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

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 to continue keeping our promise to patients like Annika 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.

Annika seven months after surgery. Photo: Margherita Mirabella.

With surgery, a weight was lifted

Zafilahy, 32 years old, before surgery. Photo: Rohanna Mertens.

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.

While routine in much of the world, surgery for many people living in low-income countries has misconceptions surrounding it, which can cause some to be fearful when it comes to receiving treatment.

That’s why when Virginie saw her husband, Zafilahy, for the first time after he returned home from his cleft lip operation, she had to be reassured that the doctors hadn’t stolen a part of his body during the procedure.

Instead, what the Operation Smile Madagascar volunteers had given him was a new smile.

Before his surgery, Zafilahy believed that he and the two other people from his community born with cleft conditions would be forced to live with an unrepaired cleft lip for the rest of their lives. None of them learned that a solution existed.

Throughout his life, Zafilahy was often called “Telo Moloha,” which translates to “three lips.”

But he never let the harassment prevent him from living a life of happiness.

During the 32 years he lived with an unrepaired cleft lip, he became a farmer, married the love of his life and had six children. But amid his joy, Zafilahy felt as though something was holding him back.

That was until Fidelis, a patient advocate with Operation Smile Madagascar, arrived in Zafilahy’s village spreading awareness about the non-profit’s work throughout the country.

Fidelis explained that all expenses from the surgery to repair Zafilahy’s cleft lip would be covered by Operation Smile. He felt immense relief because he knew it was a cost he wouldn’t be able to afford otherwise.

Alongside his brother and a large group of families, Zafilahy made the 13-hour bus trip to Antsirabe for the upcoming surgical programme.

It was the first time in 32 years that he’d left the comfort and familiarity of his village.

But Zafilahy wasn’t fearful of the long journey ahead. Instead, he felt eager because he knew something special awaited him at the destination.

Once they arrived, medical volunteers performed a comprehensive healthcare assessment to confirm Zafilahy was healthy enough to undergo anaesthesia.

For Operation Smile, patient safety is the greatest priority. To ensure that they receive the highest quality of medical care, each patient is screened for potential health issues that could impact their procedure or put them at risk.

When he was finally scheduled for surgery, Zafilahy was ecstatic.

A surgery that often lasts as little as 45 minutes changed Zafilahy’s life forever.

Zafilahy, after surgery. Photo: Rohanna Mertens.

Today with his new smile, Zafilahy is very happy and feels as though a weight has been lifted. He couldn’t wait to return home to his family and live a life free from the stigma of a cleft condition.

“Thank you, Operation Smile,” he stated. “Now, I do not worry about my health. I will be a happy man with no more worries.”

Help us to continue keeping our promise to patients like Zafilahy 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.

Photo: Rohanna Mertens.

His dream is within reach

Cosmas, 21 years old. 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.

If any of Cosmas’ 12 brothers and sisters were in need of medical care growing up, the closest health clinic to their home was a 30-minutue walk. As for the closest hospital, that was a three-hour walk.

Not once during any of his regular check-ups to the clinic was Cosmas told that his cleft condition could be repaired with surgery.

Cosmas grew to accept that his cleft as God’s will but was still unhappy. He believed that he’d live with the burden of an unrepaired cleft lip forever. For 21 years, he did.

But on a day that Cosmas expected to be like any other, a friend in his community told him that he wouldn’t have to live the rest of his life with his cleft condition because Operation Smile Malawi had an upcoming medical mission.

Unfortunately, he learned about the upcoming mission too late. Even if he and his dad had the money to pay for travel, they never would’ve reached the mission site in time. But both men refused to give up.

Ganizan, Cosmas’ father, was a 70-year-old subsistence farmer. Cosmas earned a small salary as a farmer, but he also learned that neither he nor his father could pay for surgery through the local hospital.

Cosmas was hopeful that he would receive another opportunity to get safe surgery for free through Operation Smile Malawi.

When Cosmas was 21 years old, Ganizan was determined to find a way to get his son the surgery that he knew would change his life. Walking the three hours it took to reach the district hospital in Dedza, Ganizan sought out more information about the process of getting his son to the next Operation Smile Malawi mission.

He was told to arrive back at the district hospital in August where a bus provided by Operation Smile Malawi would be waiting to take them to Lilongwe at no cost.

