Annual Report 2020

2020 Annual Report

Henitsoa Rafalia

A Letter From Our Co-Founders

Dear friends,

As we all know, 2020 was an unusual year. Yet, through the challenges posed by the COVID-19 pandemic, Operation Smile accomplished many remarkable things. Together, we continue to move forward. The challenges we’ve faced have also allowed us to be creative to enhance and innovate what we’ve been able to do in the past. We know that our obstacles have become our opportunities.

The immense need for safe surgical care for people living with cleft lip and cleft palate kept us focused. We mobilized and pushed forward to continue our commitment to the children and the families that we serve. Our teams continue to work hard to support the fight against the pandemic. In this way, our challenges have become our strengths.

This display of commitment has fortified our relationships with governments and their ministries of health as we collaborate to enhance their health systems. These relationships are so important as we look forward to our 40th anniversary with a goal to greatly expand our impact.

Our dream is to create an equal opportunity for every child to receive extraordinary cleft care.

To reach more children and families, we will bring our expertise closer to their homes and into their communities. By working hand-in-glove with local health professionals in their hospitals, we can help bring world-class cleft surgery and comprehensive care to places where it hasn’t been before. This expansion wouldn’t be possible without the support of our donors, volunteers, students, foundations, partners and staff by our side. We profoundly thank every one of you as we innovate and establish new ways to reach the children and families to whom we are so committed.

As Operation Smile’s Co-Founders, we have always believed in the power of children to unite people. Their intrinsic energy, paired with the reality of economic and health disparities beyond their control, opens countless doors and ensures the progress of Operation Smile. As we look ahead, we are excited to accompany you on this extraordinary journey, as we provide a renewed opportunity for so many beautiful families around our world together.

All our best,

Caring Never Stops

COVID-19 has changed the world in ways we couldn’t have imagined before it arrived. In March 2020, we decided to postpone our programs for the months ahead to keep patients, families, volunteers, staff and their communities safe. More than 10,000 people scheduled for cleft surgery and dental care would have to wait longer for much-needed treatment.

Our hearts ached, but we were also inspired to act.

Many of our kind and courageous medical volunteers joined their colleagues on the front lines. Our teams created new opportunities for the virtual training and education of health workers around the world. And eventually – wherever possible – we continued providing life-saving cleft surgeries.

Amid pain and uncertainty, we united behind three words:

Caring never stops.

Our teams around the world proved just that.

Fortifying the Front Line

As the pandemic challenged health workers everywhere, we knew that we had a responsibility to help. With hospitals unable to meet the sudden demand, supplies of personal protective equipment (PPE) were rapidly consumed as COVID-19 spread.

We quickly provided hospitals around the world with donations of millions of units of PPE including face masks, surgical gloves, face shields, goggles, hand sanitizer and more to protect front-line staff. Following the evidence as guided by medical experts and top scientists, our medical leadership bolstered our already-stringent infection protection standards to create the safest possible environments for our patients, families, volunteers and staff.

In our home community of Virginia Beach, Virginia, we also donated PPE to the hospital in our neighborhood. Across the United States, our student volunteers delivered thousands of meals and encouragement to front-line heroes.

Working with partner organizations, we helped distribute 168 oxygen concentrators and 200 pulse oximeters to hospitals across Africa, improving intensive care units. We also delivered online life support training and educational seminars that helped health workers in low- and middle-income countries rise to the challenge.

Commitment Amid the Crisis

At the same time, we kept the health and well-being of families affected by cleft lip and cleft palate close to our hearts.

Due to lockdowns and travel restrictions, many families struggled to feed their loved ones and protect themselves against the spread of the virus. Untreated cleft conditions can also put children at a higher risk of becoming sick. We knew we needed to reach as many families as we could.

Around the world, Operation Smile volunteers and staff rallied to help hard-hit communities. In Madagascar, our team put together packages of food, hand-washing supplies and washable masks and safely delivered them to families.

Extra Smile Nutrition Campaign

“With this health crisis, Operation Smile has not forgotten him, nor us,” said Vololona, the grandmother of Icardi, a Malagasy child awaiting cleft surgery. “We’re extremely grateful.”

