Going Far Together: A Future for Women in Healthcare Around the World

By Dr. Naikhoba Munabi, plastic surgery resident at the University of Southern California and former Global Surgery Fellow at Operation Smile.

Dr. Naikhoba Munabi, left, stands beside Fouzia Mahmoudi, Operation Smile Morocco Co-Founder and Vice President, centre, and Operation Smile Co-Founder and President, Kathy Magee, during the 2020 March all women's mission in Oujda, Morocco. 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.

When asked how I’ve been able to climb the ladder of success to where I am today, my answer is always simple: I didn’t do it alone.

I come from a family of physicians, including women such as my mother and grandmother. On the occasions that people have said my race or gender would limit my ability to succeed in my chosen career, I looked to my family to confirm that these opinions were wrong.

My inspiration and support came from outside of my family, too. Female teachers, coaches, lab directors and classmates mentored and helped me believe in my capabilities. Even when I entered the arena of surgery where few women exist, I always had sources of encouragement to continue pushing forward in pursuit of my dreams.

Cleft surgeon Dr. Luca Autelitano of Italy, left, examines a patient with Dr. Naikhoba Munabi. Photo: Lorenzo Monacelli.

Unfortunately, not all women in the world are so lucky.

Almost 1 billion women globally do not have formal employment because they lack access to education, encouragement to continue persevering in a career of their choice, or do not know what a woman can achieve. But 18 million more healthcare workers are needed in the world. It is vital that women enter and continue in medical careers to help address the needs of some of the poorest and most disenfranchised individuals worldwide.

Better mentorship can help get more women into healthcare. Earlier this year during Operation Smile’s inaugural Women in Medicine: Inspiring a Generation medical programme in Oujda, Morocco, 25% of female volunteers said they struggled to find mentorship and guidance in their career despite wanting it.

Team photo of the female medical and nonmedical volunteers during the Women in Medicine: Inspiring a Generation medical mission. Photo: Jasmin Shah.

In male-dominated careers, such as medicine, societal norms are not always encouraging of women. The presence of a mentor can be the difference between a woman entering and staying in healthcare or turning away from adversity.

25% of female volunteers said they struggled to find mentorship and guidance in their career despite wanting it.

Bringing 95 female medical professionals from 23 countries together in Oujda helped establish those critical mentorship contacts. During the programme:

  • 73% of women who weren’t able to find a mentor in their home countries were able to identify one during the mission.
  • 100% wanted to maintain those professional relationships in the future.
  • 97% of women were more confident in their ability to perform their jobs.
  • 100% felt inspired to mentor women in their home countries.
Graph showing how mentorship during the mission had a trickle-down effect for participant home countries. 100% of participants established professional contacts to maintain in the future and 100% felt empowered to mentor working women at home. Graph courtesy of Naikhoba Munabi.

The Women in Medicine medical programme also inspired women to become leaders. Despite only 29% of volunteers having leadership experience with Operation Smile, 93% felt inspired to become a leader in the organisation and 97% felt inspired to become leaders in their home country. Through this desire to lead, 99% of women felt they would also advance professionally and 97% hoped their careers would involve working with other women in the future.

Simply put, creating a collaborative environment for female healthcare professionals encouraged women from all around the world to continue advancing and forging the path for more women to follow.

One of the best parts of being a global surgery fellow has been finding commonality with so many people of diverse origins around the world. The world is brimming with talent, including exceptional female talent. Operation Smile’s female volunteers are role models to other young aspiring and ambitious women in their communities. The women I have met worldwide have been an inspiration to me. The Women in Medicine medical programme was an ode to those female volunteers, their capabilities, their perseverance and their will to care for others.

Help us to continue doing everything we can for patients impacted by the COVID-19 pandemic. When it’s safe to resume surgeries, the support you give today will not only provide more children with the life-changing care they need but enable the next generation of healthcare workers to deliver care where it’s needed most.

Dr. Naikhoba Munabi pictured with volunteers from the all women's mission after completing the cleft surgery simulation workshop. Photo courtesy of Naikhoba Munabi.

About the author: Dr. Naikhoba Munabi is a resident physician in plastic and reconstructive surgery at the University of Southern California. She took two years away from clinical training to work with Operation Smile as a Global Surgery Fellow. During her time with Operation Smile she worked with teams in multiple countries with a focus on sub-Saharan Africa. Dr. Munabi’s public health interests include education, health systems strengthening, and women’s empowerment. Clinically, she plans to continue training to be a craniofacial surgeon.

Clement’s “Why”

It’s nearing the end of a long day – the first day of surgeries during a recent Operation Smile medical mission in Koforidua, Ghana.

After 15 hours of nonstop work, Clement Ofosuhemeng remains deep in the process of putting his entire being into his role as Operation Smile Ghana’s patient coordinator.

As he spoke about his reason for taking on the daunting task of finding and serving patients and families affected by cleft in his country, you can see – and feel – the emotions ebb and flow within this soft-spoken and fervently-determined man.

“I see it as the only way to say thank you to my mother and then to humanity,” Clement says. “And I love doing it, and I don’t mind going to any length to get the patients.”

He’s done just that with unprecedented success since he became involved with Operation Smile in 2015 – first as a volunteer before becoming a full-time member of Operation Smile Ghana’s staff.

Operation Smile Ghana’s patient coordinator Clement Ofosuhemeng conducts a cleft awareness and patient recruitment campaign in Twifo Praso, Ghana. Photo: Zute Lightfoot.

Clement’s “why” is as dramatic and powerful as it is ingrained in the young Ghanaian activist.

As told to him by his grandmother, when Clement’s mother became pregnant with him, his father began having an affair with another woman. The woman then attempted to kill Clement’s mother by poisoning her food when she was six months pregnant.

The poison caused his mother to bleed profusely and she was rushed to a hospital. While she was unconscious, doctors decided that the only way to save her life was to abort Clement, who they believed would suffer life-threatening consequences. When Clement’s mother learned of the plan, she ran away from the hospital to a remote location to live for the remainder of her pregnancy.

Three months later, when she went into labour at the house where she was staying, no one was around to help deliver the baby.

“According to my mother, she said I’m the only child that when she was giving birth, she didn’t suffer at all. It was a smooth delivery,” Clement says. “Later, people came around and they rushed us to the hospital. And here I am. I don’t have any deformities…

“So, when I was little, I was a stubborn child. There was one time that she sent me to go and fetch water for her, and I didn’t want to go.

“She told me: ‘Clement, do you know that I stood for you when you were in my womb? You need to stand for me, no matter what. I just need a glass of water and you don’t want to go.’ I was 10 years old by then and I asked her, ‘What do you mean by that?’ And she said that one day she would tell me.”

But tragedy struck before that day would come. Clement’s mother died while giving birth later that year. The reason: there was no doctor available to perform a life-saving caesarean section. Clement’s sibling died as well.

“So, when I grew up, the thing that she used to tell me, I realised that it’s indeed true,” Clement says, holding back tears. “I told myself that if my mother stood for me when I was in her womb – she stood for me against all odds – what can I do for humanity?”

Operation Smile Ghana’s patient coordinator Clement Ofosuhemeng leads a storytelling session at the patient shelter during the November 2017 medical mission to Koforidua, Ghana. Photo: Zute Lightfoot.

Clement’s opportunity came in 2015 while he was working on his postgraduate national service project in the accounting department at Korle Bu Teaching Hospital in Accra, Ghana.

