Dear friends,

As we reflect on the past year, we are humbled by the love and leadership demonstrated by our local teams and medical volunteers around the world. Despite the COVID-19 pandemic restricting travel and straining health care systems, our teams across more than 30 countries responded with innovative solutions to reach the patients who need us most.

Around the world, we established virtual speech therapy programs for patients awaiting surgery, donated medical equipment to hospitals combating oxygen shortages, shipped life-saving ready-to-use therapeutic food (RUTF) to families fighting food insecurities, and we provided critical supplies and trainings for infection protection control, all with the ultimate goal of enhancing safe surgery protocols.

The skill and passion of our global network of more than 6,000 medical professionals ensures we offer each child the same quality care we would expect for our own children. Over the years, our relentless focus on the quality of a child’s care has given us a window into the greater need.

In the countries where we work, we estimate that there are 5 million people living with untreated cleft conditions, most of whom live beyond the reach of existing hospital care. Therefore, we are called to increase access to and strengthen standards of surgical care. Through our expertise in treating cleft conditions, we are able to increase access to a comprehensive care model that meets the full range of a patient’s needs including speech therapy, nutrition, dentistry, orthodontics, psychosocial support and more.

As we leveraged Operation Smile’s strengths through the uncertainties of a global health challenge, we realized that 40 years of experience led us to co-create solutions with local medical leaders for the successful delivery of safe, quality surgery and cleft care.

Operation Smile’s investments in our local volunteers have equipped them with the skills and resources to withstand the challenges we are facing today. It set us up to launch our next decade of commitment.

Marking our 40th anniversary year, Operation Smile has announced a 10-year commitment to increase access to care for 1 million patients who need cleft care and other essential surgeries.

We will reach our goal by working alongside our local partners including ministries of health, donors, hospitals, corporations and academic institutions to scale up our investments to increase access to more and safer care. This means expanding opportunities for women in medicine, research, investing in the education of health workers, and empowering the next generation of global health leaders.

Since the day we started Operation Smile, the face of a child has always been our guide. Children born with cleft conditions took us back to their communities to show us the need and get us to pay attention to their health-system infrastructure. Through excellence in cleft surgery, we can now open the door to impact community health systems as we build on 40 years of trust. Our commitment to children born with cleft conditions is unwavering. Now, more than ever, we are called to expand innovative solutions that will lead us into the next decade of love and leadership.

Warm regards,

While our 2021 fiscal year* proved to be another challenging year for our patients, their families and our teams around the world, it was also a year that showcased Operation Smile’s commitment, resilience and adaptiveness.

The enduring COVID-19 pandemic presented our global community with adversity in myriad ways from lockdowns to food insecurity to health systems stretched beyond their limits.

Time and again, thanks to the unwavering compassion and generosity of our supporters and volunteers, our teams continued to provide patients with life-changing cleft surgery and comprehensive care amid daunting, ever-changing and complex circumstances.

_{*Operation Smile’s 2021 fiscal year was July 1, 2020 through June 30, 2021}

When communities around the world were hit hard by the virus, thousands of patients in need of cleft care were left waiting.

Our global teams of volunteers were mobilized into action as they sought out new ways of safely resuming surgery and care. On a global scale, Operation Smile implemented additional stringent safety protocols during surgical programs, including temperature screening, mask-wearing, COVID-19 testing, socially distanced screening areas, increased sanitation measures and more.

The health of our volunteers, patients and their families has always remained at the forefront of our mission. But in order to reach patients like Lilia amid fear and uncertainty, we needed to go beyond our typical approach.

Valeria’s eight-month ultrasound revealed that her daughter, Lilia, would be born with a cleft lip and cleft palate. She had already lost her job as a kindergarten teacher due to pandemic lockdowns, and, tragically, her husband passed away just before Lilia was born. Grief, fear, loneliness and doubt filled Valeria’s thoughts. Still, she persevered.

While it seemed as though her dreams for her daughter would remain out of reach, Valeria connected with Operation Smile Mexico. Hope replaced her fear, support replaced loneliness, and care replaced doubt.

