Two lives transformed by one new smile

Girl with a cleft lip
Twelve-year-old Sandra before cleft surgery. Photo: Zute Lightfoot.

Our promise of improving health and dignity during the Covid-19 pandemic endures. Once again, we’re providing surgery and in-person care while taking stringent measures to keep families safe. Hope is on the horizon. We remain focused on what cleft care makes possible for children, helping them to better breathe, eat, speak and live with confidence. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

From Sandra’s Madagascar village where she’s lived her entire life, the nearest hospital is a 5-hour walk away.

This is the reality for many families living in areas of the world where access to safe and timely medical care is not only limited but oftentimes non-existent altogether.

Geographical and financial barriers, and sometimes a fear of the unknown, can prevent patients like Sandra from accessing the life-changing care they need early in their lives.

Sandra lived the first 12 years of her life with an unrepaired cleft lip. Her family knew that care was possible, but their limited income and a strong stigma that deepened their fear of doctors and hospitals made it seem like Sandra’s surgery would remain out of reach.

Grandmother wearing pink shirt
Sandra's grandmother, Manuelle. Photo: Zute Lightfoot.

It wasn’t until her grandmother, Manuelle, learned about Operation Smile and its global community of trusted medical volunteers that everything began to change.

With only two weeks before the surgical programme was scheduled to start, Manuelle was determined to get her granddaughter the care that she deserved despite any fears she had.

When it finally came time for their journey to Antananarivo, the capital city of Madagascar, love and perseverance motivated Manuelle. She walked five hours to the nearest hospital where an Operation Smile bus was waiting to transport her, Sandra, and many other families to the mission site.

Ten hours later, they stepped off the bus feeling both eager and nervous.

Grandmother and child arrive at cleft mission site
Sandra and her grandmother, Manuelle, arrive to screening during a 2015 Operation Smile surgical programme in Antananarivo. Photo: Zute Lightfoot.

After a day filled with comprehensive health evaluations from anaesthesiologists, paediatricians and more, Sandra was told news that would forever change her life.

She was scheduled to receive free cleft surgery.

Girl in surgical gown before cleft surgery
Sandra spent time in our child life area with volunteer psychosocial care provider Cynthia Fitchpatrick of the U.S. who helped prepare her for surgery. Photo: Zute Lightfoot.
Grandmother and granddaughter after cleft surgery
Manuelle remained by Sandra's side during every step of her cleft care journey. Photo: Zute Lightfoot.

Upon arriving home to their village following the mission, they were greeted by family and friends who were anxiously awaiting to see Sandra’s new smile.

It was through this journey with her granddaughter that Manuelle learned just how impactful free cleft surgery can be, and she wanted to do more for the people of her community.

Manuelle once passed a child with a cleft condition from a neighbouring community walking down the road. She felt in her heart that she had a responsibility to inform the child’s family of the opportunities that existed.

She wanted more families and grandparents to see the same incredible changes in their children that she saw in her own granddaughter.

Smiling girl surrounded by friends holding a photo of herself before cleft surgery
During a follow-up visit to her village, Sandra smiles wide while surrounded by friends and family. Photo: Zute Lightfoot.

Before surgery, Sandra enjoyed school but constantly dealt with teasing by other children who would tell her that she had a broken lip.

Operation Smile visited Sandra at her home six months after surgery. They were greeted by a new Sandra, one who skipped happily around her village surrounded by friends and a beautiful smile on her face.

With the burden of painful bullying seemingly lifted from her shoulders, Sandra now lives a happier and healthier life as an outgoing 12-year-old who loves to play and study her favorite subject Malagasy.

Girl with a repaired cleft drawing with her friend
Sandra sits beside a friend drawing. Photo: Zute Lightfoot.

With every smile and sound of laughter from her granddaughter, Manuelle became more determined to share her Operation Smile experience with as many people as she could reach.

From house to house, Manuelle reassured families by describing the process of a mission, helping quell any fears they might have and urge them to reach out to Operation Smile.

“I’m happy to recruit for Operation Smile, and I will work hard to find more patients because of the work that they do,” Manuelle said.

During one trip, she walked nearly five miles, crossed a river and hiked another mile to reach a boy named Gino and a girl named Nordine. Both children were recruited for a later Operation Smile surgical programme in Madagascar.

When asked what motivates her to find more children, Manuelle said, “My grandchild once suffered from cleft lip. My grandchild Sandra was teased, dropped out of school, and was a shy girl. Now I can’t keep her in the house. She has many friends and is constantly smiling. She is beautiful.

“I would like to give that gift, the gift of smiling to others like Sandra.”

Help us keep our promise to patients like Sandra amid the Covid-19 pandemic. Your support today means we can continue to help them through these uncertain times and provide them with the surgery they deserve when it’s safe to resume our work around the world.

Smiling girl with a repaired cleft
Sandra, after surgery. Photo: Zute Lightfoot.

Life-changing partnership in Egypt: Q&A with Dr. Mohamed El-Shazly

Our promise of improving health and dignity during the Covid-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

Amid political turmoil in Libya, two neighbouring countries united to spread peace and healing for families affected by cleft conditions.

Local Operation Smile Egypt volunteers and staff welcomed nearly 30 patients from Libya who were born with cleft lip and cleft palate. This was no small feat, as Libya is still in the process of recovering from a decade of suffering and instability.

According to regional director of the Middle East and North Africa region and CEO of Operation Smile Egypt Dr. Mohamed El-Shazly, the goal of bringing children in need to Egypt for care has been in the works since February 2021.

“The Operation Smile Egypt teams have been working on this programme with Libya for a long time through pre-screening sessions by way of virtual resources, sharing photos, lab results and health history for more than 30 patients,” Mohamed said. “Twenty-four patients were physically screened at Operation Smile Egypt’s cleft centre.”

Libya is an area of the world where conflict and war have left its healthcare system on the verge of collapse, and 1.3 million people living in the country struggle to access the most basic of health services.