Korle Bu is home to Ghana’s National Reconstructive Plastic Surgery and Burns Centre, which is headed by Operation Smile Ghana medical director Dr. Opoku Ampomah. A co-worker, biomedical technician and Operation Smile Ghana volunteer Emmanuel Kumahor, introduced Clement to the organisation, and he immediately became energised to volunteer.

Clement has helped to bring hundreds of potential patients to each medical mission in Ghana since he joined the organisation. Their patient recruitment push for the April 2015 mission to Cape Coast, Clement’s first, proved to be pivotal.

Prior to that mission, patient turnout numbers were dwindling in Ghana, putting Operation Smile’s work in the country at risk. Both Clement and Sabrina knew that the patients and families were out there, mostly scattered around the thousands of remote villages in the country. However, they were just not being reached nor convinced – nor able – to receive Operation Smile’s care.

“When I heard that, I was saddened and I said, ‘Well, why? Is it true that there are no patients left in the country, or is it that something is not being done right? That might be the reason.’” Clement says. “So, I said, ‘Okay, well, I have a very strong connection on the ground,’ and I put up a strategy that I thought would work.”

And it did.

Operation Smile Ghana’s patient coordinator Clement Ofosuhemeng meets Ama, a woman who’s lived with an unrepaired cleft lip for 80 years and tells her about Operation Smile Ghana and an upcoming medical mission at which she could finally receive surgery. Photo: Zute Lightfoot.

The majority of people in Ghana are of Christian faith, and Clement’s uncle is a professional theological lecturer. Clement knew about the widespread and severe social stigma associated with cleft in the country, so he partnered with his uncle to raise awareness about both Operation Smile Ghana’s work and the true nature of cleft conditions – that they are a surgically treatable conditions and not the result of supernatural curses – throughout his vast network of church leaders.

Clement also embarked on several awareness campaigns that brought this message of hope and healing to the most remote and impoverished communities throughout the country.

“There are places that when I go, cars don’t go there. So, if I have to walk, I will walk. If I have to crawl, I will crawl. If I have to swim to that place, I will swim,” Clement says with stern conviction. “My mission is to go as far as I can go to spread the message wide, so that we will be able to help patients with cleft lip and cleft palate.”

Clement adds that Operation Smile Ghana isn’t just saving lives within the medical context.

“In Ghana, there are some cases that when mothers give birth to babies with cleft, they kill them. I must be frank. It’s hard to say, but that is the Gospel truth,” Clement says. “When someone gives birth to a baby with cleft, society frowns on them. They are rejected and isolated. People share derogatory remarks about them and point fingers at them. They are seen as not fit to be accepted as human beings.

“And I’ve been through all the regions in Ghana, and I can say for sure that the stigma runs through all the regions. They see them to be from the rivers. They see them to be from the smaller gods. They see them to be animals.

“Of course, if the person is educated, then that person knows that it is possible for surgery to be done. And if the person is also around people that are well-enlightened about this particular deformity, then that person will get proper counsel.

“But what if that person happens to be in a community where they frown on such cases? That’s where the problem lies.”

Operation Smile Ghana’s patient coordinator Clement Ofosuhemeng and his network of volunteer patient advocates reach people affected by cleft in some of Ghana’s most remote communities. Photo: Zute Lightfoot.

Convincing naturally sceptical families and patients that they can trust Operation Smile is where Clement excels. Utilising his persistent yet kind-hearted nature, he explains that the organisation performs this work across Africa and around the world by showing them several Operation Smile foundations’ websites and before-and-after photos of past patients. He says that many conversations begin with patients and caregivers thinking it all sounds too good to be true, as the medical care is free, and Operation Smile Ghana covers the expenses of travel to and from the mission as well as lodging and food during it. But most of the time, he’s eventually able to break through.

“I try my best to establish a very good rapport with them, so that they feel comfortable coming to me, comfortable calling me. I always call them – numerous calls, numerous counselling sessions so they feel that we are here for them,” Clement says. “We are with them to go through the procedure before the surgery, during the surgery and after the surgery. So, it’s not only the surgery.”

Operation Smile Ghana’s patient coordinator Clement Ofosuhemeng, left, and volunteer Emmanuel Amass Amankwah listen as a patient’s mother shares her story during the November 2017 medical mission to Koforidua, Ghana. Photo: Zute Lightfoot.

Once patients and their caregivers arrive to the mission’s patient shelter, incredible transformations begin to take shape. Operation Smile Ghana takes special care to create a supportive community atmosphere among the families. They educate the attendees about cleft conditions and offer activities that have the potential to become income earning, such as tie-dying fabric and crafting beaded jewellery.

At the shelter during a recent mission, Clement called for a group of patients and their families to gather in a circle. He asked for each of them to share their stories. As the group listened, the emotions are nearly palpable.

Clement said that the sharing of these experiences resonates far beyond the patient shelter and into the communities from where they came.

“When they come to the shelter and then they see so many people with cleft, it strengthens them. They may have thought that they were the only one with a cleft, but now what are they seeing? People with various degrees of cleft. So, at the shelter, it’s like a family.

“Right from day one, I’m always with them. We crack jokes. I share my story with them. And sometimes, the stories they have are way more powerful than even mine…

“When they return to their villages, I see them to be potential ambassadors to help erase the stigma. Now that they have received education about cleft, they can spread the information, the good news and the truth so that it will remove the negative perception that people have about cleft. So, when I’m able to recruit more than 300 potential patients, I see them all as people that can help make the job work – to make information about Operational Smile go viral.”

Operation Smile Ghana’s patient coordinator Clement Ofosuhemeng and volunteer patient advocates Issac Arthur and Patrick Kwane Yalley conduct a cleft awareness and patient recruitment campaign in Mfantsiman, Ghana. Photo: Zute Lightfoot.

COVID-19 Conversation: Putting our Expertise to Work

Now, more than ever it’s our charge to safeguard the health and well-being of individuals around the world. We’re building upon our expertise in delivering cleft surgery and care in resource-limited settings as well as our history of improving the health and dignity of those we serve.

That’s why we’re finding the most meaningful ways that we can support people and their health needs in the communities where we work, even when medical missions are postponed, care centres are closed, and the future feels uncertain. It’s in this uncertainty that our swift action is required, and we’re doing everything that we can to help patients, families, and countries as this affects them.

This “COVID-19 Conversation” featured a live question-and-answer session with Ernest Gaie, our Senior Advisor of Global Business Operations, and Stuart Myers, our Senior Vice President of Global Operations and Programmes. The session was hosted by Laura Gonzalez, our Digital Content Manager, and John Streit, our Managing Editor and Writer, moderated the audience’s chat and questions.

Ernest brings 20 years of field-based experience working with nonprofit organisations primarily in sub-Saharan Africa and is a proud recipient of the Clinton Global Health Initiative for his outstanding leadership and management of Africare’s response to the Ebola epidemic in Liberia between 2014 and 2015.

Stuart has 15 years of experience of working within 30 countries on operations and programme management and has served in key roles at Project HOPE and the People to People Foundation.

Event Transcript

Laura: All right. So we’re going to go ahead and get started. I just want to say a quick thank you to all of you guys on the line for joining tonight. We’re so excited to announce Operation Smile’s first “COVID-19 Conversation” and the topic of this conversation is going to be “Putting Our Expertise to Work.”

I’m Laura Gonzalez; I’m Operation Smile’s Digital Content Manager, and a lot of my work focuses heavily around our storytelling. I work really closely with my colleague, John, and I’ll let him introduce himself and then go over some of our rules for the chat.

