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Improving Health Systems Global

Health for All: Transcending Borders

Improving Health Systems Global

Health for All: Transcending Borders

As part of our Transcending Borders initiative and our capacity-building programs, Operation Smile will continue our work in places like La Guajira to reach more patients. Photo: Rohanna Mertens.

In 2022, more than 100 million people were displaced worldwide due to violence, conflict or human rights violations. 

Operation Smile has declared a commitment to create brighter futures for people with cleft conditions regardless of race, religion, economic status and more. Our Transcending Borders signature initiative addresses this dire need by striving to create more resilient and inclusive health systems that serve the needs of vulnerable people.

Migrants often face barriers to obtaining health care due to discrimination, restricted services and cultural differences. And in many countries, the COVID-19 pandemic has disrupted health systems, further deepening the already disproportionate impact on displaced populations. 

“It was overwhelming just to see these camps where a lot of our patients live,” said Kristie Porcaro, chief of strategy and partnerships at Operation Smile. “But I think with the work and the commitment of our volunteers and also our staff, these children will live a better life, and they’ll be supported by the efforts of Operation Smile.”

Through its three pillars, Transcending Borders spotlights programs and partnerships aimed at increasing access to care for patients with cleft conditions regardless of their countries of origin and immigration statuses.


Pillar #1: Cleft Surgery and Comprehensive Care Programs

Seven-year-old Pedro and his mother, Marbelis. Photo: Rohanna Mertens.

The ongoing political and socioeconomic crisis in Venezuela has resulted in corruption, violence and a significant deterioration in basic services provision. Over 5 million migrants have been forced to leave the country with an estimated 1.7 of whom have settled in neighboring Colombia like Pedro and his mom, Marbelis. 

Pedro and his friends play at the April Third refugee camp in Uribia, Colombia. Photo: Rohanna Mertens.

“When I was in Venezuela, I found out about a surgical [program] (unrelated to Operation Smile) and enlisted, but nothing happened,” Marbelis said. “Some physicians came to our house advising that I would have a chance for him to get an operation. I enrolled in that, but again, nothing happened.

“I got tired of waiting.”

In March 2018, the family decided to leave Venezuela for Colombia. They knew that a better life lie on the other side of the border, including the opportunity for Pedro to receive cleft surgery.

It would take several months before Pedro’s family settled in their refugee camp. However, it was only a matter of weeks after their arrival that the local health care community identified Pedro’s need for cleft care and told Marbelis about Operation Smile Colombia.

“I almost ran in here, and when I saw him, I started to cry, because he looks so beautiful,” Marbelis said. “There was a time that I couldn't (get surgery for Pedro), but it was achieved with Operation Smile.” 

Pedro, today. Photo: Camilo Zapata Fonnegra.

Over 150,000 Venezuelan migrants have sought refuge in the department of La Guajira in the north of Colombia. Historically, this area is where the Wayuu indigenous communities and internally displaced populations have struggled with chronic food insecurity, malnutrition and lack of access to resources. 

Elba and her daughter Lexxi are among them.

For millennia, the Wayuu people have called La Guajira home. But for Elba and Lexxi’s family, it’s become a difficult place for them to thrive. Her family lives in an impoverished, remote and dangerous area near the border with Venezuela. 

Elba weaves a mochila, a traditional Wayuu wool bag, as Lexxi watches. Photo: Rohanna Mertens.

Elba did her best to care for Lexxi, but it would be eight years before she discovered help was available from Operation Smile Colombia.

“My heart was pounding so loud and I had to tell myself to calm down,” Elba said after seeing Lexxi’s new smile for the first time. “She looks so beautiful now, and I feel nothing but sheer happiness.”

As part of our Transcending Borders initiative and our capacity-building programs, Operation Smile will continue our work in La Guajira to reach more patients like Lexxi and Pedro and create more resilient and inclusive health systems to serve the needs of all people. 

Lexxi, age 9, with her mom, Elba. Photo: Rohanna Mertens.

Operation Smile will scale up its screening programs to identify a greater number of patients and families earlier in life who are in need of cleft surgery and support.

Our teams around the world will also conduct top-quality cleft surgery training for medical professionals from the region and upgrade two local hospital rooms, which will increase the yearly provision of surgeries by 350%.

Pillar #2: Health Systems Strengthening Programs

Libyan volunteers and trainees at Benghazi airport before boarding the plane to fly to Operation Smile Egypt's July 2021 surgical program. Operation Smile photo.

As war and conflict in Libya have pushed the health system to the verge of collapse, 1.3 million people are now struggling to access basic services. Amid political turmoil in Libya, Operation Smile Egypt and Libya united to deliver treatment to Libyans affected by cleft conditions. 

In cooperation with the Red Cross, Libyan nonprofit Drawing Smiles, the United Nations International Organization for Migration, UNICEF Libya and the Egyptian and Libyan ministries of health, Operation Smile welcomed nearly 30 patients from Libya living with untreated cleft conditions. 

“There are a lot of patients suffering from cleft conditions. The specialized surgery programs like plastic surgery in [Libya] are not yet fully developed,” said Dr. Mohamed El-Shazly, regional director of the Middle East and North Africa region and CEO of Operation Smile Egypt. “Children often can’t receive surgery due to the current unsafe situations, war and political instability.”

The program was the first of its kind in Egypt and resulted in Libyan patients receiving cleft surgery and care while Libyan medical professionals also received training. 

Libyan surgical volunteers observing Operation Smile Egypt volunteer surgeon Dr. Mostafa Elsonbaty. Operation Smile photo.

“Three surgeons, one anesthesiologist, one pediatrician, one dentist and one patient imaging technician received training,” Mohamed said. “They were very keen to get the maximum knowledge possible to follow up with their patients in their home county and to start a nucleus for this service in Libya.”

Over the next decade, Operation Smile will care for more patients from Libya, Yemen, Palestine and Syria, delivering life-saving care and improving the health and well-being of children born with cleft conditions. 

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Operation Smile photo.

Pillar #3: Pursue Partnerships and Advocacy


As part of our Transcending Borders initiative, we work closely with international organizations such as Save the Children, SOS Children’s Villages, the United Nations High Commissioner for Refugees as well as local governments and nonprofits to provide comprehensive care and support for patients living with cleft conditions. 

We recognize that families in search of better lives often face unfair and seemingly insurmountable challenges along their journeys to receiving the care they need. If nothing changes, they will continue to face these hardships due to discrimination, restricted services, cultural differences and more. 

But no single organization or initiative alone can tackle all the need in our world. 

With our 10-year commitment to increase access to care for 1 million patients, Operation Smile believes that, together, we can bring about transformative change that will improve the lives and livelihoods of the people we treat and the professionals who serve them.

Seeking to decrease barriers to care and while increasing training opportunities for more local health care professionals over the next decade, Operation Smile has established more signature initiatives like Transcending Borders that will work to empower more people to care for more patients in more places.

Karla, 3 years old, gets a big kiss from her dad, Angel, 15 months after she received cleft surgery from Operation Smile Mexico. Photo: Jasmin Shah.


It takes as little as $240 and as few as 45 minutes to provide life-changing surgery and a bright, beautiful new smile to a waiting child.