“There are a lot of patients suffering from cleft conditions. The specialised surgery programmes like plastic surgery in this country are not yet fully developed,” Mohamed said. “Children often can’t receive surgery due to the current unsafe situations, war and political instability.”

This programme was the first of its kind with respect to children and families from another country travelling into Egypt to receive care. With the support of both Libyan and Egyptian ministries of health, 24 patients were screened, 17 underwent surgical care and seven Libyan medical professionals received training.

We recently connected with Mohamed to learn more about the care and training provided during this mission and how he hopes it will be the first of many surgical programmes Operation Smile Egypt will host in the future.

Dr. Mohamed El-Shazly giving a presentation
Regional director of the Middle East and North Africa region, CEO of Operation Smile Egypt and surgeon Dr. Mohamed El-Shazly. Photo: Marc Ascher.

Q: This programme was a beautiful display of the compassion and solidarity between Operation Smile Egypt and Libyan families and healthcare workers. Could you provide more context behind the orchestration of this surgical programme?

A: “It was an amazing start to Operation Smile Egypt’s fiscal year activities with a new type of programme providing healthcare for neighbouring countries, especially countries that are suffering from health, war and political problems. There are a lot of patients who need help and support who will lose the ideal timing of surgery due to their country’s problems.

“We have some connections in Libya through plastic surgery and anaesthesia residents who were trained in Egypt. They were the main contact with the authorities in Libya. The minister of health and the health coordinator in the temporary Libyan government were very enthusiastic and supportive of this programme.”

girl wearing a mask colouring on the floor
A Libyan patient plays in the child life area while they wait for cleft surgery during Operation Smile Egypt's July 2021 surgical programme. Operation Smile photo.

Q: Could you describe the need for cleft surgery for these Libyan children? Why weren’t they able to receive surgery in Libya? What’s the overall environment like for these patients and the Libyan health system?

A: “There are a lot of patients suffering from cleft conditions, and they are existing in different sites in Libya from the far desert areas to the main cities. The specialised surgery programmes like plastic surgery in this country are not yet fully developed. Many Libyan patients seek medical advice and management in Egypt and Tunisia. Children born with cleft conditions often can’t receive surgery due to the current unsafe situations, war and political instability.”

Group of men standing in front of an airplane
Libyan volunteers and trainees at Benghazi airport before boarding the plane to fly to Operation Smile Egypt's July 2021 surgical mission. Operation Smile photo.

Q: Did Operation Smile Egypt see a need and extend a helping hand to Libya? Or did Libya seek help from our team?

A: “Libya did seek help and asked us to travel into country, which isn’t possible nowadays due to the unsafe conditions. The Libyan ministry of health and the Medical Attaché of the Libyan Embassy in Egypt – who visited the mission – had delivered and expressed his appreciation to the medical team and the support of Libyan and Egyptian ministries of health for this programme. He expressed his willingness to continue the cooperation in the near future with a huge programme for treating Libyan children and training of Libyan volunteers.”

Q: Which partner organisations and government agencies helped make this programme possible, and how did they contribute to its success, respectively?

A: “The Libyan non-profit Drawing Smiles was the responsible body to recruit and screen patients and prepare all logistics. The International Organization of Migration connected us with the same foundation in Libya who helped in patient recruitment. UNICEF Libya also served a role in patient recruitment.

“While the Egyptian ministry of health assisted with the needs to cross borders, the Libyan ministry of health funded air tickets for patients and their families. Assiut University provided free medical supplies, discounted accommodation and food supplies for the families and free management in the new and old Assiut University hospitals for non-Egyptian citizens.”

Volunteers posing for a team photo outside the hospital
Operation Smile Egypt volunteers and Libyan volunteers come together and pose for a team picture in front of the Assiut University Paediatric Hospital. Operation Smile photo.

Q: Could you provide us with more detail on the logistics behind the transportation of 30 Libyan patients across the border?

A: “Transportation was made possible with the support of the Libyan and Egyptian ministries of health and foreign affairs and a private plane transporting Libyan children with their families, who landed in Assiut Airport to find our staff and student team welcoming them and presenting them our gifts.

“Libyan citizens didn’t need a visa, but there was a security agreement which was done virtually weeks before the event with the state securities. Vaccination status and Covid-19 testing were performed in Libya, repeated during the mission and before flying back.”

surgeon performing a cleft surgery as two volunteers look on
Libyan surgical volunteers observing Operation Smile Egypt volunteer surgeon Dr. Mostafa Elsonbaty. Operation Smile photo.

Q: You mentioned that seven trainees from various Libyan universities and hospitals received training. Could you provide us with more detail on that? Why do you believe this training was important?

A: “Three surgeons, one anaesthesiologist, one paediatrician, one dentist and one patient imaging technician (PIT) received training.

“It’s a good start to building a team there following Operation Smile global standards, and the feedback was amazing from them and from the Medical Attaché of the Libyan embassy in Egypt. Also, our educators had presented the most possible experience and training modules to the Libyan volunteers in surgery, anaesthesia, paediatric care, dental care and PIT. They were serious and 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.”

Q: Could you share the sentiments that the patients and their families shared with you and your team?

A: “Most of them couldn’t believe we would provide surgery for their patients. They were more than welcomed in Egypt, and they hope that there are people still caring for them, even people not inside their country. A lot of appreciation to the foundation that gave what they needed for free. They were very happy to find this care in Egypt.”

Help us to continue keeping our promise to patients living in places like Libya and Egypt amid the COVID-19 pandemic. Your support today means we can help patients through these uncertain times and provide them with the care and surgery they deserve.

Volunteer nurse caring for a child awaiting cleft surgery
Operation Smile Egypt volunteer operating room nurse Manal Ramsis cares for a Libyan patient before their surgery. Operation Smile photo.

A grandmother’s everlasting love

Baby girl with cleft being held by her grandmother
Eight-month-old Heydi with her grandmother, Claudina. Photo: Margherita Mirabella.