John: Hi, I’m John Streit, the Managing Editor and Writer for Operation Smile, and alongside Laura, we’ve been keeping really close tabs on all of the stories that we’re going to be talking about tonight. And you know, we’ve been in this unprecedented the time, but we’re excited to share our initial response and how we’re putting our expertise to work with you guys.

I’ll be moderating the chat area of the webcast tonight. So, if you have any questions or want to engage in conversation with me during the webinar when Ernest or Stuart are speaking, just to enter it into the chat area, and I’ll be engaging in there. And then also, if you have any questions, I’ll be gathering those and, time permitted, will ask Stuart and Earnest some questions at the end of our event.

Laura: Thank you so much, John. And now I’m really excited to introduce you guys to two of our panelists. We feel really appreciative to have their time today and to hear what they have to say about Operation Smile’s response to the COVID-19 pandemic.

So, our panelists are Ernest Gaie; he’s our senior advisor of global business operations. Ernest brings decades of field basic experience working with nonprofit organisations in sub-Saharan Africa and was honoured by the Clinton Global Health Initiative for his outstanding leadership and management of Africa’s response to the Ebola epidemic between 2014 and 2015.

And Stuart Myers is our senior vice president of global operations and programmes. Stuart has served in key roles at Project Hope and People to People Foundation. He has worked in 30 countries over 15 years and has expertise in operations and project management.

Stuart, Ernest, thank you so much for joining today’s conversation.

Stuart: Thank you for having us. I appreciate the opportunity to share some of the things that have been going on.

Ernest: Thanks for having us, Laura and John, for sure.

Laura: Yeah, so we’re going to hop right into some questions, and then as John mentioned, at the end we might have an opportunity for audience participation.

So, Ernest, the current pandemic isn’t your first experience responding to an outbreak of infectious disease. How did your leadership and management of Africare’s response to the 2014 and ‘15 Ebola epidemic in Liberia prepare you for your current response with Operation Smile in regards to COVID-19?

Ernest: Yeah, sure, thanks Laura.

You know, after the Ebola in Liberia, I said to myself that I hope I never have an opportunity to get involved in another epidemic and, wow, five to six years down the road here I am again. I guess it’s a true call to our humanity and our profession and what we are passionate about, so, really glad to be here and to be a part of this noble institution.

I want to say that infectious disease outbreaks, such as the Ebola virus disease and now COVID-19, do have significant impact on health systems when you have such a scale and magnitude as we’ve had with COVID-19 that was declared a pandemic.

And when we talk about the health system it’s everything inclusive – health care workers, the health infrastructure, the testing and just the whole clinical aspect of it – the testing and diagnosis capability, the clinical solutions and just the surveillance aspect of it as well. So these things are largely impacted, and it is even more impactful when it comes to low and middle income countries. The reason is simple, we just struggle with weaker health systems and competing priorities and therefore, the level of investment that is required for the health system is also compromised by those competing priorities. And that was the case with Liberia where I worked with Aftercare as a country director. We served as a partner to the Ministry of Health just basically trying to help rebuild the health system in Liberia and show that essential health services were rebuilt and provided to folks.

And so, in 2014, we had this epidemic, the Ebola virus epidemic, and one of the reasons why it was it was critical for us to engage as an organisation was we realised that quickly, because the system was so overwhelmed, critical and essential health care was also compromised. At the time, Liberia was recording some of the worst maternal and child health indicators in the world. And therefore, the fact that the health facilities were also overwhelmed, they were unable to continue to provide essential maternal and child health care services. People realised that people were dying from basic simple sicknesses like malaria.

So as an organisation, one of the things that I did was to quickly bring back our programme team and say, “Look, listen, as a major partner to the Ministry of Health, this is a health emergency.” We cannot just sit and say, “We are implementing a development programme. And therefore, we’ll deal with the emergency; we’ll come back and deal with the post-recovery and development initiative.” So we reprogrammed; we repurposed some of the resources that we had for the response to, one, ensure that health care workers and the facilities had the requisite support to respond to any cases of Ebola that did show up at those facilities, but, two, to ensure that other essential services were provided.

I think this is the intersect. This is the experience and the skill set that I bring to this. I’m really pleased with the level of flexibility that has been demonstrated by Operation Smile and it’s leadership. I just really want to recognise the senior leadership and our Chief Medical Officer (Dr. Ruben Ayala) for stepping up and not just stepping out but demonstrating and putting forth it’s extensive network of medical expertise and other resources. I think this is just a phenomenal initiative that has happened so quickly. I was asked to lead and was able to mobilise the team that we’re currently working with.

One of the things that we did was to get out to our regional directors to get out to the respective foundations and programme countries that we work with and really try to gauge what the situation was in their respective countries and to understand from them, first-hand, where the critical needs and gaps were, and how we, as an organisation, can engage in the response as a partner, like a true partner, to them in good times, but in challenging times. I’m pleased to say that, out of that process, we now have a global COVID-19 response plan and implementation framework that we’ll be talking about later on this call. But really it has been a phenomenal experience – really incredible people we are working with and I’m so delighted that my experience from Ebola is really contributing towards our overall global response to support our foundations.

Laura: It’s wonderful to have that expertise that you bring, and when you speak about implementation of programmes like this, I think, Stuart, you kind of jumped in feet first when you joined the organisation. How have you been able to balance delving into the organisation, getting to know Operation Smile while also having to deal with such a dramatic disruption in the way that we run our programmes typically?

Stuart: I have to start by saying it’s coming up on the 90-day mark, and I have to say, it’s probably the most interesting 90 days I have ever had. I started I think the day the global conference started (early February 2020) and was an attendee there and attendee at the regional directors’ conference after. So, I got a very, very good overview of what Operation Smile was and started to just barely get an idea of how the pieces all fit together.

And then the COVID-19 pandemic began. What that allowed me to do was to see what I think is some of the best of Operation Smile. The easy thing for Operation Smile to have done would have been to say, “You know, it’s a pandemic. We’re not a relief organisation; we’ll just wait at home.” But from top to bottom of the organisation, the exact opposite response took place.

I think it was a good demonstration of the culture of Operation Smile, the compassion that it has for the people, patients and foundations and partners that we work with. It was also a time to experience firsthand the expertise that is available in the organisation: People like Ernest, people like Ruben, the Chief Medical Officer, (Operation Smile Co-Founder and CEO Dr. Bill Magee) and all of the regional directors, country directors and partners to see all of those people pull together in a response to what became a very, very serious problem for not just any one of our countries but all of them together. To see all come together in a very short timeframe and a very professional manner was very heartening for me. It’s really instructional, but also very heartening.

Laura: Yeah and you both speak about the leadership and the way that you guys, as members of that leadership group, came together. Can you take us a little bit behind the scenes after the pandemic was officially declared and governments around the world began implementing the various mandates that resulted in our medical programmes being postponed and international travel being postponed? What were the conversations like when leadership convened and decided that we did need to adapt the way that we’re working?

Stuart: The conversations immediately turned to focus upon, “What was the impact going to be upon our patients?” and furthermore, “What was the impact going to be on our volunteers?” At the time that the pandemic really rose to the surface as a serious global issue, we still had a number of missions that were planned in anticipation of being able to treat patients. We had international volunteers and local volunteers all geared up and ready to go.

But what really came to the forefront was making sure that the patients were safe and that our volunteers would be safe. That led to a number of discussions around both of those issues and also discussions with some other NGOs about how they were responding to the virus and the impact on their programmes, now looking for possibilities of where, even though our mission schedule may have been disrupted, how do we participate and help at the local level with the responses that were taking place.