Teams around the world led similar efforts, providing more than 300 cases of ready-to-use therapeutic food in response to COVID-19, a nutrient-rich peanut paste, to help children suffering from malnutrition grow healthy enough for surgery. Including the months prior to the pandemic, we distributed 779 cases of life-saving peanut-based nutritional products to 10 countries during the 2020 fiscal year.

And in Latin America, we engaged with patients though we were physically apart. Children affected by cleft conditions often need speech therapy and psychosocial counseling as they grow. Using smartphones and computers, we began hosting virtual consultations to continue providing these crucial treatments.

Impact Before the Pandemic

As we reflect on the lives we helped change before the pandemic, we realize that our legacy of healing led us to this moment. Once again, we’re providing surgery and in-person care while taking stringent measures to keep families safe. Hope is on the horizon. And we remain focused on what cleft care makes possible for children, helping them to better breathe, eat, speak and live with confidence.

111 medical missions

We conducted 111 medical programs across 74 sites in 29 countries. Of that total, 80 missions were conducted by a majority of local medical volunteers who are elevating their countries’ standards of cleft surgery and comprehensive care for the long term.

3 New Medical Sites

Medical programs extended to three new sites in three countries including China, Mozambique and Russia.

15,100+ Patients Healed

We provided more than 15,100 patients with surgery and dental care at medical programs and care centers in 31 countries last year. Since 1982, we’ve helped more than 314,000 people receive life-changing surgical and dental care that opened up worlds of newfound health, livelihood, joy and acceptance.

247,200+ Patient Interactions

We provided more than 247,200 patient interactions including patient health screenings; operations and post-operative care at medical missions; dental screenings and procedures; and operations and consultations at care centers. It takes the expertise and effort of many specialists to ensure the health and well-being of our patients. We strive to provide comprehensive care so patients and families can thrive both before and after surgery.

31 Care Centers

Operation Smile operates 31 care centers in 19 countries providing year-round medical services. At our care centers, we’re providing multidisciplinary cleft care that’s more accessible to patients, allowing them to get care closer to home when they need it.

78% of Volunteer Positions

We’re proud that 78% of the medical volunteer positions filled on our missions in fiscal year 2020 were held by health care professionals from low- and middle-income countries; a majority of whom received training and education from Operation Smile.

$20,233,251 of Donated Medical Care

In fiscal year 2020, 5,490 medical volunteer positions were filled by skilled and passionate professionals who donated 237,264 hours. If Operation Smile had to pay for their medical services, it would have cost at least $20,233,251. Our work is made possible through their compassion and generosity.

Women in Medicine: Inspiring a Generation

We surround ourselves with highly skilled medical volunteers who are creating opportunities to educate, encourage and empower the next generation of advocacy-minded leaders.

However, women serving in medical roles in resource-limited environments can face obstacles as they pursue leadership positions. This inspired our first international medical mission comprised entirely of female volunteers: Women in Medicine: Inspiring a Generation.

“For me, being an instructor or teacher in this is extremely important because we need a generation to inherit this and inspire generations,” said Dr. Teresita Pannaci, volunteer dentist and instructor. “When I see this new generation that we're beginning to train, they're working, they understand what their role is, they are committed to the lives of patients."

This collaborative environment offered young female medical professionals with training that enhanced their skills and inspired them to become leaders in their field.

In fact, 93% of the mission’s volunteers felt motivated to become leaders in Operation Smile following the experience, and 97% felt inspired to help lead their specialties in their home countries.

We hope that these talented women – and all our medical volunteers – devoted to improving the well-being of others will serve as role models for ambitious women and men aspiring to change lives.

1,400+ health workers trained

More than 1,400 health workers across an array of medical specialties including surgery, dentistry, speech therapy, nursing and more received specialty-specific training at both medical missions and education programs.

Resident Leadership Program

We created opportunities for 57 medical residents from 21 countries to bolster their skills in surgery, anesthesia and pediatrics through the Resident Leadership Program. Twenty-three of those residents served on medical missions in 12 countries.

1,400 American Heart Association certifications 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.

Ensuring Care Where It’s Needed Most

As we continue navigating new ways to safeguard our care delivery, our local volunteers are reaching and serving patients and their families during this trying time, reinforcing just how vital our in-country teams are to the success of our organization.