Our promise of improving health and dignity during the Covid-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

Claudina knew that her 16-year-old daughter, Wara, had a high-risk pregnancy. But she never imagined the series of challenges that would ultimately unfold after Wara went into labour.

With a need for additional medical support, Wara was sent to a hospital in La Paz, Bolivia, where a medical team could provide her the care she required.

But there was one major obstacle standing in their way: The hospital was five hours away from their home.

Determined to overcome any obstacle for her family, and with no other options, Claudina and Wara ordered a taxi and set out on their way.

However, during the drive, it became apparent that Wara wouldn’t make it to the hospital before giving birth.

Thinking fast, Claudina instructed the taxi driver to pull over, and quickly stepped up to deliver her newest granddaughter Heydi.

But seeing Heydi’s cleft condition for the first time in the back seat of the taxi, Claudina and Wara soon grasped that their troubles were far from over.

Baby with a cleft lip
Photo: Margherita Mirabella.

After the ambulance arrived, they were rushed to a nearby community health centre before being transferred to the La Paz hospital where Wara and Heydi spent the next 36 hours recovering.

During this time, Claudina began to focus her attention on the next obstacle that the family would face – finding a way to get Heydi surgery to repair her cleft lip.

Although there was no indication that Heydi would be born with a cleft condition, that didn’t stop other family members and people in their community from making harmful remarks in passing and placing all blame on Wara.

This took an emotional toll on Wara. Despite the immense love she had for her daughter, Wara felt in her heart that making Claudina Heydi’s principal caregiver was the best decision for her family.

More than anything, Wara wanted Heydi to live a happy life without worry or fear of the stigma that’s often associated with having a cleft condition.

Heydi’s grandfather, Florencio, inquired about care from a private hospital that he knew provided surgery. But as farmers who made a meagre income selling potatoes and beans, Claudina and Florencio feared that without surgery, their granddaughter would live her entire life with an unrepaired cleft lip.

But they continued their search, never once giving up hope.

Then one day, a family member told them about Operation Smile Bolivia and the team of medical professionals who provide free reconstructive cleft surgery to children like Heydi around the world.

Smiling woman fills out medical evaluation with patient's grandmother
Volunteer paediatric anaesthesiologist Dr. Karin Strand of Sweden and volunteer post-anaesthesia care unit physician Dr. Ben Hu of the U.S. provide Heydi's comprehensive health evaluation to determine if she's healthy enough to receive cleft surgery during a 2018 surgical programme in Santa Cruz. Photo: Margherita Mirabella.

Claudina’s hope deepened when she received a call informing her that a surgical mission would be taking place soon.

One week before the programme, Heydi was seen by Operation Smile medical volunteers in La Paz and given a comprehensive medical evaluation to ensure she was a candidate for safe surgery. As a healthy 8-month-old, she passed and was cleared to attend the mission 18 hours away in Santa Cruz.

Claudina, Heydi and many other families of children born with cleft who were looking forward to receiving surgery boarded the bus for the long journey ahead.

On the day of Heydi’s surgery, Claudina waited anxiously, remembering the hardships it had taken their family to get to this point.

But seeing Heydi smile for the first time after surgery made every unexpected hurdle they endured throughout the past year worth it.

Anaesthesiologist carrying baby after successful cleft surgery
Volunteer cleft surgeon Dr. Carlos Hugo Dorado of Bolivia, left, and paediatric anaesthesiologist Dr. Karin Strand of Sweden, centre, carry Heydi out of the operating room toward the waiting arms of her grandmother, Claudina. Photo: Margherita Mirabella.

There was no doubt that Claudina loved Heydi from the moment she was born, regardless of her cleft condition.

But now, she knew Heydi wouldn’t have to worry about the opinions of others or the stigma surrounding cleft.

She would grow up feeling loved and cherished by everyone.

girl with repaired cleft reaching for a photo of herself before surgery held by her grandmother
Photo: Margherita Mirabella.
girl in pink jacket smiling
Heydi, today. Photo: Margherita Mirabella.

Explore more stories from Bolivia:

Walk alongside Shijun

Sad child with a cleft lip and palate
Thirteen-year-old Shijun, before surgery. Photo: Zute Lightfoot.

Our promise of improving health and dignity during the COVID-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

As a fifth grader, the one thing Shijun wanted most was to study his favourite subjects of literature and maths.

But being born with a cleft lip and palate in the Guangdong Province of China, he struggled to enjoy his time at school with the bullying he faced on a regular basis.

Although the harassment he received made him angry, Shijun chose to walk away instead of fighting with those who treated him badly.

It pained Shijun’s parents to witness their son endure the hurtful comments and isolation. But there was something that always gave them hope: They knew surgery to repair Shijun’s cleft condition was possible.

Paidong, Shijun’s dad, had a cousin who received surgery to repair his cleft condition and now lives a happier life.

This knowledge of a solution motivated Paidong to search tirelessly for the care his son needed.

But for years, Paidong was left disappointed after each attempt: The cost of surgery was beyond his means and impossible for his family to pay despite his yearly salary as a construction worker.

During one of his attempts, Paidong travelled to Guiyang to see a doctor who he hoped could help. The transportation to the city cost approximately 10% of Paidong’s annual income. And even after the immense cost, Shijun couldn’t receive surgery, and the family once again returned home with no results.

Operation Smile believes that parents should never have to choose between keeping a roof over their family’s head or the care that their child needs to stay healthy.

Boy with cleft walking hand in hand with his father
Shijun and his dad, Paidong, walk side by side to the hospital. Photo: Zute Lightfoot.

This cycle of frustration and heartbreak came to an end when Shijun’s uncle discovered new information while visiting a friend at a local hospital in Bijie City.

After mentioning to the nurse that his nephew had a cleft lip, they immediately told him about Operation Smile China.

Learning that the organisation had a surgical programme scheduled in Dafang in the coming weeks, Shijun’s uncle rushed home to tell his family the exciting news.