Because we recognised very early that there was going to be a tremendous strain on the local health systems, and in order to make sure that they were able to respond appropriately, we took action to authorise our foundations, for example, to release buys and potentially equipment that we had in hand could be useful in responding to do the pandemic. So a lot of discussions around safety and volunteers, but then very quickly also discussions around, “How could we best respond?”

Laura: And so we’ve seen around the world that our staff and our volunteers have been innovating to serve the needs of the local communities where we’re working. Could you tell us a little bit more about some of those innovations, maybe the ones that are most impressive to you or the most out-of-the-box?

Stuart: Ernest, I’ll let you take this one.

Ernest: Thank you, Stuart. So on the COVID response side of things, as I said earlier, the leadership decided that it will reprogramme and repurpose to really support some of the initiatives that the foundations have stepped up to it as part of their own national response as well. So, we were able to release some funding to the different foundations, and the funding has been used to support some of the initiatives. In India for example there are regions where we have a comprehensive care centre – our regional director and executive director Abhishek (Sengupta) has worked with his team to address the immediate need of some of the most vulnerable populations.

They were able to provide food and non-food hygiene kits to go along with families. This is typical and we’re going to continue to see this as long as this pandemic continues, that more vulnerable populations will be faced with multiple challenges.

Not just with the epidemic itself but challenges around how do they meet their basic needs and how will they be able to even access health care if they need basic health care. So, that’s something that is happening. Other foundations have stepped up as Stuart mentioned to donate their supplies to the response, to their partner hospital partners or to the ministries of health.

We have also provided some trainings as well, and we have webinars that we have set up just to show that health care workers, front-line health care workers, have the basic training and skill set to respond to this pandemic. So those are some of the kind of initiatives that are happening.

In some other instances, we’ve been able to provide the foundations with the ability to provide equipment. In Malawi, for example, our team, staying engaged with some of the patients and their families, have also provided income-generating training so families are being taught to produce soap. We thought that was really fascinating and very great on their part, to ensure that they are able to have one of the critical supplies that they need to continue to protect themselves. I mean, like everybody is saying, “Wash your hands; sanitise your hands.”

Well if you don’t have the materials or the supplies to do that, how can you do that in an effective way? And so, you know, that’s just one of the ways. I’ll turn it over to Stuart to talk about what we’re doing from a technological standpoint to continue to stay engage with some of our patients.

Stuart: Sure, thank you. One of the things that started roughly at the same time that the pandemic started is that we began, in Nicaragua, to use a digital platform to reach out to patients, for example, who needed services related to speech pathology and potentially psychosocial support. That is a new initiative for us. We are looking at ways that we can, for example, roll that platform out across Latin America.

Also, a number of the local foundations have been doing things with text messaging and SMS messaging, where we’ve had access to cell phone numbers. We’ve been able to send a message just to check and make sure that our patients are doing okay and are doing well. So there are a number of ways that we’re trying to utilise technology that exists to be able to stay in touch with our patients and also help to respond to the COVID pandemic itself.

One of our speech pathologists uses the platform to communicate with patients. I think there’s a lot of potential in that type of initiative. If you have the platform, there are a number of things you can do across the continuum of comprehensive care, and that could reach back to your first initial contacts with the patient and getting them screened, getting them into the queue for treatment, all the way through the surgery process and then even beyond that to additional services that they might need.

So, we’re very excited about that. We think that’s a something that’s got great potential for us in the future.

Laura: Right, and speaking of the future, we’re getting some great questions in the chat about what returning to normal looks like once were given the all-clear that it’s safe to resume operations as usual. What are we doing right now to ensure that that transition is smooth?

Stuart: One of the things I think to keep in mind about something like an epidemic, it’s a different kind of event than, say, an earthquake or a hurricane, where the event is very concentrated and then you can immediately move into a relief and recovery. The pandemic, as we’ve all seen, has sort of been a rolling event. Country after country seems to get affected. Our assumption is that countries will come out of the pandemic in roughly the same kind of manner.

There will be a rolling recovery and restart. We’re working with our regional directors and the local foundations to try to get a handle on what that will look like both in terms of what it looks like in terms of timing of reopening countries and what kind of recovery period, for example, is the local health system going to need when they’ve been stretched so far to resolve the pandemic. They’re likely to have needs of their own in terms of just being able to do simple things like restocking supplies and making sure that they have staff available that’s well, rested and able to participate.

We’re looking for, essentially, at what we think will be a rolling kind of reopening and restarting. It will be driven by how quickly the countries are able to respond to COVID, but then also how quickly, for example, can they get back to where they can do the types of surgeries that we do in the local health system. Ernest, is there something you want to add to that?

Ernest: Yeah, sure, thanks. Laura, I’m glad that you asked this question, because I think it’s a critical question for us, and we need to be able to let people know what we’re doing so far. That will kind of pivot us into implementing our core programmes.

Just a couple of things: one, I think it’s important for us to realise that one of the things that such epidemics or pandemics when it comes to health systems is that if you roll the confidence and trust of people in the system – and when I say people, I’m talking about both service providers and those who were seeking the service.

So, health care workers, they want to be sure that they have the appropriate infrastructure that will protect them while they are providing the services and care. They want to make sure that they have personal protective equipment that can also help to protect them. They want to make sure that they do have the testing capabilities within their respective health facilities to ensure that they’re providing. And on the fourth side is that they need to be sure that when a patient walks in they have the clinical supplies, whether it’s vaccines or whatever kind of medical supplies that are needed to provide care. That has to be there to assure them.

On the other side, patients need to be assured that when they walk into a facility showing symptoms, or they feel that they have some kind of illness, they may not know that that facility is equipped to diagnose and to be able to treat and care for them.

Thankfully, as an organisation, to our federated model, our foundations are really stepping up to do that. We’re really grateful to have this extensive network of volunteers across the globe that have quickly adapted and adjusted themselves and put themselves to the front line.

So in terms of that assurance, we are already there. And you know patients are coming in to our senior volunteers … our staff and they show them that yes, “When things quiet down, it will be easier. We can trust these facilities and these health care workers to provide care for us.” More than that, through our foundation and leadership and with the trust and confidence of our donors and our partners, we reallocated the funding to support the national response.

As I speak to you, we have acquired almost 170 oxygen concentrators. We have acquired over 200 pulse oximeters and we have acquired a little over 500,000 assorted personal protective supplies that are all going right now to sub-Saharan Africa and to two countries in North Africa.

These, in our view, are just part of us reassuring the service providers and those who are seeking the services that, “Look, listen, we have the capability; we have the support network; we’re here as a key strategic partner to you as minister of health; we want to help you through this process. We will be standing and walking with you as we transition back to normal programming.”

So, I think that trust is critical, and I’m really, really very pleased that even those who are our individual (donors) are aware of what we’re doing, and they trust Operation Smile. And I can tell you, clearly, for sure that from our Co-Founders, Bill and Kathy (Magee), to our Chief Operating Officer Jim Siti, to our Chief Development Officer Kendra (Davenport) to (Senior Vice President of Global Philanthropy) Kristie (Porcaro), everybody is working around the clock to really stay engaged with all the different stakeholders, informing them of what we’re doing and reassuring them that during this critical period, we are repurposing and we’re providing much-needed support.

Here at home, we were able to provide basic needs to Sentara medical hospital here in in Virginia Beach. More than that, through our Student Programs, you can see that from the East Coast, Mid-America, Midwest, and West Coast, Kathy and Bridget (Clifford) and Jennifer (McKendree) are working tirelessly with their teams and students to provide hot meals to front-line health care workers. I mean, it is incredible teamwork here, and trust, in my opinion, is what is fueling this but the passion and the drive that we have are additional support to this.