For patients like Lexxi who lives in a very remote village and Pedro, whose family fled turmoil in Venezuela to Colombia in search of a better life, receiving surgery and ongoing care for their cleft conditions once seemed unimaginable. But through local missions in Colombia – programs that are run entirely by Colombian volunteers – hope prevails for these hardest-to-reach patients.

With more children like Pedro and Lexxi waiting for the day when safe and timely surgery changes their lives, local efforts in Colombia illustrate how we can provide essential care for patients closer to their communities in more places around the world.

Places like Durgapur, India.

Through patient outreach efforts at its Durgapur Cleft Center, the Operation Smile India local team addresses the need for safe cleft care in the surrounding districts and communities.

Having provided more than 1,000 surgeries since its opening, the Durgapur center not only makes surgery available for patients like Shyam but provides them with the complete care they deserve like dentistry, speech therapy and orthodontics.

The trust placed in the volunteers and staff by families solidified their commitment to step up when patients’ needs extended beyond cleft care amid the pandemic.

Distributing hundreds of care packages to families, the Durgapur center provided families with weeks worth of food and hygiene products when lockdowns caused devastating job losses.

“When we started this, we wanted to start small with the center. We started by advancing safe surgery, then we started adding the other components,” said Abhishek Sengupta, Operation Smile India’s executive director. “The next step is taking things to the community – to connect the last mile for our patients.

Global Essential Surgery Project

Though we remain committed to providing people with the cleft surgery they deserve, we’re also working toward a day when everyone can receive the safe, timely and effective care they need closer to their communities.

Financially supported by the UBS Optimus Foundation and in collaboration with ministries of health, NGO partners and local stakeholders, health workers, and hospitals, our Global Essential Surgery project addresses the root causes that prevent hospitals from treating more people living with conditions that can be healed by surgery. The project seeks to provide more training opportunities to improve the skills of health workers, revitalize critical infrastructure, and address barriers that prevent patients from seeking or reaching care.

At designated hospitals in Madagascar, Nicaragua and Vietnam, the project has trained more than 1,000 health workers, built new operating rooms, created safe surgery protocols and raised communities’ awareness of surgically treatable conditions that are served at those hospitals.

Early results are promising: The number people receiving surgery at these partner hospitals has increased by more than 60% since the project began. More people are seeking care, hospitals are better able to meet this new demand, and both patients and care providers are satisfied with the results.

Empowering Youth Worldwide

When challenges arise, our global community of student volunteers has repeatedly proven their commitment to advocating for the lives of children affected by cleft conditions.

“Who would’ve known 38 years ago when we got kids involved that we’d be where we are today,” said Operation Smile Co-Founder Dr. Bill Magee. “We need you now more than ever before.”

Even as the world confronted COVID-19, 90 students across the U.S. and Latin America once again demonstrated their selfless spirit by delivering meals to hospital health care workers through the Serving Smiles project.

Since its launch, Serving Smiles not only brought much-needed business to family-owned restaurants during the pandemic but delivered more than 6,300 meals to local hospitals in 12 states, fueling thousands of medical professionals on the front lines.

To me, that’s inspirational and shows how one small act can go a long way for another,” said Abby Hendrickson, student volunteer from Virginia.

This project underscores the impact our passionate student leaders have when united under a common cause of helping those in need.

The Power of Partnerships

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 truly a global family, and we rely on the passion and dedication of our partner country foundations that provide crucial funding for our programs around the world. Our teams in Australia, Canada, Ireland, Italy, Sweden and the United Kingdom contributed $12,925,961, which is more than 12% of our total revenue.

In addition to establishing the Durgapur Cleft Center, Baxter International Foundation’s investment in our four care centers in India ensured over 1,750 patients and their families received free surgical and comprehensive treatments and covered their costs of lodging, transportation and meals while in our care in 2020.

Longtime corporate partner Stryker has supported a wide range of our training and education programs, including surgical training rotations in Rwanda that taught 33 general surgeons’ skills in reconstructive plastic surgery that they are now practicing in their communities.