Just like every other attempt at getting his son surgery, Paidong felt both hopeful and anxious in the weeks leading up to the Operation Smile China surgical programme. But he was filled with relief knowing that his family wouldn’t be responsible for the cost of transportation to the mission site and the surgical care Shijun would hopefully receive.

Soon, it was time for Shijun and his uncle to travel to the mission. Paidong made plans to return to Dafang County to meet them at the mission site – there was no way he would miss this opportunity.

boy with his father and uncle
Paidong, left, registers Shijun for screening during a 2016 Operation Smile China surgical mission in Dafang. Photo: Zute Lightfoot.

After a comprehensive health evaluation, Shijun was cleared for surgery by our volunteer medical team and scheduled for his operation to repair his cleft lip.

When it comes to our work of delivering exceptional cleft care to people around the world, the safety of our patients has been, and will always be, our greatest priority.

Throughout the screening process, medical volunteers take patients’ blood pressure, temperature and other vitals to ensure that there are no underlying health concerns that would risk the patient’s safety during surgery.

boy being escorted by medical team for cleft surgery
Shijun bravely walks into the operating room with anaesthesiologist Dr. Daniel Kim of Brazil. Photo: Zute Lightfoot.
surgery team performing cleft surgery
Volunteer plastic surgeon Dr. Shu Maoguo of China, centre, and plastic surgeon observer Dr. Brad Gandolfi of the U.S., left, perform surgery on 13-year-old Shijun. Photo: Zute Lightfoot.

On the morning of his scheduled surgery, Shijun was excited and couldn’t wait to see his new smile for the first time. He began to think of everything he wanted to do after surgery including play basketball with his friends without fear of being teased.

When he looked in the mirror and saw his smile for the first time, he said, “Thank you, thank you I feel good.”

boy looking at himself in a mirror after cleft surgery
Shijun stares at his new smile in the mirror the morning after his cleft surgery. Photo: Zute Lightfoot.

A few days following his surgery, Shijun returned to his grandparents’ home where family and neighbours were thrilled to see how much of a difference one surgery can make.

There were weeks filled with happiness among his family and friends. But a tragic accident halted all celebrations when Shijun fell and broke his leg, delaying his cleft palate surgery.

Paidong shared with us that he works hard to earn enough money to pay for the surgeries Shijun needs to recover from the compound fracture.

But he’s grateful to Operation Smile China and its devoted community of volunteers who took care of his son. Paidong knows that when it’s time, he will not have the financial burden of also paying for Shijun’s cleft palate surgery.

Looking at Shijun today, it’s difficult to tell that he once had a cleft lip.

Operation Smile is committed to providing patients with health that lasts – we look forward to providing Shijun with the additional surgery he needs for his cleft palate and any other essential treatments he needs to live a happier and healthier life.

Help us to continue keeping our promise to patients like Shijun amid the Covid-19 pandemic. Your support today means we can help patients through these uncertain times and provide them with the care and surgery they deserve when it’s safe to resume our work.

boy smiling after cleft surgery
Shijun smiles wide one year after surgery. Photo: Zute Lightfoot.

As if he didn’t have a name

Our promise of improving health and dignity during the Covid-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

Joseph walks in his flip-flops behind his father and stepmother through their neighbourhood in San Remigio on the Philippine island of Cebu.

The 6-year-old carries a big plastic bag to collect recyclables and scrap metal, asking neighbours to sell him empty plastic bottles, pieces of metal, cans and glass jars.

The family gathers anything that might be worth a few more pesos before they sell it on to “the boss,” who then sells those items to turn a profit.

“The boss” pays Joseph’s father, Julito, a fixed price: 3 pesos per kilogramme of cans, 2 pesos per kilogramme of glass bottles and only 1 peso per kilogramme of plastics. On a good day, the family of five receives 100 pesos, which totals out to $2 at the most.

Joseph is the family’s youngest child and the only one born with a cleft lip and cleft palate.

Boy with a cleft lip and palate
Joseph, 6 years old. Photo: Jörgen Hildebrandt.

His mother, who died several years ago due to heart disease, also collected scrap metal and recyclables.

While there are still many misconceptions surrounding the cause of cleft conditions, which can be environmental or hereditary, Julito believes his son’s cleft condition may have been caused by hours of bumpy motorbike rides Joseph’s mother endured while she was pregnant.

Boy with cleft lip and palate surrounded by rubbish
Joseph helps to sort his family's haul before taking it to "the boss." Photo: Jörgen Hildebrandt.

Joseph doesn’t attend school.

“He tried once, but came home crying. They call him ‘bungi,’” a derogatory word for cleft, Julito explains.

Sometimes the neighbourhood children throw stones at him — the same treatment they give the stray dogs in the area.

“Then, he fights back and comes home angry, crying and upset,” Julito said.

For unknown reasons, Southeast Asia, including the Philippines, is a region where cleft conditions are more common than the rest of the world — around one in 500 children are born with cleft lip and cleft palate.

The global average is closer to one in 750 births. Even though there are skilled plastic surgeons in the country — some who volunteer for Operation Smile — most families cannot afford the cost of surgery.

Joseph’s family is no exception.

Even the bus fare to the hospitals of Cebu City is too costly for some families.

However, when Julito learned about Operation Smile and the free surgeries it provides to children like Joseph, he became hopeful for his son’s future.

Boy with a cleft lip and palate standing in line with his father at an Operation Smile medical mission site
Photo: Jörgen Hildebrandt.

After a local non-governmental organisation, Abounding In Love, provided Julito and his family with free transportation and lodging to an upcoming Operation Smile medical mission, Joseph was closer than he’d ever been to receiving a new smile.

Following their bus trip to the mission, Julito gazed around at the scene before him, surprised to see how many other children had the same condition as Joseph. While relieved to learn that his son wasn’t the only child to have a cleft, Julito soon became worried.

“I have mixed feelings,” he said. “I’m happy Joseph is not alone, but also afraid he will not qualify for surgery since there are so many in need of help.”