I mentioned Ruben, our Chief Medical Officer, who is constantly engaging his colleagues in the medical field and our regional medical officers, so I can safely say that with the support and what is already going on in our respective foundations and programme countries and through our regional directors who can see a seamless transition back into all programmes.

Two things that we are working on right now to ensure that that is also included: one, we do realise that the infrastructure, particularly when it comes to our comprehensive care centres, we are now working with medical directors in those foundations where we have care centres, the (executive directors) and regional directors to ensure that the infrastructure is properly equipped to triage patients as they come in, so that in the future if we ever, God forbid, do have a similar situation that staff and other patients are not at risk when they walk in.

We’re doing trainings right now, we are partnering with other organisations to continue to ensure that front-line health care workers have the appropriate knowledge and skill set to really provide care in a safe manner.

Laura: Yeah, I’m hearing a lot of this trust and compassion which I feel are our core values of our organisation. We are out of time, but Stuart, did you have any kind of closing words you’d like to add?

Stuart: Just that, you know, the event has been unprecedented, and all organisations are trying to figure out how to how to respond in the immediate sense and how to position and come out of this pandemic. I think Operation Smile will not be an exception to that.

We are actively reviewing how we do, for example, our mission activities and what that will look like in a post-COVID world, where there may be restrictions on the size of groups that you can get together, how long they can stay together. So they’re going to be some adjustments along those lines that we will need to add, and we’re working our way through those very well. I’m very optimistic about and positive about the progress we’ve made and what the future looks like for us moving forward.

The organisation is a great organisation. It’s got a very critical role to play. We’re sure that we play the role in the current situation but also that we continue to play that important role as we move forward. I just appreciate everybody’s effort and support.

Laura: Thank you, both Steward and Ernest, so much for joining and for sharing your expertise with our audience. I know they appreciate it.

Audience Q&A

Zak: What did the rebuilding of the (Liberian) health system look like post epidemic?

Ernest: It was challenging, considering that the system was already impacted by the 14-year civil conflict. However, there was commitment from international development partners like USAID, Irish-Aid, DFID, World Bank and others that continued to fund the rebuilding process. So, we continued training healthcare workers, strengthening supply chains with delivery of essential medical supplies including pharmaceuticals, and improving health infrastructure. The focus was really building local health systems’ capacity at primary health care level to deliver essential health care in the areas of extended programme of immunisation/EPI, reproductive, maternal, neonatal and child health.

Linda: What criteria will Operation Smile use to determine that it is safe to resume international missions?

Ernest: Our Medical Advisory Council is currently working on this. However, we certainly operate within the global framework and will continue to observe global and national advisory, especially those based on scientific evidence as well as from recognised global health organisations.

Stuart: This will require a loosening of travel restrictions on both ends of the trip, i.e., the departure and arrival ends. While it’s not certain at this time what, if any, COVID-related documentation might be required in addition to normal travel documents, we are assuming that some form of testing or vaccine will need to be in place before we can ramp up international missions again.

Janine: Are the centres being used for the COVID-19 patients as an outreach to support area hospitals?

Ernest: Not at the moment due to the respective national governments’ stay-at-home mandates. However, as mentioned during the live event, our teams are using digital platforms to continue to provide consultations to patients where possible like in Nicaragua. Our plan is to further develop and expand this capability within our programme delivery.

Diana: Will Operation Smile be COVID testing (patients) before surgeries?

Ernest: We will continue to strengthen the capacity of our partner hospitals to include COVID-19 along with other pre-surgery testing that are part of our regiment. This will include providing testing equipment and supplies and training lab technicians on additional infectious disease diagnostics. We will also include this process for our volunteer team composition to ensure total safety for all including volunteers and patients.

Stuart: The current thinking is that we mostly likely will. Our standards of care are currently under review to take into account the implications of COVID-19 on our delivery of care.

Janine: Will there be more opportunities to participate in brainstorming ways to help others or the sharing of information?

Laura: Yes! “COVID-19 Conversation” will be an ongoing series, so please continue to tune in and keep asking great questions. We are passing all of the great ideas discussed in this forum throughout the organisation, so keep them coming! You can also visit https://operationsmile.ie/get-involved/fundraise/ to check out more great ways to support our work.

Lynn: Is there anything we could do as nurse or doctor volunteers in our homes, in addition to donating money right now?

John: While monetary donations are critically needed and will provide us with the ability and agility to respond to COVID-19 and ensure that we can resume providing surgeries when it’s safe to do so, there are many ways you can support your communities during the pandemic. You could consider donating cash or food to your local food bank, as this is an area of massive need that’s been amplified by shutdowns. You could also start by researching community-level response initiatives and find the best fit for you! The need out there is great, but with the kindness and support of people like you, Lynn, we will get through this together!

FA: Where can I volunteer in regards to Operation Smile?

John: Thank you, FA. We appreciate your willingness to support Operation Smile’s response to the COVID-19 pandemic. To explore ways to become involved, please visit https://operationsmile.ie/get-involved/fundraise/ to learn more about the many ways that you can make an impact!

Our Global Response to the COVID-19 Pandemic

Editor’s note: April 24, 2020 updates include our first virtual events on our response to the pandemic and the donation of food and hygiene supplies to patients’ families in Guatemala.

Today, our teams around the world are refocusing their efforts to fight the COVID-19 pandemic in their communities while remaining committed to caring for our patients’ and their families’ health and well-being.

From Vietnam to Guatemala, we’re providing immediate relief through redirecting supplies and equipment to support health workers who are on the frontline.

In places like Nicaragua and Colombia, we are utilising technology to safely deliver consultations like speech therapy and psychosocial counseling to our patients.

“I’ve been impressed by our countries’ unselfishness in responding to a difficult situation amid significant uncertainty,” said Stuart Myers, Operation Smile Senior Vice President of Programmes. “The easy move – the safe move – would have been to stand back and see how things played out. They didn’t do that. They willingly gave what they had available to help others in need.”

Click here to watch Stuart and Ernest Gaie, Senior Advisor, Global Business Operations, in our first “COVID-19 Conversations” virtual event about our response to the pandemic and stay tuned for more from this ongoing series.

Photo: Peter Stuckings.

Redirecting supplies and equipment

By redirecting crucially needed supplies and equipment such as gloves, masks, gowns, ventilators where they are most needed, our teams worldwide are providing immediate relief to hospitals and supply chains that are being stretched beyond capacity.

Much of our expertise is geared toward operating in resource-poor settings, and the COVID-19 pandemic has created a similar lack of supplies and equipment in some of the world’s wealthiest countries.

In many of the countries where we work, our teams are donating the personal protective equipment they have on-hand to hospitals in their communities.

This includes the United States, where we donated 1,800 face masks and 4,500 gloves to Sentara Princess Anne Hospital in Virginia Beach, Virginia.

“We are grateful, as Operation Smile is a neighbour who stepped up to help us help the community,” said hospital CEO Paul Gaden. “These donated supplies are much-needed as we deal with this global health pandemic.”

Operation Smile donated 1,800 face masks and 4,500 gloves to Sentara Princess Anne Hospital in Virginia Beach, Virginia. Operation Smile photo.

Similar donations are being distributed around the world by our international foundations in Bolivia, Ghana, Guatemala, Honduras, Italy, Mexico, Morocco, Nicaragua, Morocco, Panama, Paraguay, Peru, South Africa and Vietnam.

