The Smile Operation

Did you know that every three minutes a child is born with a cleft lip or cleft palate somewhere in the world? In Africa, this equates to one in every 1 000 children and of which, sadly more than one in 10 will not live beyond their first birthday.

The good news is that cleft lip / cleft palates are very treatable. However, due to lack of resources and local capacity the number of patients continues to grow. This motivated the formation Operation Smile which aims to ‘Changes lives, One Smile at a time’.

Operation Smile Inc. is a nonprofit, volunteer medical organisation that provides free reconstructive surgery to children and adults born with a cleft lip and/or cleft palate, or any other correctable facial deformity in over 60 countries around the world. Since inception, in 1982, Operation Smile has provided over 200 000 free, life changing procedures worldwide. Operation Smile South Africa (OSSA) was founded in 2006 as the regional hub for Southern and Central Africa and has already facilitated more than 25 000 free procedures. OSSA conducts Medical Missions and Educational Programmes in Democratic Public of Congo (DRC), Lesotho, Madagascar, Malawi, Namibia, Rwanda, South Africa and Swaziland, and plans to extend its work to Mozambique shortly.

What is a cleft lip / cleft palate? The definition of a cleft lip is a visible separation in the skin of their top lip. This space can be a small hole, or it can be a significant opening that extends from the base of the baby’s nose all the way down to her top jaw and gums. Between eight and twelve weeks of pregnancy, the baby’s mouth begins to form. When the development is incomplete, the baby has what is known as a cleft palate.

Without corrective surgery, the child may be unable to nurse, eat, speak, smile or socialise. They are often shunned and rejected, prevented from going to school or finding employment later in life. Hence the urgent need for awareness and intervention for those children and adults, born in poverty stricken countries where health care is either too expensive or inaccessible, and a solution unattainable.

In order to assist with the backlog of patients waiting for care, OSSA runs surgical missions. During a typical surgical mission, OSSA volunteers operate on 150-180 patients over a period of 10 days, returning for a week, six, twelve and eighteen month post-operative assessments. Patients in need are offered free transport and accommodation for the duration to ensure that patients are able to access the appropriate care. OSSA is also committed to never making a negative impact on their partner Ministries of Health. Every glove, gown, stitch, instrument and piece of equipment is brought by Operation Smile. This also helps to ensure that the strict Global Standards of Care are followed on every mission.

While OSSA places significant emphasis on its medical missions, it is also dedicated to the social and medical development of local infrastructure to ensure that even more children and adults have access to high quality treatment, locally, when they need it.

Surgical programmes include: Surgical Missions - a National Patient Referral Programme in which connects South African patients with local centres and volunteers and the World Care Patient Programme. The World Care patients refer to those patients that require more specialised care than can be provided on medical missions.

To date, OSSA has screened more than 7 000 patients, performed nearly 4 500 procedures and conducted 27 missions in Africa. OSSA’s World Care Programme has provided pro-bono care to 16 patients from across Africa. As part of OSSA longstanding commitment to help change the lives of children, it continues to expand the reach of all of these programmes.

The commitment to building capacity and creating sustainable systems in each of OSSA’s partner countries are accomplished through the Education Programmes and achieved by working together with relevant Ministries of Health. Training and education programmes are provided to volunteers and healthcare providers (urban and rural). These includes free hands-on mission-based training, certified courses such as the American Heart Association (AHA), Basic Life Support (BLS) and Pediatric Advanced Life Support (PALS) training and Helping Babies Breath (HBB) programmes. In addition, Operation Smile provides the opportunity for fellowships at its global cleft centre and is running pilot programmes in speech assistant and breast feeding training.

One of the obstacles that OSSA faces is bringing the patients in for follow-up, care and treatment due the expense of travel, even when local. Hence the challenge to bringing assessments closer to the patients while at the same time developing partnerships to further incentivise families to return for post-mission follow-up healthcare. OSSA is committed to improving the percentage of patients who return for follow-up care therefore ensuring the quality of care provided. 

The success of Operation Smile over the last 30 years is due to the amazing volunteer, diplomatic, corporate and individual support that the organisation receives. Together with their partners they create change, provide hope and give people who would not otherwise have the opportunity and chance to live a normal life.

Operation Smile South Africa invites patients to be pre-screened for possible surgery from 30 September to 4 October 2013 in Mpumalanga and from 14-18 October 2013 in Limpopo. For additional information and questions and queries, contact Sive, Tel: +27 447 3608, E-mail:

- Adva Brivik is an intern at Operation Smile South Africa.

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