Amid the bustling atmosphere of the mission, Joseph tries to make sense of the situation.

He keeps asking his father why they are there, and when Julito explains, Joseph looks at him with surprise: “So they are going to fix my lip now?”

Boy with cleft lip and palate being examined
Photo: Jörgen Hildebrandt.

After a passing a comprehensive health evaluation, Joseph became one of many children who were selected to receive surgery.

The day after his cleft lip is repaired, Joseph stares at himself in the mirror for a long time.

With love and hope for his son, Julito won’t give up until Joseph receives cleft palate surgery.

Smiling father looking at his son after cleft surgery
Photo: Jörgen Hildebrandt.

A year has passed since Joseph’s surgery.

While Julito still struggles to provide for his family, life has drastically changed for Joseph since arriving home after the mission.

“When we were discharged from the hospital and arrived at home, all our neighbours were very excited to see Joseph and told him he looked so handsome,” Julito said. “When we came to our house, he got a mirror and looked at his face and said, ‘Oh, I’m very handsome now!’”

But Joseph’s confidence isn’t the only bright spot in life after surgery.

Smiling boy after cleft surgery
Photo: Jörgen Hildebrandt.

Joseph has returned to school, eager to learn and become friends with those who once bullied and teased him.

“The first day at school, Joseph prepared himself carefully,” Julito explains. “He washed himself and prepared his school bag and dressed in his school uniform. When we got to the classroom, he asked if I was going to stay there with him. I said, ‘Yes, of course, I’m going to wait for you,’ but my son then explained that there was no need; he could manage to go home on his own.

“He’s not shy anymore. Unlike before, he likes going outdoors. And even if children still tease him sometimes, he doesn’t get mad at them — he knows his face is different now. Hopefully, the surgeries will bring him a different life than mine. He has more confidence now, and maybe this will give him a chance to get a proper job in the future.”

Help us keep our promise to patients like Joseph amid the Covid-19 pandemic. Your support today means we can continue to help them through these uncertain times and provide them with the surgery they deserve when it’s safe to resume our work around the world.

Smiling boy in school
Photo: Jörgen Hildebrandt.

A Second Chance at a New Smile

mother holding child with a cleft lip
Seven-month-old Mohamed with his mum, Benjebi. Photo: Margherita Mirabella.

Our promise of improving health and dignity during the Covid-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

Holding her 3-week-old child in her arms, Benjebi tried to process the news she’d just received: Her son, Mohamed, was too young to receive cleft surgery.

After travelling more than 370 miles to attend an Operation Smile Morocco surgical programme in Oujda, Benjebi felt devastated to learn that Mohamed would return home without a new smile.

As thoughts of what Mohamed’s future would be like began racing through her head, Benjebi received news that made her feel hopeful once again.

The volunteer medical team told her that an upcoming Operation Smile Morocco mission was scheduled to take place in Dakhla six months later.

Benjebi clung to her renewed hope on their long journey back home. In six months, Mohamed would be old enough for surgery.

Remembering back to the day she gave birth, Benjebi never imagined she would have a child with a cleft lip. Unaware that this condition affected so many people, Benjebi felt isolated seeing her baby for the first time.

baby with a cleft lip looking at camera
Mohamed, before surgery. Photo: Margherita Mirabella.

After Mohamed’s birth, Benjebi became anxious as she watched her husband, Hamid, intensely stare at their new baby boy. She worried he wouldn’t accept their son because of his cleft condition.

But that was not the case.

Hamid loved his son, but he was confused by his son’s condition. It was like nothing he had ever seen before. Calming his wife’s fears, Hamid reassured Benjebi that he loved Mohamed and would always love him despite his cleft lip.

Sadly, their families did not show the same support.

Lacking access to education on the potential causes of cleft conditions, which can be environmental, hereditary or a combination of both factors, Benjebi and Hamid’s families blamed Benjebi.

They believed that Mohamed’s cleft condition was caused by Benjebi looking at a bad spirit during her pregnancy.

Despite the hurtful comments from family members, Hamid and Benjebi knew that nothing anyone said could diminish the love they both had for Mohamed.

This unconditional devotion motivated Benjebi and Hamid to overcome any obstacle that threatened to stand in the way of Mohamed receiving the smile he deserved.

In the months that followed their first attempt at getting Mohamed surgery in Oujda, Benjebi worked tirelessly to ensure that he would be healthy enough for surgery when the mission in Dakhla arrived.

As she boarded the bus that Operation Smile Morocco provided to transport families on the 32-hour journey to Dakhla, Benjebi hoped that her commitment to Mohamed’s health had paid off.

Surrounded by hundreds of families who’d also travelled to the surgical mission with hopes of their child receiving a new smile, Benjebi felt connected to the other mothers of children born with cleft conditions.

It felt as though for the first time, she wasn’t alone.

dentist smiling at baby with cleft lip
During Operation Smile Morocco's 2015 surgical mission in Dakhla, volunteer dentist Dr. Lo Hanane of Morocco examines Mohamed during the screening process. Photo: Margherita Mirabella.

Each patient underwent a comprehensive medical evaluation to ensure that they were healthy enough to receive surgery.

After Mohamed was examined by our volunteer paediatricians, dentists, anaesthesiologists and other medical professionals, Benjebi cried tears of joy when the team told her the words she’d been waiting to hear since first learning about Operation Smile Morocco: Mohamed was healthy enough to receive surgery.

smiling boy with repaired cleft lip
Mohamed, one year after surgery. Photo: Margherita Mirabella.

The following day, upon laying eyes on her son for the first time after surgery, Benjebi said it was as if Mohamed had been reborn. She took photos of her son and sent them to Hamid, who could not believe his son’s transformation and was eager to see Mohamed in person.

“I would like to thank Operation Smile for everything,” Benjebi said. “I want to encourage all doctors to volunteer and help the mothers who need help.”

When they returned home, many people from their community came to see Mohamed and share in the family’s celebration.