Operation Smile Guatemala has donated more than 4,000 surgical gloves and 400 protective masks to Hospital Juan Pablo II in Guatemala City.

“We know that we are in a time of uncertainty; we do not know what is going to happen,” said Operation Smile Guatemala’s Executive Director Beatriz Vidal. “To contribute in a time of a national emergency … This is what motives us the most. To be the difference, to be agents of change.”

The director of Children’s Hospital John Paul II, Dr. Martiza Quex, is also a volunteer paediatrician for Operation Smile Guatemala. She said that donations like this are critically needed in Guatemala, where the country’s health system is not prepared to handle a viral outbreak on the scale of COVID-19.

“They (the hospital staff) were very grateful, because this donation will allow them to protect both patients and staff,” Martiza said. “Joining efforts for the common good is very important in every moment, but especially in emergent situations like this one, where the lives and health of people are threatened regardless of where they are.”

April 9, 2020, update: Operation Smile Paraguay donated supplies and equipment to Paraguay's Health Service of the Armed Forces. Operation Smile photo.
April 9, 2020, update: Operation Smile Honduras donated $40,000 of personal protective equipment and other supplies to the Honduras Ministry of Health, which is distributing the supplies to the main public hospitals in Tegucigalpa. Operation Smile photo.
April 9, 2020, update: Operation Smile Mexico donated $10,000 of personal protective equipment and other supplies to five hospitals in three Mexican states. “Medical staff from the entire country is fighting against COVID-19 and there are not enough medical supplies in Mexico. We hope that this donation helps our medical volunteers, partners and people in the health sector in general so they can keep giving their best effort while feeling protected,” said Miguel Ángel Pichardo, executive director of Operation Smile Mexico. Operation Smile photo.
Operation Smile Vietnam donated medical equipment and supplies to Vietnam-Cuba Hospital and Thu Duc Hospital. Operation Smile photo.
Operation Smile Ghana donated medical supplies and equipment to provide frontline COVID-19 support. Operation Smile photo.
Operation Smile Ghana donated medical supplies and equipment to provide frontline COVID-19 support. Operation Smile photo.

We’re also providing additional support to partner hospitals and health workers so they can safely deliver patient care both during and after the current pandemic.

We hosted our first webinar for health care professionals in low- and middle-income countries, “Anesthesiology and Critical Care Forum: Implications of COVID-19 in LMICs,” on April 17.

And plans are underway to remodel and outfit intensive care units to treat patients with COVID-19. Alongside our partners DiaMedica and Lifebox, we purchased 100 oxygen concentrators and 200 pulse oximeters, respectively, to be delivered to hospitals in Malawi, Madagascar, Mozambique, Ghana, Kenya, Rwanda, Morocco and Egypt.

We’re also exploring more potential partnerships to continue building upon our response to the pandemic.

Continuing our commitment to patients

While we direct efforts toward responding to the pandemic, we also understand that our patients’ needs remain, as does our commitment to their health and dignity. Our foundations around the world are developing new ways to support our patients and their families through this uncertain time.

In Managua, Operation Smile Nicaragua is conducting speech therapy and psychosocial consultations using Facebook Live with patients who have internet access and by phone for those without it. Speech therapist Scarlette Gomez said that the virtual session are both highly effective and appreciated by patients and their families.

“I’ve always tried to portray therapy as something you can do at home, having a fun time and learning as much as we can,” Scarlette said. “I’ve been working with most of these patients for more than two years now and … I get excited every time I get to see them; it makes them really happy when we make progress.”

“Thanks to Operation Smile for supporting my son in doing speech therapy online, so he can continue improving his speech” said the mother of Isaias, one of Scarlette’s speech therapy patients. “Thanks to Dr. Scarlette for her support, and I hope they continue supporting us as they always have.”

Operation Smile Colombia speech therapist Angie Agudelo.

In Colombia, speech therapist Angie Agudelo is uploading videos to Operation Smile Colombia’s YouTube channel, sharing ideas of activities that kids can do while staying isolated at home.

Plans are currently underway to expand virtual consultations across all Operation Smile foundations in the Latin America and the Caribbean region.

We are also ramping up nutritional support for our patients who are suffering from malnutrition. Even before the pandemic, these are patients whose lives are at risk because they are unable to grow strong enough to receive surgery safely.

A mother in Madagascar provides ready-to-use therapeutic food to her child in 2017. Operation Smile photo.
A mother in Madagascar provides ready-to-use therapeutic food to her child in 2017. Operation Smile photo.

In Ethiopia, Rwanda, Ghana, Malawi, Madagascar, Honduras, Nicaragua, Venezuela, Dominican Republic and Guatemala, hundreds of cases of ready-to-use therapeutic food (RUTF), a nutritive peanut paste, are being mobilised and plans are underway to safely distribute these supplies to the patients and families who need them.

Around the world, our volunteers and staff are reaching out to as many of our patients and their families as they possibly can, letting them know that once it’s safe to do so, we will be there for their cleft care need as we were before the pandemic.

Innovating to address communities’ needs

Our foundations are also responding to the unique situations that are unfolding in their countries. An innovative response is being conducted by Operation Smile India.

Originally, the foundation sought to purchase and redirect supplies of personal protective equipment to its partner hospitals, but soon learned that there is a massive shortage in India, and it would be unable to provide this kind of support.

Committed to support the communities in which it works, the foundation is partnering with the Inga Health Foundation and local governments in Mumbai and Durgapur to distribute food and personal hygiene items to 700 families and workers in the informal sector who are being hit the hardest by the nationwide lockdown that’s been in effect since March 24 and will last until mid-April.

April 9, 2020, update: Operation Smile India staff prepare food kits for distribution. Operation Smile photo.

“These are people working in construction sites, small and large factories, shops and more,” said Operation Smile India’s Executive Director Abhishek Sengupta. “Given the lockdown, the places where they usually worked have been shut down, and thus they have lost their employment and daily wage. A huge chunk of these daily wage workers are migrant workers, mostly people from rural India coming into cities for employment opportunities …

“We want to stand beside communities that we serve,” Abhishek said. “We are still in contact with our patients and we are looking at opportunities to reach out to more people.”

Operation Smile India's Executive Director Abhishek Sengupta. Photo: Lorenzo Monacelli.

In the U.S., Operation Smile student volunteers are spearheading a new initiative, “Serving Smiles,” by providing meals to health care professionals who are working tirelessly on the front line of the pandemic.

The impact of Serving Smiles is three-fold: the initiative brings much-needed business to restaurants, provides health care workers with support and appreciation, and empowers students to give back during a time of dire need. During each delivery, which takes place outside of the hospitals, students practice social distancing and wear personal protective equipment to ensure that the donations are made with safety of everyone involved as the top priority.

The pilot programme is underway in the Hampton Roads, Virginia, region and plans are in the works to expand it into areas across the country.

“Never has it been so critical that our local community support one another and partner to meet the COVID-19 challenge together. On behalf of our frontline and non-frontline staff at DePaul Medical Center, we express our deepest gratitude for the outpouring of support displayed by Operation Smile and our local restaurants and food vendors. Your donations have not only fed our bodies but have nourished our minds and lifted our spirits,” said Cindy Segar-Miller, Hospital Administrator for Bon Secours DePaul Medical Center in Norfolk, Virginia.

Sixteen-year-old Operation Smile student volunteer Xander Zimmerman helped deliver lunches to Bon Secours DePaul Medical Center. “I want to step up and lend a hand. This is a way to show appreciation because every kind gesture matters,” Xander said.

