Meet the Regional Medical Officers Setting the Gold Standard for Cleft Care

A child born with a cleft condition anywhere in the world deserves access to high-quality care. That belief drives the work of Dr. Plinio Sierra, M.D., Dr. Tereza Sigaud, M.D., and Dr. Gavin Jones, MBBCh, FRCA, MBA, FCA, M.Med., three of Operation Smile’s regional medical officers, who make sure that promise holds true across countries, hospitals and surgical teams thousands of miles apart.

Their title, regional medical officer or RMO, does not fully capture what the job demands. Part safety officer, part mentor, part bridge-builder, RMOs are the reason a surgical program in rural Kenya and a comprehensive care center in Casablanca both meet the same rigorous benchmarks. As Operation Smile celebrates Cleft and Craniofacial Awareness Month this July, their stories offer a window into what it takes to deliver gold standard cleft care, not just once, but consistently, everywhere.

The Journeys That Led Them Here

Jones’s connection to Operation Smile started as a corporate sponsor in 2006, while serving as a marketing director at a pharmaceutical company in South Africa. After returning to clinical medicine in 2011, he made a personal commitment to volunteer on at least one surgical program each year as an anesthesiologist. In 2019, he stepped into the role of regional medical officer for sub-Saharan Africa.

Sigaud’s path began as a volunteer in 2012, two years after finishing her residency. On her very first program, she watched a 72-year-old man look at himself in the mirror for nearly an hour after receiving cleft lip surgery. That moment stayed with her. She returned for three more programs as a volunteer that same year and kept coming back for over a decade. In 2019, she joined the expert group reviewing Operation Smile’s 2020 Medical Global Standards, and in 2024 she became regional medical officer for Brazil, Paraguay, Peru and Guatemala.

Sierra’s story reaches back further. He first encountered Operation Smile during his residency, then joined a multidisciplinary team traveling to Sogamoso, Colombia, in 1994, a region with deep family roots for him. That first short-term surgical program left a mark. When he told his parents about the experience, his father shared something he had never known: Sierra’s great-uncle, born in the 1870s with a cleft lip and palate, had lived his entire life without access to care. Sierra has spent 32 years with Operation Smile since that first program, work that eventually became a family calling: His wife joined as a volunteer nurse in 1998, his son became a cleft surgeon and joined in 2007, and his other children have found their own connections to the organization. Three different starting points became one shared, unwavering commitment.

How Regional Medical Officers Help Deliver Gold Standard Care

Regional medical officers work closely with country teams before, during and after every surgical program. They review patient safety, support volunteers, evaluate complex cases and help ensure every program meets Operation Smile’s Medical Global Standards.

“Our role is to make sure all patients receive high-quality and safe care,” Sigaud said. “We work closely with the program country staff as well as volunteers to ensure surgeries run smoothly.”

For Sierra, the role connects global standards with local care.

Jones says the work extends beyond the operating room. RMOs also partner with hospitals and ministries of health, strengthen local health systems and help source medical supplies to support safe patient care.

Comprehensive Care Goes Beyond Surgery

A cleft condition affects more than a child’s appearance. Children may experience challenges with feeding, speech, hearing and dental development that require care throughout childhood and into early adulthood.

That is why Operation Smile brings together multidisciplinary teams that include surgeons, anesthesiologists, pediatricians, nurses, dentists, orthodontists, speech therapists, nutritionists, psychologists and other specialists. Together, they support patients through a care journey that can last up to two decades.

“Cleft care rehabilitation is a long process that is not limited to surgery alone,” Sigaud said. “Patients need an entire multidisciplinary team working together to provide the appropriate care.”

For Sierra, comprehensive care means every child has support at every stage of life.

“The promise of comprehensive treatment is not the absence of difficulties, but the assurance that the child will always be prepared to face them with the maximum of resources in their favor.”

Building Stronger Local Health Systems

Operation Smile believes lasting change begins with local medical leaders. Today, 86% of Operation Smile’s medical volunteers live in the regions they serve.

Cleft care is complex, and mastering it takes specialists years to learn. In many regions, some healthcare providers may have little to no experience treating patients with cleft conditions. Sigaud points to education as the foundation for safe, high-quality care: Training mentorship and continuous education are what develop the skilled professionals cleft care requires.

Jones sees the same principle at work across sub-Saharan Africa. Skills that are learned and practiced translate directly into safer patient care. The more local healthcare professionals are trained, the more they train the next generation of providers, raising the overall quality of health care and improving outcomes for patients well beyond cleft care.

Regional Innovations Are Strengthening Cleft Care Worldwide

Across Operation Smile’s global network, regional medical officers are helping solve local challenges while sharing lessons across countries.

In sub-Saharan Africa, Jones is expanding access to critical care training by partnering with a hospital in Kenya that offers specialized intensive care education for nurses.

In Brazil, Sigaud’s team is training primary care providers to recognize cleft conditions earlier, helping children receive timely referrals and treatment.

In the Middle East and North Africa, Sierra has helped strengthen Operation Smile’s network of multidisciplinary care centers in Morocco, bringing comprehensive cleft care closer to families while reducing the burden of travel.

“The best practices of a team in Colombia can inspire a team in Morocco, Vietnam or Ghana,” Sierra said.

That exchange of knowledge helps strengthen care for every child, everywhere.

A Message for Cleft and Craniofacial Awareness Month

Although they serve different regions, Sierra, Sigaud and Jones share one goal: ensuring every child born with a cleft condition can access safe, comprehensive care close to home.

Jones hopes the global community continues investing in cleft care, noting that it transforms lives while strengthening local health systems.

Sigaud believes continued investment in training, early diagnosis and multidisciplinary care will help even more children receive timely treatment.

For Sierra, the future is full of possibility.

“We are living in an unprecedented moment. Never before have we had the clinical knowledge, the technology, the organizational models and the global collaboration needed to close this gap. What we need now is the collective, sustained will to do it where it is needed most.”

Together, these leaders represent a global network working toward the same goal: ensuring every child has access to safe, high-quality cleft care.