With Mohamed potentially being too young to remember his life before surgery, Hamid and Benjebi hope he will grow up happy and have the confidence to chase after his dreams without fear of the harmful treatment they once endured.

smiling boy with repaired cleft lip
Mohamed, 5 years old. Photo: Lorenzo Monacelli.

We caught up with Mohamed and his family again three years later. He is now in school and enjoys singing and playing ball.

Today, Mohamed is living a life that’s no longer defined by his cleft condition.

Help us keep our promise to patients like Mohamed amid the Covid-19 pandemic. Your support today means we can continue to help them through these uncertain times and provide them with the surgery they deserve when it’s safe to resume our work around the world.

smiling boy holding a photo of himself before cleft surgery
Photo: Lorenzo Monacelli.

A Chance Encounter Brings Tiyamjane a New Smile

woman with cleft
18-year-old Tiyamjane, before surgery. Photo: Jasmin Shah.

Our promise of improving health and dignity during the Covid-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

Growing up with a cleft lip in a rural village in Malawi, Tiyamjane fought – and overcame – many struggles throughout her life.

Some of the unthinkable challenges she experienced, including the death of both her parents at a young age, drew sympathy and compassion from those closest to her. While other hardships, like the burden of living 18 years with an unrepaired cleft condition, resulted in painful stigma, unfair treatment and being shamed by people in her community.

Enduring torment, teasing and name-calling because of her cleft condition not only made Tiyamjane sad, but she also felt angry. She was angry that she was being bullied solely based on her appearance. Lacking awareness of organisations like Operation Smile Malawi, Tiyamjane believed that there was nothing she could do to change how she looked or how people treated her.

To avoid the harassment, Tiyamjane decided to leave school at 11 years old and settle into life living with one of her sisters and working on their farm.

Every day for 18 years, she carried the weight of believing her cleft lip – and the pain and anger that came with it – was permanent.

woman with cleft
Photo: Jasmin Shah.

For Tiyamjane, living with a cleft lip was isolating, and she often felt alone. But cleft conditions affect more people than she ever realised: Worldwide, it’s estimated that every three minutes a child is born with a cleft condition.

Believing that she was the only person born with a cleft condition, Tiyamjane’s mindset pivoted instantly after seeing the cleft lip of a close friend’s newborn baby. Unlike Tiyamjane’s parents, her friend learned about Operation Smile Malawi and the possibility of surgery shortly after giving birth. After living her entire life with a cleft condition, Tiyamjane was shocked to discover that the solution she never knew existed was suddenly within reach.

Once learning the details of an upcoming surgical programme in Blantyre, it wasn’t long before Tiyamjane, her sister, her friend and baby set off together to travel by bus to the mission site. As she made the journey, Tiyamjane was hopeful a brighter future lay ahead and that she could live the rest of her life free from the pain of her cleft condition.

Even after arriving at the mission site, the surprises continued to follow: Tiyamjane couldn’t believe the number of adults and children she saw during screening who also had a cleft condition. After passing her comprehensive health evaluation, Tiyamjane was deemed healthy enough for surgery by a team of medical volunteers. Though Tiyamjane was nervous on the day of her long-awaited surgery, she bravely walked through the doors of the operating room and toward a brighter future.

smiling woman with a repaired cleft lip
Tiyamjane, after surgery. Photo: Jasmin Shah.

The moment that Tiyamjane saw her new smile, she knew in her heart that her life had permanently changed. This newfound feeling of happiness deepened further when she returned home and received a warm welcome from the community that once mistreated her.

“I am always happy now,” Tiyamjane explained when Operation Smile Malawi volunteers visited her village a few months after her surgery. “Thank you for everything you did for me. Please continue to help others like you helped me.”

Help us keep our promise to patients like Tiyamjane amid the Covid-19 pandemic. Your support today means we can continue to help them through these uncertain times and provide them with the surgery they deserve when it’s safe to resume our work around the world.

smiling woman holding a photo of her before cleft surgery
Photo: Jasmin Shah.

Persevering through uncertainty, tragedy and the unexpected

Our promise of improving health and dignity during the Covid-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

Throughout the Covid-19 pandemic, health systems in developed countries were pushed to their limits while the healthcare inequities in low- and middle-income countries became further exposed. 

The communities that were already vulnerable were hit hardest by the virus. Access to help was limited, personal protective equipment was scarce, and the already-restricted capacity of healthcare systems were overwhelmed with patients.

But, throughout these times of uncertainty and fear arose stories of people around the world who, despite all odds, found a way to persevere in the face of so much adversity.

Lilia and her mom, Valeria, moments after receiving their COVID-19 test during Operation Smile Mexico's 2021 surgical programme in Puebla. Photo: Henry Cuicas.

As a 27-year-old nursery school teacher, Valeria’s entire world was turned upside down when the pandemic forced the closure of schools across Mexico.

Expecting the birth of her first child, Valeria suddenly found herself without a job and without financial means to help support her family.

While still attempting to navigate through those challenges, Valeria was once again faced with the unexpected.

“When I was eight months pregnant, they told me,” Valeria explained. “It was clear that she had a cleft lip on the right side.”

Photo: Henry Cuicas.

Though consumed with a mixture of shock and guilt, Valeria and her husband, Daniel, refused to give up and soon began preparing for their daughter Lilia’s birth.

Sadly, Daniel would never get the chance to meet his daughter. He tragically passed away just before Lilia was born.

“If my husband were here, I would tell him that we will come out of this together, that we stand by my daughter, that we need to be strong,” Valeria said. “When I had her in my belly, he used to say that she is daddy’s princess.”

It took all of Valeria’s strength to persevere through the seemingly endless list of hardships that she faced, but she was determined to overcome any obstacle for Lilia, who would be born soon.

“I had to give it all for my daughter,” Valeria said.

The local hospital’s Covid-19 restrictions prevented visitors from being in the delivery room.

So, when it was time to deliver her baby, Valeria was alone.