Participating in the Serving Smile initiative, Operation Student volunteers drop off dozens of meals to Bon Secours DePaul Medical Center in Norfolk, Virginia. Operation Smile photo.

These are just some of the ways our teams around the world are changing the way they’re working to serve the needs of the local community.

We’re committed to helping how we can in the global COVID-19 response, and we’ll remain agile to address new needs as they arise.

We will be providing ongoing updates to our global COVID-19 response through updates to this story and other blog features as well as our social media accounts.

“We would never be able to be where we are today without you, and we won’t be able to be where we need to be tomorrow without you,” said Operation Smile’s Co-Founder and CEO Dr. Bill Magee in the video below. “We need to keep forging on, accepting the challenges that come back to us day in and day out, and we know we can do it, because you are right there beside us, helping us move forward, so we can’t thank you enough.”

Meet Our Patients: Oujda, Morocco

Meet Radouane

Photo: Jasmin Shah.


Nearly three years ago, Safia gave birth alone at home to her son, Radouane. Although seeing his cleft lip made her question what kind of future her son would have, the love Safia had for him only strengthened.

“I was not afraid. I’d seen kids like that before, and I knew that this was the gods’ fate. I’m grateful for what the gods gave me,” Safia said.

Friends and family members felt only love toward Radouane after seeing his cleft lip for the first time, looking at him without malice or disgust.

“Where I come from, people were so friendly and supportive,” Safia said. “They said that he’s just another human. He’s not that different.”

Sadly, there were people in their community who let their lack of knowledge and stigma surrounding cleft conditions influence their ability to treat Radouane and Safia with the kindness they deserve.

“Each person who mocks him is mocking themselves,” Safia said. “It shows that they weren’t raised well, and that shouldn’t be the case.”

Last October, Safia learned about Operation Smile Morocco. Her eldest son saw the organisation’s Facebook page and read that it provides free surgical care for children like Radouane. Hopeful that she’d found a solution for her son, Safia traveled to the organisation’s care centre in Oujda where medical volunteers and staff began the initial stages of his cleft care process.

It was at the centre that Operation Smile Morocco informed Safia that her son would have an opportunity to receive surgery at its next medical mission taking place in Agadir.

But with Agadir being more than 600 miles away and having her other children at home to think about, Safia knew she couldn’t make that journey.

After patiently waiting nearly five months, the time came for Safia and Radouane to leave their small village located on the countryside and head toward Oujda for Operation Smile Morocco’s March mission.

Safia traveled to the nearest province of Taourirt, where some of their family members live. Three days later, Safia departed from their relatives home and journeyed two and a half hours by bus, determined to be some of the first people to arrive.

On the first day of screening, Safia and Radouane sat among hundreds of families of children living with unrepaired cleft conditions who’d all been brought together for the same reason – to get their child life-changing care from Operation Smile.

Initially shy and quiet, Radouane remained glued to his mother’s side and wary of the unfamiliar environment.

But slowly, Radouane’s cheerful and outgoing personality bloomed, and volunteers soon heard his infectious laugh across the screening site. As Safia watched her son run around stomping bubbles and playing with other children, the love and pride she had for him was evident.

“He’s my son. I love him, no matter what,” she said.

Later that same day, Safia received the news that Radouane had passed his comprehensive health evaluation and was cleared for surgery. She felt confident that, with safe surgery, her joyful son could live a happy and healthy life and receive an education just like her other children.

A few days later, after volunteers guided her back to the recovery room where Radouane began to slowly wake up from surgery, Safia couldn’t help but smile as she held him in her arms.

“I’m so grateful for the volunteers who are here. If you don’t help these children, who will?”

Meet Elmehdi

Eight-month-old Elmehdi and his mom, Soumia.


The shock Soumia, mother to 8-month-old Elmehdi, felt after giving birth turned to determination in her journey of actively seeking out a solution for her son.

“When he was born, I was scared,” Soumia said. “I didn’t know what a cleft lip was. I’d never heard of it.”

It was through social media that Soumia heard about the Operation Smile Morocco’s medical mission in Oujda. Finally seeing a solution in sight, Soumia channeled that hope to empower herself to keep going and to never let anything prevent them from getting Elmehdi the care he needed.

“I live in Tafoughalt. It took me two hours to get here. I took the bus. I’m tired, but I want my baby to get help,” Soumia said.

Elmehdi smiled as he and his family continued through each stage of the screening process. After Elmehdi passed his comprehensive health evaluation and was selected to receive surgery, Soumia expressed her relief and appreciation to the volunteers involved with this mission and every other Operation Smile mission.

“Everyone is so nice. I’m so grateful to Operation Smile. I’m happy and Elmehdi is happy,” she said.

Meet Meriem

Photo: Jasmin Shah.


On a day that’s oftentimes the happiest of a mother’s life, Khadija felt fear and uncertainty when she looked at her daughter, Meriem.

“For the first two hours, I was so scared. But slowly, I accepted the fact that I had a daughter with a cleft lip,” Khadija said. “It’s God’s fate. God creates us the way he wants.”

Khadija’s friends and family instantly loved Meriem, treating her and cherishing her like any other child in their family.

For many parents living in low- and middle-income countries, with children who are born with cleft conditions, safe surgical care is often inaccessible or unknown. Thankfully, this wasn’t the case for Khadija.

Immediately after giving birth, she learned that surgery was possible, which allowed Khadija to remain hopeful and confident that her baby girl would one day receive a new and beautiful smile.

But for many families who lack the awareness or knowledge of organisations like Operation Smile, they spend months, or even years, never knowing that there are solutions out there for their children.

The doctor who helped Khadija give birth calmed her fears and shared that Operation Smile Morocco could help her and her daughter.

“Despite the fact that I’d already accepted her no matter what, it was such a relief to know that there was a solution,” Khadija said.

While Khadija always cherished her daughter the way she was, others from their community treated Meriem with disdain, regarding her as someone who didn’t matter.

“What I found the most challenging was people pointing at my daughter for being different. Not my family, but the strangers would ask, ‘Why is she like that?’ and wondered if I was responsible for the cleft,” she said.

After learning about this upcoming mission, Khadija didn’t hesitate to make the 12-hour journey from Casablanca.

Now, looking at Meriem’s new smile, Khadija said that she’s relieved her daughter will never have to endure teasing or hear the hurtful comments people once said.

“My wish for my daughter is that she will get a good education. She will grow up and live a normal life.”

A message from Teri Cosgrove, Operation Smile Ireland CEO

Dear friends

Above all I hope this message finds you safe and well. As part of the Operation Smile family, you have helped thousands of children smile again by providing priceless, life changing cleft surgery, so I wanted to reach out to you in this time of uncertainty with an update on how Operation Smile is responding to Covid-19.

Firstly, please know that your support has already done so much to strengthen healthcare systems in the countries where we work. Through our focus on cleft surgery, we have educated and trained healthcare workers not only in surgery but in life support, nursing and Anaesthesia. This training will now help save lives all around the world. Here are some examples of recent activities:

  • Just two weeks ago in Malawi, three Operation Smile volunteer anaesthetists delivered seven days training for 80 Anaesthesia Clinical Officers, upskilling their knowledge in safe anaesthesia and airway care which will now help with the Covid-19 response in Malawi.
  • In Ethiopia, we have helped train over 50 anaesthetists, and equipped the regional hospital in Jimma with essential equipment which will support their provision of critical care.
  • Last year, Operation Smile delivered American Heart Association life support training to 2,370 medical personnel which will save lives. This happens in every country that we work in.

