relationships that help ease fears and lead to healing.

Faustina realizes a brighter future that she ever thought was possible, her 17 years of suffering reminds us of the debilitating effects of living with an untreated cleft condition. We believe that access to safe, effective and timely surgery is not a privilege, it’s a fundamental human right. We also know that providing surgery through mission and care center activity is only part of the solution.  

It’s stories like Faustina’s that compel us to create sustainable solutions with the goal of strengthening health systems so that patients can receive the surgery that they need, when they need it, close to home. 

In places around the world like Ghana, health systems are not able to meet the demand for cleft surgery and many more essential surgical conditions. Patients’ families’ financial means and physical distance from care are compounded by many hospitals’ lack of highly trained health workers that can deliver quality care, equipment, supplies and infrastructure.  

For decades, Operation Smile has invested in the training and education of health workers in low- and middle-income countries so that they can provide high-quality care both during our medical programs and every day at their home hospitals.

In Rwanda, our commitment to strengthening the skills of local health workers continues through twice-annual surgical training rotations, which provide general surgery and anesthesia residents with hands-on training in reconstructive plastic surgery techniques.  

Rwanda faces dire challenges when it comes to the number and skill of its health care professionals: Only two reconstructive plastic surgeons and 18 anesthesiologists serve the country of nearly 12 million people. 

And the need extends far beyond cleft conditions. Much of the surgical demand in the country results from trauma and burn wounds. The lack of adequately trained surgeons forces some patients to wait for years before they’re able to receive treatment, which worsens their conditions and further burdens the health system. 

But through the rotations, more than 25 Rwandan general surgery residents have completed the training, bringing these life-changing and life-saving skills to communities across the country. The rotations have also strengthened the skills of residents in anesthesiology, another area of massive need in Rwanda, with five graduates completing the program since its inception. 

After many years of working together to enhance the level of care hospitals offer patients, Operation Smile and Vietnam proudly announced the establishment of eight new guidelines for patient safety.  

Co-created by the organization and Vietnam’s Ministry of Health, these standards for safe surgery will impact the entire country.  

Available for adoption at 1,450 medical facilities and 63 provinces across Vietnam, the guidelines have the potential to affect up to three million surgeries every year. 

The announcement during a conference held in Hanoi on April 2, 2019, not only signified a major milestone for Operation Smile and the country but marked a vital step toward advancing the future of surgical care for families living in Vietnam.   

As Operation Smile continues expanding its long-term impact into more countries, we’re forced to witness the devastating effects of hospitals operating with inadequate equipment and infrastructure.  

We believe that for our patients to live healthy and dignified lives, we must not only create solutions that eliminate gaps separating patients from care but ensure that the highest quality of surgical excellence is available to the people who arrive seeking help. 

In rural northeastern Nicaragua, these needed life-changing solutions are already providing people with care that wasn’t available to them a few years ago thanks to the pilot project called “Surgery for the People.” 

With the high-quality facilities, cutting-edge laparoscopic equipment and advanced training of the medical staff, patients are experiencing new methods of treatment and healing at the two primary hospitals in Siuna and Bonanza.  

Today, less people are being turned away without care, more lives are being saved and patients are returning home to their families and loved ones just days after surgery.   

Over the years, we’ve recognized that upholding our promise of treating the whole patient means we must go beyond surgery and beyond the medical mission.  

Even after receiving cleft surgery and leaving the mission site, many patients still require additional treatment to fulfill their physical and emotional needs. 

By increasing the availability of ongoing, comprehensive services like speech therapy, dentistry, orthodontics, psychosocial care and nutrition at our year-round care centers, Operation Smile and its community of devoted volunteers deliver a level of complete care that every human deserves. 

Our commitment to ensuring that our patients thrive in life is evident in the work we’re achieving in Morocco. 

Improving a patient’s ability to communicate clearly to friends and family members makes speech therapy one of the most essential and prominent disciplines of comprehensive care provided by Operation Smile.  

Thanks to volunteer speech language therapists like Salmah Kola of South Africa, patients receive opportunities to thrive in every aspect of life.  

Q: Can you describe the value that speech language therapists bring to Operation Smile’s patients? 

A: “Speech therapists play a vital role in many areas within the mission context, namely feeding, speech development and correction, and language development across all ages. People with a cleft palate often present speech problems, making their speech difficult to understand and resulting in bullying or being shunned by the community. Although a cleft palate surgery fixes the palate, these patients often require follow-up speech therapy. This can be a long-term need, and all patients are encouraged to return to follow-up missions to assist with their speech.” 

Q: Have you been involved in training and education for Operation Smile? What is the value of providing those educational opportunities for medical professionals? 

A: “Collaboration is a recurring theme here, and a by-product of collaboration for me is capacity-building and upskilling. Every single mission that I have been on has included a training component. The training is as important as the surgeries that are performed. By equipping local volunteers with knowledge and skills, we ensure that the legacy of comprehensive care continues long after we have left.” 