Local volunteers provided Lilia with ongoing comprehensive care until it was safe to resume surgeries. In addition to receiving a cleft palate feeding plate that made it easier for her to eat, Lilia participated in virtual speech therapies that helped her emotional and speech development. Finally, at surgical programs conducted by teams of Operation Smile Mexico volunteers, Lilia received cleft lip surgery in March 2021 followed by her cleft palate surgery in September 2021.

“This has changed my life because I know there is always a hope,” Valeria said. “I know that I’m not alone; I know that my daughter counts on people, special angels who support her, that love her. I thank Operation Smile for how wonderful you are.”

As the pandemic impacts families and communities around the world, Operation Smile remains dedicated to providing comprehensive cleft care that helps our patients better breathe, eat, speak and live lives of greater quality and confidence. In addition to cleft surgery, our teams pioneered new ways enhancing our ability to deliver essential treatments including speech therapy, dentistry, psychosocial care, nutritional support and more. 

While most of this ongoing comprehensive care was performed with patients at our care centers, the sudden impact of the pandemic hitting countries worldwide made providing this care in person impossible. 

Driven to overcome these hardships, volunteer speech therapists and psychosocial care providers working in care centers across Latin America and the Caribbean established “HablemOS,” a virtual and telephone-based therapy program designed to reach patients affected by lockdowns or who live in remote areas. 

The HablemOS team have delivered speech consultations to more than 3,200 patients with the potential of reaching even more by replicating similar programs in the other countries we serve.  

“I want to give thanks to those who made this opportunity possible,” said volunteer speech pathologist Milagros Rojas. “COVID was not a limitation, because anything is possible when things are done with humanity and infinite love.” 

Learn more at operationsmile.org/hablemos

A common gap in the ability of low resource environments to deliver more surgical care is the lack of surgeons, anesthesiologists and nurses.

Once such place is Rwanda, where there are only two reconstructive plastic surgeons serving a country of more than 13 million people. To address this dire need, Operation Smile is partnering with the University of Rwanda, Partners in Health and the Rwandan ministry of health to reduce barriers to accessing reconstructive plastic surgery. The collaborative has evolved from a service delivery-focused partnership that hosted surgical training rotations twice a year to a health system-focused partnership.

This has allowed more than 25 general surgery residents to receive high-quality education throughout the program so far.

Operation Smile’s capacity-building efforts in Rwanda continue to evolve, as it’s currently participating in a three-year training program for reconstructive plastic surgery residents alongside its partners at the University of Rwanda, the College of Surgeons of East, Central and Southern Africa (COSECSA) and the Rwandan Surgical Society.

When the first cohort of residents graduate from the program in 2022, the number of Rwandan reconstructive plastic surgeons will more than double from two to five. Rwanda serves as an example of the types of multifaceted programs we are building with partners in countries around the world.

Operation Smile’s global medical education efforts also persevered during the COVID-19 pandemic through its American Heart Association (AHA) life support trainings, which empowered health care professionals from places of need with life-saving skills that strengthened their respective health systems.

From July 2020 through June 2021, Operation Smile hosted 67 AHA training programs in which 1,157 health workers participated. This included training for 111 trainers, and 1,115 total certificates were earned.

In many of the places where we work, health workers lack access to life-saving cardiopulmonary resuscitation (CPR) training. Last year through our 48 American Heart Association training programs in 20 countries, health workers earned 1,400 basic and pediatric advanced life support provider and instructor certifications.

While our teams around the world are meeting today’s challenges, Operation Smile continues to work toward a future where everyone has access to the safe, effective and timely care they need and deserve.

But doing so means that we need to help to solve some of the world’s most pressing problems in global surgery.

Led by Dr. Allyn Auslander, Associate Vice President of Research, we are currently conducting cutting-edge epidemiology and genetic research to understand risk factors for cleft conditions that are unique to our patient populations.

Based on nine years of data collected through Operation Smile’s International Family Study, we have published evidence that pregnant women who reported smoke exposure from cooking indoors during pregnancy were 49% more likely to give birth to a child with a cleft condition than those who did not in eight of our program countries.   