As a medical charity working in developing countries, we have formed a Covid-19 Response Team to clearly identify where we can help our Operation Smile family overseas. We are doing everything we can to find ways to help to support the fight against Covid -19.

  • Local Operation Smile teams will continue to provide safe surgery for children born with cleft conditions, where it is possible and safe to do so.
  • When possible, we will continue to provide nutritional support for at risk infants and as we gather information on cleft patients for our registers, our outreach coordinators will become part of the support network for communities if Covid -19 spreads.
  • Our registers will remain active so that when surgery does become possible, we are able to reach children left behind as quickly as possible.
  • Led by Dr Ruben Ayala, Chief Medical Officer, our senior leadership team is evaluating ways we can directly support the fight against Covid -19 with Ministries of Health requests and through our extensive medical networks. This may include redirecting essential consumables such as masks, gowns and gloves and some equipment into hospitals.

There is so much that we have done and will do together. We will keep our website up to date with our latest news and I hope you will visit us at www.operationsmile.ie. If you have any questions regarding our work at this time please contact us at 01 667 6659 or info@operationsmile.ie. Thank you so much for your ongoing support. It’s humbling to see the very best of humanity through you, at the most difficult of times.

With our very best wishes to you and your family as we weather this storm together.

Teri Cosgrove

Chief Executive Officer Operation Smile Ireland

An Update from Operation Smile Chief Medical Officer Dr. Ruben Ayala on the COVID-19 Pandemic

Dear friends and Operation Smile supporters from around the world,

As the Operation Smile global family, we all believe that every day gives us a chance to serve, aid our communities, offer opportunities for our children and help heal humanity.

Today, we are in the midst of extraordinary times. Grounded in empathy, solidarity and concern for one another, our actions require the utmost measure, thoughtfulness and decisiveness.

The worldwide spread of the new coronavirus that causes the disease known as COVID-19 poses incredible challenges. Safeguarding the health and well-being of all, including everyone involved with Operation Smile, has been at the forefront of our activities. The safety of patients, caregivers, volunteers, staff, supporters and partners in each of our communities around the world has always been, and will continue to be, our top priority.

As new knowledge and evidence has become available from efforts guided by medical experts and top scientists, our senior leadership and our COVID-19 response team have remained watchful. We have constantly monitored the evolution of this disease from the onset.

The World Health Organisation declared COVID-19 as a pandemic on 11 March 2020. On 6 March 2020, after careful consideration of information produced by international health agencies and consultations with our partners where we work, we decided to suspend all international travel for volunteers who were to serve on Operation Smile programmes and activities.

This decision currently stands through 31 May 2020, and this period may be extended pending further evaluation of the state of COVID-19 globally.

For the time being, all programmes including medical missions, education and training, and public activities in Operation Smile programme countries have been temporarily paused. This includes Operation Smile’s year-round care centres. We are taking a case-by-case approach in consultation with our in-country executives and anticipate further cancellations and postponements through April, May and June.

We are also fine-tuning strategies to ensure we can amplify our efforts toward our patients once the situation improves. All decisions related to the resumption of our medical programmes will continue to be made in collaboration with our in-country teams, their local health ministries and other key stakeholders with safety as the top priority.

Finally, we understand that, in many countries, the talent of our volunteers is being directed toward emergent health care for people affected by COVID-19. We thank these heroes for their selfless and courageous service.

Around the world, we are also redirecting essential supplies and equipment, continuing nutritional support efforts where possible, and working with a multitude of partners and ministries of health to assist in this unprecedented time of need. In the spirit of solidarity, we’re working hard to find the most meaningful ways that we can to support the health needs of the communities in which we work.

In the words of WHO Director-General Dr. Tedros Adhanom Ghebreyesus, “let’s all look out for each other, because we need each other.”

Now, more than ever, we must rely on each other to act with kindness, compassion and empathy.

From our global family to yours, we wish you and everyone in your community the best of health.

We invite you to refer to the WHO’s website for COVID-19 for further information and guidance.

In health,

Dr. Ruben Ayala, Chief Medical Officer, Operation Smile


A Life-Changing Journey for Two Sisters

When we first met Vaviroa and Nambina on our medical mission to Tamatave, Madagascar, the six- and two-year-old sisters shyly hid behind their parents and barely said a word. Years of bullying taught these young girls that the world didn’t want to see their smiles.

The girls’ parents knew that because both of their daughters were born with cleft, they would suffer deeply their entire lives — experiencing social ostracism, bullying, even physical pain — but surgery was out of the question. They had never been able to take their daughters to see a doctor, let alone afford two surgeries.

But that all changed this past fall, when Vaviroa and Nambina both received surgeries to fix their clefts — thanks to generous people like you.

As we prepare to go back to Madagascar this week, we hope you’ll take a moment to watch the inspiring video below about these brave sisters and their incredible journey.

A Passion for Malagasy Smiles

True passion is a rare and precious thing. In the case of Andriarimalala Solo Radaoroson, his passion for Operation Smile’s work in Madagascar changed not only his life, but numerous other lives as well.

Mr. Lala, as he is affectionately known, had never witnessed a cleft condition until his daughter, Laly, was born with a cleft lip.

“I had heard about it as a boy, but I was very sad when she was born as I had never thought it could happen to her,” Lala said.

He admitted that her condition was difficult to manage, as she seemed to fall ill more often than other children. He feared she would not live long.

However, when Laly was nearly 2 years old, he heard a radio announcement regarding an Operation Smile medical mission to Tamatave in September 2015. After travelling nearly 400 kilometers by bus, Laly was selected for and underwent surgery. The free procedure proved to be a defining moment for Lala and his family. “There is no word to describe our happiness,” he said. “She was finally like everyone else.”

“I am not going to stop. Once I have finished with my district I will move on to the next one.”
Andriarimalala Solo Radaoroson

Upon returning home to his village, Lala found himself aflame with a desire to tell more people about the life-changing surgeries Operation Smile provides for patients in Madagascar.

“When I saw all the people with this problem, I decided to tell everyone that there is an organization that does this work,” he said enthusiastically. “Many people think I am a liar at first and trying to lure them into something strange, but eventually, they accept me.”

This indomitable spirit persuaded 33 patients from Lala’s district to travel to the Antananarivo medical mission in April 2016. Twenty-one of these adults and children were scheduled for surgery while the others will be assisted at upcoming missions.

Lala visits families around his district either on his bicycle or in the course of his work as a builder. He admitted this commitment means he’s not able to earn as much as he would if he were working full time. However, after his daughter received surgery, he wanted to bring the same happiness to people affected by cleft conditions in his district.

Lala follows a three-step process, beginning by showing them pre- and post-operation images of Laly. He then attempts to convince them that a transformation like his daughter’s is possible and finally explains that this surgery will cost them nothing.

One of the patients who Lala impacted is Fidelis, a shy 8-year-old who loves to play soccer but clings close to his mother. She found hope for her son when Lala visited them and explained how Operation Smile could help.

“People, especially children, tease him and so he often runs away from school as he cannot bear the teasing,” she said. “We didn’t know it could be fixed until Mr. Lala came and showed us the pictures. Now we are so happy that our son will live a normal life.”

Lala has no plans to slow down his search for potential Operation Smile patients.

“I am not going to stop,” he said. “Once I have finished with my district I will move on to the next one. I want Malagasy people to know Operation Smile can help them.”

Editor’s Note: Mr. Lala delivered on his promise again when he brought 57 patients and their families to the September 2016 Antsirabe medical mission.

Photo: Zute Lightfoot.