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From the Field Guatemala

Serving More People in More Places: Operation Smile Champion Program

From the Field Guatemala

Serving More People in More Places: Operation Smile Champion Program

Heidy waits patiently with her 21-month-old daughter, Leyda, for the moment when volunteers will call her into the operating room. This is the sixth time Heidy has brought Leyda to a surgical program with the hope that she would be receive a new smile. Photo: Lorenzo Monacelli.

While there are thousands of people in Guatemala living with untreated cleft conditions, there is also a total of 5 million people in need of cleft care globally. 

Most people in both groups face unsurmountable barriers to access the health care they need.

Piloted in Escuintla, Guatemala, the Operation Smile Champion Program brought together experienced volunteers to educate and collaborate with Guatemalan mentees with the goal of helping more families like Leyda and Heidy’s access timely cleft care.

With better-trained doctors, local health care systems are better equipped to serve more people in more places.

Five times, Heidy traveled to a surgical program in Guatemala. Five times, she and Leyda returned home carrying with them the heartache of watching other families experience the joy of a new smile. 

Volunteer pediatrician Dr. Alma Castañeda of Guatemala took on the role of championing the mentorship of fellow Guatemalan pediatrician Dr. Sofía Posadas. Here, Alma examines a patient during screening for her comprehensive health evaluation. Photo: Lorenzo Monacelli.

During the program, 12 patients were screened by anesthesiologists, nutritionists, nurses and pediatricians like Dr. Alma Castañeda.

Alma has attended approximately 20 surgical programs for Operation Smile, but delivering life-changing cleft surgery wasn’t the only motive for the men and women who volunteered their expertise during the Champion Program.

“In the Guatemalan health system, the most marked gaps are poverty, little access to health care for people who live far away, lack of awareness of health care systems, fear,” Alma said. “My desire to be part of the [Champion] surgical program of Operation Smile is to be able to train others and train myself to be able to teach and convey information to other volunteers.”

During the first Champion Program in Escuintla, Guatemala, volunteer dentist Dr. Monica De Leon of Guatemala, right, mentors dentist Dr. Eugenia Azmitia of Guatemala about the specifics of creating obturators for patients with cleft palate. Photo: Lorenzo Monacelli.

Through prioritizing educational exchange and mentorship opportunities over surgical volume, the Champion Program focused heavily on building capacity, establishing potential future hospital partnerships and increasing available medical professionals equipped to serve. 

“In most cases, it’s the difference between a patient who can thrive without orthognathic surgery and others who will require it, if they can obtain it at all,” said dentist Dr. Monica De Leon. “For me, being part of the Champion Program means channeling that desire to help the population with cleft lip and palate. The passion for teaching and learning is because it opens new worlds and new ideas, and efficient, effective care can be provided for the benefit of the patient.”

Monica further explains that timely dental care is critical for a patient’s growth and development.

In addition to providing transformational surgery, one of the lasting solutions the program sought to accomplish was to increase access to specialized health care such as dentistry for children like Edwin. 

Meet 7-month-old Edwin. Two days before the surgical program in Escuintla, the lives of Edwin’s parents, Rosemary and José, changed completely after they discovered for the first time that surgery for their son’s cleft condition was possible. Photo: Lorenzo Monacelli.

Edwin’s mom, Rosemary, quickly began making arrangements to take the six-hour bus ride to the screening site after she discovered a program was taking place in two days.

Having learned that surgery was possible seven months after the birth of her son, Rosemary was surprised to see so many parents just like her who had children with cleft conditions. Until that moment, she believed she was the only mother with a child who had a cleft lip. She shared with the team how comforting it was to connect with other mothers at the program and learn about their experiences while also sharing her own. 

Rosemary excitedly called her husband to tell him that Edwin passed his comprehensive health evaluation and would be receiving surgery. In just one week, an entire family’s world changed. 

Anesthesiologist Dr. Silvia Ramos, center, championed the training and education of her mentees Drs. Luis Nieves, back left; María Alejandra Levia; and Mercedes Payan, back right. Photo: Lorenzo Monacelli.

Every surgical table also served as an education table.

Experienced mentors were paired with mentees, who came from partner hospitals all across Guatemala, including Petén, Escuintla and Guatemala City. These mentorship opportunities not only sparked interest for future volunteers and bolstered their skills, but it encouraged mentees to open new doors between their academic institutions in the country and Operation Smile.

Anesthesiologist Dr. Silvia Ramos of Guatemala oversaw the education of her mentees Drs. Luis Nieves and María Alejandra Levia throughout the week.

“What greater pride than being able to teach my students. The mentees were people that I trained in the hospital where I work. It’s being able to have the opportunity to interact with people who have the same goal, the same vision,” Silvia said. “To teach someone else who has that dream. As an anesthesiologist ... I can train other people. They can serve our country, they can serve the community with love, with passion.”

Volunteer cleft surgeon Dr. Dana Johns, center, performs surgery as cleft surgeons and mentees Drs. Lucrecia Matías of Guatemala and Reza Jarrahy of the U.S. oversee her work. Photo: Lorenzo Monacelli.

There is a shortage of adequately trained health care professionals in most low- and middle-income countries. In particular, the lack of credentialed plastic surgeons in countries like Rwanda and Guatemala lead to gaps in patient care and local capacity. 

This not only places a burden on the health system in that country, but it also creates extensive delays in patient care, forcing people to wait months or even years to receive basic health services and treatment. 

The Champion Program intentionally aims to alleviate that suffering by facilitating training opportunities that will increase the number of local health care professionals who are trained and empowered to serve the needs of their home country. 

“For me, the Champion Program means an opportunity to donate my work to people who need it, to learn from people who have ample experience, to learn the techniques and to give joy to people who need it,” said mentee Dr. Lucrecia Matías of Guatemala. “My expectation from this program is to learn from the mentors and improve my work to be able to serve people. One of the things I most hope for is to be 100% involved in Operation Smile.”

With more surgeons equipped to tackle the need for cleft care, more patients like Edwin and Leyda are receiving the high-quality and timely surgery every person deserves. 

Leyda rests comfortably in her mother’s arms after receiving her long-awaited cleft surgery. Photo: Lorenzo Monacelli.

After enduring six attempts at surgery, facing unforeseen obstacles and overcoming multiple health complications, Leyda was surrounded by the unwavering love of her family as she took her first step toward a brighter future.

As one of 10 patients who departed from the program site with a new smile, Leyda and her mom, Heidy, were particularly excited to be heading home.  

Leyda was the final patient to receive surgery, but she will not be the last to benefit from the long-term impacts of this Champion Program. Through the sharing of knowledge and skills between mentors and their mentees, more medical professionals left the program feeling empowered and prepared to help more children like Leyda in their local communities receive the high-quality care they deserve when they need it most. 


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.