Q: How do you feel that your service to Operation Smile has made you a better professional? 

A: “I have and will always maintain that although going on missions means that we give and share of ourselves and our expertise, we are also very much on the receiving end. The impact missions have had on me as a professional are great and valued, but these are not as important as the impact it has had on me as a human being. I have been humbled to be lucky enough to be a small part of this gigantic puzzle. I’m honored to work with people from all over the world who entrust me with something as valuable as their loved one’s feeding and communication. 

“The exciting thing about volunteering with Operation Smile is that the services we offer are constantly being monitored and improved upon. Working with the population affected by cleft is about more than just the aesthetic change. It’s about the changes we can make to our patients’ quality of life in the long term.” 

Regardless of what challenges arise, Operation Smile strives to help its student volunteers overcome obstacles and evolve into advocates of change for children living with cleft conditions.  

In Winston-Salem, North Carolina, our International Student Leadership Conference united more than 350 high school students from 21 countries around the world at Wake Forest University to engage with each other, learn from motivational speakers and participate in collaborative leadership training.

At just 10 years old, Elizabeth Alberti was facing her seventh surgery to repair her cleft condition. While Elizabeth was initially nervous about undergoing another procedure, her anxiety soon evolved into advocacy.

“One afternoon, she had a sudden burst of perspective,” Elizabeth’s mom, Heather, recounted. “She said, ‘Mom, here I am pushing back about having another surgery, and I just realized that there are kids all over the world who would give anything to have just one.’” Empowered and inspired by her surgeon and Operation Smile volunteer Dr. Arun Gosain, Elizabeth decided to help children living with cleft conditions access the same quality of care that she received through launching the first “Team E” digital campaign.

After sharing her story, posting personal videos and speaking openly about the challenges of living with a cleft condition, it wasn’t long before Elizabeth raised $16,000 for the organization, successfully giving more than 60 children new smiles. 

For the second consecutive year in a row, Operation Smile was proud to extend our impact to more patients and families with the help of our incredible corporate partners.  

In 2019, we teamed up with Lay’s once again to spread smiles across the country with the #SmileWithLays campaign! Our specially designed “Smile Bags,” featuring some of our dedicated volunteers, were available across the U.S. Thanks to another successful campaign, Lay’s made a $1 million donation to Operation Smile! 

With a burgeoning population and less than 5 percent of gross domestic product expenditures directed toward public health care, the health system in India is ill-equipped to provide comprehensive care to those living with cleft lip and cleft palate throughout the country. Currently, the backlog of untreated cleft cases stands at an estimated 200,000. 

With a shared vision to address this dire need, the Baxter International Foundation has committed $2.2 million over three years to support a project that advances safe surgery in India. With this support, we are implementing a scalable solution for equitably increasing access to surgical and multidisciplinary cleft care for some of the world’s most marginalized patients.  

The funds support the ongoing maintenance of Operation Smile’s three year-round multidisciplinary and surgical care centers in Mumbai, Srinagar and Bangalore, operated in partnership with INGA Health Foundation. In addition, the funds helped Operation Smile launch a new center in Durgapur, West Bengal, at the IQ City Narayana Multispecialty Hospital on March 7, 2019. The Durgapur center serves as a hub for operations, supporting surgical service, multidisciplinary care, education and training, and ongoing medical programs in West Bengal and surrounding states.  

Over the coming three years, this project is expected to impact 300,000 patients, family members, community members and health workers.

Read more for our financial statement and board information.

We hold ourselves accountable to the trust you place in our work to improve health and dignity through safe, effective and timely surgery.

Committed to being the best steward of your gifts, we direct funds to programs that bring the highest standards of care to people living with cleft and other facial and dental conditions. Our stringent medical standards require the purchase of high-quality, and therefore high-cost, medical supplies, which are then shipped worldwide to our program sites. We send skilled medical and nonmedical volunteers to be beside patients who need them. By training and credentialing local medical professionals, we empower them to deliver world-class care in communities where they live. For patients and families facing financial hardship in order to attend our programs, we cover the costs of transportation, lodging and food. By partnering with national governments and other organizations, we’re working toward long-term health system improvements so that future generations can receive care in their communities. It’s our honor to participate on the world stage of surgical innovation and excellence to raise awareness about cleft conditions, safe surgery and the need for more equitable health services globally. 

Most importantly, we pride ourselves on following the highest standards of accountability, effectiveness and efficiency.

As one of the largest volunteer-driven surgical organizations, Operation Smile celebrates the hundreds of employees around the world who work tirelessly to ensure that the organization continues to extend its impact. Our heartfelt gratitude also goes out to the families of employees and volunteers whose sacrifices make our life-changing work possible.