Last year, the Smile with Lay’s campaign raised $1 million, bringing its three-year total to $3 million in donations. We were honored to have our Co-Founder and President Kathy Magee featured on her own “Smile Bag,” as well as volunteer Dr. Dane Hoang and student volunteer Brady Hishmeh.

Birdsong Peanuts provided ready to use food

Since 2017, our partnership with Birdsong Peanuts has provided ready-to-use therapeutic food (RUTF) for thousands of patients born with cleft who are suffering from malnutrition in 10 countries. A nutrient-rich peanut paste, RUTF is saving lives by providing crucial nutrition so more children can receive safe surgery.

Since 2011, Mediterranean Shipping Company has donated more than $2 million to Operation Smile. Last year, its employees volunteered alongside medical teams in Guatemala, Mexico and Paraguay and helped transport cargo to medical programs in Ghana, Malawi and Madagascar.

Direct-sales paper-crafting company Close To My Heart’s consultants have raised more than $1.8 million since 2007, enough to provide 7,500 surgeries, through various grassroots campaigns and fundraisers.

Since 2013, our supporters shopping on Amazon raised more than $333,000 for Operation Smile as their charity of choice through AmazonSmile.

Bob & Joan Scheel

Bob & Joan Scheel

Generous supporters like Bob Scheel allow our teams around the world to deliver comprehensive and innovative programs. Bob’s gifts support our care center in Guatemala, a country that holds a special place in his and his family’s hearts. “I understand the economic challenges many Guatemalan people endure and the difficulties of accessing medical care and surgery,” Bob said. “Helping to change the lives of children is something I have always been passionate about and is truly dear to me.”

In 2020, we also welcomed new gift-in-kind partners, whose gifts help us reduce the overhead cost of items that are essential to our programs. We’d like to thank B. Braun Medical Inc., Glenmark Pharmaceuticals, Hikma, Jubilant Cadista Pharma, Sandoz Inc., Clif Bar & Company, GenDose Pharmaceuticals, GE Healthcare and Stratic Lederwaren for their support.

We’d also like to thank each and every one of our compassionate supporters who come from all walks of life to join our journey of hope and healing. Every dollar you contribute means that we come one step closer to a future where the health and dignity of all are improved by safe surgery.

Financial Statement

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.


  • Contributions$83,556,264

  • Gifts-in-kind3,294,824

  • Contributed services20,233,251

  • Other1,125,640

  • Total$108,209,979


  • Program Services

  • Medical missions$38,709,980

  • Education & sustainability22,458,012

  • Total programs services61,167,992

  • Fundraising 21,747,539

  • Administration7,121,110

  • Other3,000

  • Total Expenses$90,039,641


  • Assets

  • Cash & investments$40,939,373

  • Other current assets15,405,401

  • Property & equipment18,385,518

  • Total assets74,730,292

  • Liabilities

  • Current liabilities6,674,832

  • Capital lease obligations68,400

  • Total liabilities6,743,232

  • Net Assets

  • Unrestricted54,086,795

  • Temporarily restricted13,900,265

  • Total net assets67,987,060

  • Total liabilities & net assets$74,730,292

Board of Directors


  • Board Director
  • CEO, RoundhouseOne
  • San Francisco, Calif., U.S.


  • Board Director †
  • Chairman of the Board and President, Boyd Steamship Corp.
  • Panama City, Panama


  • Board Director *
  • Retired Plastic Surgeon
  • Quinton, Va., U.S.


  • Board Director †
  • General Dentist and Owner, First State Dental P.A.
  • Wilmington, Del., U.S.


  • Board Director and Officer
  • President and Co-Founder, Operation Smile
  • Virginia Beach, Va., U.S.


  • Board Director
  • Former Co-Owner,
  • American By-Products Recyclers and Planet Earth Biodiesel
  • Atlantic Highlands, N.J., U.S.


  • Board Director and Officer
  • CEO and Co-Founder, Operation Smile
  • Virginia Beach, Va., U.S.


  • Board Director and Officer §
  • Managing Partner, Federal Capital Partners
  • Chevy Chase, Md., U.S.


  • Board Director and Officer
  • COO and Partner, J.R. Reingold & Associates
  • Alexandria, Va., U.S.


  • Board Director and Officer *
  • CEO and Founder, Swift Transportation Company
  • Phoenix, Ariz., U.S.