Although Valeria knew that her daughter would be born with a cleft condition, she was still in shock when she saw Lilia’s smile for the first time.

Initially, Valeria blamed herself for Lilia’s cleft condition. Questions and doubt swarmed her thoughts. Had she not taken proper care of herself? Maybe it was something she ate.  

Valeria knew that Lilia would need surgery to repair her cleft condition, but since she was born in the peak of the pandemic in June 2020, many medical procedures, including cleft surgeries, were on hold in Mexico for the foreseeable future.

What Valeria wanted most was to give Lilia a happy life; however, with the challenges of the pandemic, her dream for her daughter seemed out of reach.

Photo: Henry Cuicas.

But soon, with the help of her sister, Valeria discovered Operation Smile Mexico.

It was after connecting with the organisation that Valeria not only learned she wasn’t at fault for her daughter’s cleft lip, but that the local volunteer team would provide Lilia with ongoing comprehensive care until it was safe to resume surgeries.

Due to Lilia being born with a cleft lip and palate, feeding was an exceptionally difficult task during her first month of life.

Dr. Daniel Zunzunegui, a volunteer dentist for Operation Smile Mexico, fit Lilia with a feeding plate. Molded to the roof of a baby’s mouth, the plates serve as a first step toward surgery, leading patients like Lilia away from starvation and malnutrition.

Learning that Lilia wouldn’t have to live with her cleft condition motivated Valeria. From her first appointment with Operation Smile Mexico, Valeria knew this organisation would support her and her daughter.

After months of Valeria feeling alone and discouraged, the Operation Smile Mexico team offered safety, hope and stability in her pursuit of surgery for Lilia.

While the pandemic made it temporarily unsafe to provide surgery, the local team in Mexico worked tirelessly to provide care, including speech therapy, throughout the pandemic and began seeing patients on a limited scale toward the end of 2020.

“Virtual speech therapies are a tool we had to develop due to the pandemic to reach the patients who need these therapies,” said Elidé Romero, Operation Smile Mexico volunteer speech therapist.

Lilia with Operation Smile Mexico volunteer speech therapist Elidé Romero during screening day. Photo: Henry Cuicas.

For patients like Lilia who are born with a cleft lip and palate, speech therapy before and after surgery is a vital component of comprehensive care. Even before they begin to form words.

Speech therapists provide children like Lilia with palate-strengthening exercises and techniques to help improve the surgical outcome.

But the work before surgery is just as important as receiving continuous care afterward. Their ongoing speech therapy care helps patients speak more clearly as they grow.

“(Lilia’s) main improvements include, one, reducing the risk of having a development gap,” Elidé said. “On the other hand, we teach mums how to interact with their babies in a way that’s enriching for the babies’ speech and complete development.”

Valeria made sure that Lilia never missed an appointment or therapy session.

“The speech therapy support is very impressive. My daughter has progressed well,” Valeria said. “I have seen a change in my daughter during the therapies. She does many little things like babbling, moving around, screaming, playing. Things she almost didn’t do at all before.

“She no longer has the sadness she felt at the beginning.”

Photo: Henry Cuicas.

As the world began to adjust to the new reality posed by Covid-19, Operation Smile Mexico began to resume surgical programmes.

When it became safe to do so, volunteers resumed delivering surgery to families like Valeria’s who hadn’t been able to access the timely surgical care they needed and deserved.

With strict Covid-19 protocols in place to ensure the safety of all volunteers, staff and patients, Operation Smile Mexico hosted a surgical mission in Puebla in March 2021.

“When I saw the other families with their babies with cleft conditions, I thought, ‘I’m not the only one. There are more families besides me.’”

After a comprehensive medical evaluation, Valeria was told that 9-month-old Lilia would be receiving surgery the next day.

“Honestly, I didn’t expect it,” Valeria said with tears in her eyes. “I thank God because I asked for it a lot. I have gone through a lot since my daughter was born.”

Valeria kisses Lilia once more before the medial team takes Lilia into the operating room where she will receive her free cleft surgery. Photo: Henry Cuicas.

Having a child with a cleft condition is often a scary experience – especially for a first-time parent.

This fear was compounded for Valeria because she was going through this experience in the midst of a global pandemic.

But, despite the obstacles, setbacks and tragedy of losing her husband, Valeria did everything possible to make sure her daughter would receive the cleft care that she deserved.

Lilia successfully received surgery to repair her cleft lip, but her cleft care journey is still ongoing.

Valeria reunites with Lilia moments after her successful surgery. Photo: Henry Cuicas.

She will need continued speech therapy and another surgery to repair her cleft palate.

Operation Smile Mexico is committed to providing Lilia and Valeria with health that lasts and can’t wait to see how Lilia progresses as she continues to grow.

Photo: Henry Cuicas.

The love Valeria has for her daughter gave her the strength to make incredible sacrifices. Due to her determination and perseverance, Lilia will have a happier and healthier life.

“I will always be there for her, and I will always fight for my daughter,” Valeria said. “No matter what I have to do for her, I will always be there for Lilia. She will always be my child.”

Help us keep our promise to patients like Lilia amid the Covid-19 pandemic. Your support today means we can continue to help them through these uncertain times and provide them with the surgery they deserve when it’s safe to resume our work around the world.

Lilia, after surgery. Photo: Henry Cuicas.

A family’s journey towards healing

Annika and Nuria
Eight-month-old Annika with her mum, Justina. Photo: Margherita Mirabella.

Our promise of improving health and dignity during the Covid-19 pandemic endures. We’re helping frontline health workers stay safe, nourished and empowered to better serve their patients by providing life-saving supplies and equipment, as well as remote training to bolster their response. We’re also providing nutritional assistance, hygiene kits and virtual health services to support people and their health needs so they can thrive. If you can, when you can, help us keep our promise to care for children and create hope for tomorrow.

Rather than having feelings of joy and relief, the birth of her daughter led to some of the most frightening moments of Justina’s life. 

Seconds after being born, Annika needed immediate mouth-to-mouth resuscitation.