In addition to identifying actionable preventative measures, such as the use of safe cookstoves and education on the dangers of indoor open-flame cooking, the study also points to an urgent need for global representation in epidemiological and genetic research. The study currently has the largest and most diverse cleft genetic repository from low- and middle- income countries. This includes groups of people, such as patients with cleft conditions from Madagascar, who are rarely, if ever, included in peer-reviewed research.

“If the status quo in medical research and innovation holds, the same inequities that ensure world-class medical care for people living in high-income environments will mean that the majority of humanity – we’re talking billions of people – will continue to live without on an ever-increasing scale,” Allyn said. “… I believe the first step is representation in research and there is much work to be done.”

With one gift, Anthony L. Burgess found a way for his love of his late wife, Hideko, and their passion for Operation Smile’s mission to live on for generations to come.

Anthony donated $1 million with a bequest at his passing to provide the means for Operation Smile to create the Anthony L. and Hideko S. Burgess Interactive Learning Center (ILC) at its global headquarters in Virginia Beach, Virginia.

With its immersive experience, the ILC will promote empathy and encourage cultural inclusivity by allowing students and visitors to walk alongside a patient in a replica of our surgical program process to help them understand the challenges and realities of our patients and their families’ lives, as well as learn more about global health care.

"The bequest from Mr. Burgess is a full-circle love story," said Kathy Magee, Co-Founder and President of Operation Smile. "Mr. Burgess came into the organization as a monthly donor and, through our planned giving program, established a living legacy with the Interactive Learning Center. He made a generous decision to complete the project in honor of his wife and their 55-year marriage, knowing that the ILC will foster learning, education and cultural understanding for generations to come."

The ILC will honor Anthony, Hideko and their long-term devotion to the people we serve. Dan Burgess says his parents would be proud to have their names tied to something with the potential to inspire future generations to serve through empathy and love. 

“There is no greater joy than the joy of giving,” Dan said. “There really isn’t, and maybe they will take that away from this and incorporate that in their lives.”

Learn more at operationsmile.org/ilc

When Operation Smile Student Programs sees a need, it challenges its student volunteers to address it. And its young leaders answered the call through the “Sending Hope” initiative.

Knowing that proper nutrition and good health are key in ensuring that patients are healthy enough to receive surgery, Operation Smile’s student volunteers were determined to make sure that patients in Guatemala, Nicaragua, Panama and Paraguay received the support they needed amid the pandemic.

Students from nine countries banded together to provide meal kits and essential care items to help patients become healthy enough for surgery as soon as it was safe to do so. So far, the initiative has helped more than 800 Operation Smile patients, raised more than $80,000 and provided families with more than 9,000 health care items.

We simply wouldn’t have been able to provide our patients with world-class care, improve health systems nor respond to the many challenges posed by the pandemic without the support of the many partners that make our work possible.

Operation Smile is a global family, and we rely on the passion and dedication of our foundations in Australia, Canada, Ireland, Italy, Sweden and the United Kingdom that provide crucial funding for our programs around the world. These teams contributed $20,425,950, which accounted for 23% of our total revenue.

Last year, the Johnson & Johnson Baby Care campaign, “3 for Change,” was successfully launched in Colombia and Mexico, with co-branded products sold across more than 100 distribution points and a direct donation of $30,000 from the company. The campaign led to an 847% increase of individual donors during its first three months, with more than 527,000 people reaching Operation Smile Colombia’s Facebook page in less than two months. It included pediatric conferences, education initiatives and had a positive impact on the way we portray children born with cleft lip and cleft palate by presenting their stories in an uplifting manner.  

Baxter International Foundation made a three-year commitment of 2 million dollars from 2021 to 2023 to invest in our four care centers in India with the objective to ensure many patients and their families receive free surgical and comprehensive treatments, including covering the cost of lodging, transportation and meals while in our care.

A partnership that started eight years ago, our partnership with Mölnlycke is a comprehensive collaboration. Mölnlycke donates surgical gloves to Operation Smile and supports it financially through employee-led fundraising events to raise money for the organization. Mölnlycke has its own project in Cebu, Philippines, and has extended its global partnership with many “Mölnlycke Champions” all over the world.

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.

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.