  • Board Director ‡
  • Secretary General, World Information Technology
  • and Services Alliance
  • Ashburn, Va., U.S.


  • Board Director ‡
  • Managing Director and Portfolio Manager, PIMCO
  • Newport Beach, Calif., U.S.


  • Board Director ‡
  • President, Bruce Smith Enterprise
  • Virginia Beach, Va., U.S.


  • Board Director and Officer
  • Partner,
  • Thorn Run Partners LLC
  • Washington, D.C., U.S.
  • Founder & CEO
  • Healthcare Lighthouse
  • Denver, Colo., U.S.

* Term ended 12/2019

Term started 3/2020

Term started 6/2020

§ Term ended 6/2020

Senior Leadership


  • Officer
  • Chief Financial Officer, Operation Smile
  • Virginia Beach, Va., U.S.


  • Officer
  • Chief Medical Officer, Operation Smile
  • Virginia Beach, Va., U.S.


  • General Counsel, Operation Smile
  • Virginia Beach, Va., U.S.


  • Officer
  • Chief Development Officer, Operation Smile
  • Virginia Beach, Va., U.S.


  • Chief of Logistics and Facilities, Operation Smile
  • Virginia Beach, Va., U.S.


  • Officer
  • Vice President of Global Media Strategy and Public Relations, Operation Smile
  • Virginia Beach, Va., U.S.


  • Board Director and Officer
  • President and Co-Founder, Operation Smile
  • Virginia Beach, Va., U.S.


  • Board Director and Officer
  • CEO and Co-Founder, Operation Smile
  • Virginia Beach, Va., U.S.


  • Senior Vice President of Global Philanthropy, Operation Smile
  • Virginia Beach, Va., U.S.


  • Officer
  • Chief Operating Officer, Operation Smile
  • Virginia Beach, Va., U.S.

Senior leadership as of June 30, 2020

Creative Credits

We work with an incredible group of creative professionals, volunteers and supporting staff who help us connect global audiences to the heart of each story we tell.

Their approach to portraying the beauty and dignity of patients, the passion of volunteers and supporters, and the orchestration of our medical programs allows us to experience an indelible memory in the moment that the video, photo or story is captured, no matter where we are in the world. Thank you for your part in bringing these stories to life.

Abhishek Sengupta, Aimee Berniard, Alexandra Bitonti, Alison Smyth, Andrea Jacoboski-Taylor, Asha Patel, Ashley Gutierrez, Beny Zambrano, Bethany Bogacki, Carlos Rueda, Chris Lane, Clement Ofosuhemeng, Clinton Homuth, Cristian Roncancio, Dalia Abouelwafa, Daniel Aldamiz, Dede Kwadjo, Dylan Davenport, Elikem Nyavor, Emilee Anderson, Emmanuel Amass Amankwah, Evie Etienne, Fouzia Mahmoudi, Gary Marshall, George Knowles, Hentisoa Rafaliarifaly, Holly Zoeller, Hussam Ellauzi, Isabella Garzón, Jacob Watson, Jasmin Shah, Jena Bright, Jenna Weiler, John Essick, John Streit, Jorge Saim, Joy Knowles, Justin Weiler, Karey Gardner, Karolina Mottram, Kat Millar, Kat Wallace Knowles, Katie Downtain Ward, Kayla Milligan, Kelvin Turner, Kody Zenger, Laura Gonzalez, Lauren Bright, Laurie Messenger, Leila Hemaidan, Lorenzo Monacelli, Madison Ebel, Marc Asher, Margherita Mirabella, Minna Moisio, Nelson Moreno, Nicholas Nottage, Nicole Bell, Nicolette Tallmadge, Nour Mahmoudi, Oli Cohen, Paul McReynolds, Payton Davenport, Reynaldo Ortiz, Rohanna Mertens, Ryan Barlow, Ryan Pribyl, Sabrina Ghiddi, Sandra Oyakhilome, Sean Riordan, Sofia Machado Lemus, Sol Sanchez, Souravi Roy, Steve Barrett, Susanne Edmark, Susanne Isberg, Tristan Benedict-Hall, Yogita Kumari, Yvonne Mosley, and Zute Lightfoot.