After watching her daughter spend two weeks being fed with a feeding tube in the hospital’s intensive care unit in La Paz, Bolivia, Justina no longer knew what to do or who to believe.

The weeks after Annika was born were filled with a whirlwind of emotions and inconsistent opinions from medical professionals.

One doctor told Justina that her baby would be a child with special needs. Another said that Annika was sick.

But the reality was that Annika was born with a cleft condition.

Photo: Margherita Mirabella.

For Justina, it seemed like a lifetime ago that she was enjoying the happy memories of finding out she was pregnant. She believed she was starting menopause at 37 years old when, much to her surprise, she was actually expecting her third child.

Those nine months waiting for Annika to arrive were filled with joy and anticipation for the entire family.

When that day finally came, Justina’s happiness and excitement were replaced with sadness.

Diagnosed with postnatal depression, Justina felt devastated at the thought of Annika not being able to live the life her daughter deserved because of the cleft condition. She often cried, wondering if it would’ve been better if Annika had died, and at times, she wanted to die herself.

But with the support of her husband, Asencio, two older daughters and the help of her therapist, Justina found the strength she needed to persevere for herself and for Annika.

More importantly, she realised that Annika was just like any other child beyond her cleft condition. With a resolve to do everything in her power to provide a good life for her family, Justina turned her all of her focus toward getting her daughter the care she needed to repair her cleft condition.

At the school of one of Justina’s older daughters, a teacher heard that Annika was born with a cleft condition and told Justina about Operation Smile Bolivia.

The teacher explained the organisation’s mission of providing free life-changing cleft repair surgeries to those who need it most. Initially, Justina thought the idea of free surgery was too good to be true, but she soon realised that this was the solution for which she’d been searching.

With a new sense of calm, Justina contacted Operation Smile Bolivia.

From that moment on, everything began to look different for Justina and her family. Finally, there was hope for Annika’s future.

The family attended a pre-mission screening the week before the medical programme was set to take place. Annika was seen by a surgeon and anaesthesiologist who gave her a comprehensive medical evaluation to ensure that she was healthy enough for surgery.

For the first time, Justina didn’t feel so alone.

Annika was approved for surgery in Santa Cruz – 18 hours away from their home in La Paz.

While she was thrilled that Annika was cleared for surgery, Justina began to worry about how she would afford the cost of transportation to the Santa Cruz mission site.

It was soon after that Operation Smile Bolivia informed her that all transportation fees came at no cost for patients and families.

With bus tickets and travel supplies in-hand, Justina, Annika and many more families boarded the bus for the long trip.

Justina, Annika and many other families wait with hopes that their child will receive life-changing surgery during a 2018 Operation Smile surgical programme in Bolivia. Photo: Margherita Mirabella.

Once in Santa Cruz, the families staying at the patient centre were taken to the zoo for a day of fun before surgeries began. For many, this was the first time leaving their communities. The fun activity hoped to ease the stress and anxiety of being in an unfamiliar environment.

“Everything is wonderful – the care, the shelter, the trip to the zoo,” Justina said. “Everyone is so warm and kind.”

Justina remembers the day of Annika’s surgery as one filled with many nerves. But she also can’t forget the joy of seeing her daughter for the first time in the recovery room.

Volunteer pre- and post-operative nurse Asa Ostberg of Sweden checks on how Annika is feeling after her surgery. Photo: Margherita Mirabella.

Justina and her family had endured so much since Annika’s birth. But the conflicting doctors’ diagnoses, hospital visits and feelings of uncertainty were all left in the past as Justina held her daughter in her arms.

Annika, after surgery. Photo: Margherita Mirabella.

After a few days of recovering, an overjoyed Justina and Annika boarded the bus for a long journey home.

With Annika’s cleft condition repaired and her health in good standing, her family could finally begin living their lives without fear, doubt and uncertainty.

“I’m never going to stop thanking Operation Smile and God,” Justina said.

Help us keep our promise to patients like Annika amid the Covid-19 pandemic. Your support today means we can continue to help them through these uncertain times and provide them with the surgery they deserve when it’s safe to resume our work around the world.

Smiling baby with a repaired cleft
Annika seven months after surgery. Photo: Margherita Mirabella.

Operation Smile UK appoints Mairéad O’Callaghan as Executive Director

We are delighted to announce that Mairéad O’Callaghan has been appointed as the Executive Director of Operation Smile UK starting 1 July. She will succeed Karen Jaques as she moves into a new position of Senior Regional Vice President for Africa after five very successful years in the role of Chief Executive, OSUK.

Having joined the organisation in 2011 as Country Manager for Operation Smile Ireland, Mairéad has been the Head of Individual & Legacy Giving for Operation Smile UK since 2017, during which time she has been instrumental to the growth of the organisation. She has a strong reputation within the organisation and beyond and is deeply committed to our vision of a world where all people have access to health and dignity through safe surgery.

Throughout her career with Operation Smile, Mairéad has amplified the many voices of our organisation through her work in direct marketing, gaining the support of the British public to alleviate the suffering of children born with cleft conditions. We greatly look forward to the continued momentum Mairéad will bring to her new role as we develop our presence in the UK to support the incredible global work of Operation Smile.

Mairéad says ‘I’m immensely honoured to move into this role, and greatly look forward to working with the trustees, staff, and volunteers in the UK, and our colleagues and partners overseas as we continue to overcome inequalities in access to surgical care around the world. There is so much to do, and so much that we can and will do together for children born with cleft conditions.’

Chair of the Board Dr. Maria Moore says ‘It is with pleasure that we announce two key staff changes for Operation Smile UK and for the global organisation. Karen Jaques’ new role as Senior Regional Vice President for Africa will support the organisation as it prepares to consolidate its work on a regional basis. She leaves OSUK with an exceptional team in place to support our new Executive Director, Mairéad O’Callaghan who has led on our steady income growth with her. We wish them both well and look forward to further outstanding outcomes from them both.’