After much waiting, the day finally arrived, and Cosmas and his father left their community to begin the long 7-hour trip to the mission site.

After passing his comprehensive health evaluation, Cosmas and his father learn that he's been placed on the surgical schedule during a 2015 Operation Smile Malawi medical mission in Lilongwe. Photo: Margherita Mirabella.

Following their journey, they arrived in Lilongwe, and Cosmas felt at peace seeing others like him. For the first time, he knew that he wasn’t the only one living with a cleft condition.

As many as nine in 10 people around the world can’t access basic, surgical care and can endure years of bullying, social isolation and severe health problems from an untreated cleft condition. For Cosmas, a lack of education and awareness about cleft conditions in his community proved to be a barrier that lasted two decades.

Although he was often teased, all Cosmas wanted growing up was to be treated like everyone else. He had friends and loved to watch soccer and his favourite player, Malawi’s own Fisher Kondowe.

On the verge of undergoing a surgery that he waited on for more than two decades, Cosmas was looking forward to enjoying the activities of his peers without being burdened by his cleft condition.

His experience at the Operation Smile medical mission was much different than life in his community. There was no worry about being harassed or teased. For once in his life, he was around people who accepted him.

“When I go home people will stop making fun of me,” Cosmas said.

He walked into the operating room with confidence, knowing that he’d come out with a completely new smile – he couldn’t wait for the opportunities his future would hold.

Cosmas, one year after his surgery. Photo: Margherita Mirabella.

Ganizan didn’t stop smiling when he saw his son for the first time after surgery.

He had spent 20 years watching his son struggle to come to terms with his cleft condition and now his life is renewed. Both Cosmas and his father gave a big thumbs up when asked if they were satisfied with the surgery.

When he saw his reflection for the first time, he could not believe the change he saw in the mirror.

Since returning home, Cosmas feels like he is now free.

Although he always had friends, he didn’t like to go out in public with them for fear of being teased. Now, he feels excited to go out with friends because nobody stares at him or calls him names.

Interacting with others is something that Cosmas now embraces. He is currently in his first year of high school, and his favourite subject is social studies with dreams of becoming a police officer.

“I am very happy and thankful to Operation Smile, and I hope they will keep helping others,” Cosmas said.

Help us to continue keeping our promise to patients like Cosmas 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.

Photo: Margherita Mirabella.

Her name is Jane Rose

Jane Rose longed to be called by her name. Writing it repeatedly in her notebook, the spirited 7-year-old hoped that the dream she wrote on paper would eventually come true.

But in reality, she faced almost constant bullying because of her cleft condition from many children in her community who refused to call her anything besides “bungi,” a derogatory word for cleft.

Seven-year-old Jane Rose, before. Photo: Jörgen Hildebrandt.

“My heart breaks every time I hear them bully her. The only way to stop it is to get her cleft lip repaired. They will not stop otherwise,” said Eutigio, Jane Rose’s father.

Jane Rose loves going to school and is very intelligent. She refused to give in to her abusers.

With big dreams of one day becoming a teacher, she felt determined to attend school each day despite the constant bullying.

Jane Rose's father, Eutigio, watches as his daughter completes her homework. Photo: Jörgen Hildebrandt.

Her family lives in a house made of bamboo in Cebu City, Philippines. With no access to electricity or water in their home, Jane Rose and her family share the only nearby well with the many neighbours in the area.

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 a cleft condition. The global average is closer to one in 750 births.

Even though there are skilled plastic surgeons in the country – some who volunteer with Operation Smile – most families can’t afford the cost of surgery.

It broke Eutigio’s heart knowing that as a garbage collector, the cost of surgery for Jane Rose was beyond his means.

In the past, he’s tried twice to get his daughter this life-changing surgery for free through other organisations.

But both times, Jane Rose was denied because of health issues.

With each failed attempt, Eutigio’s anxiety and worry for his daughter deepened.

“My biggest fear is that she’ll grow up being bullied all her life,” he said.

Photo: Jörgen Hildebrandt.

It wasn’t until Eutigio learned about Operation Smile Philippines that he believed and hoped their third attempt at surgery would be different.

Upon arriving at the medical mission, Jane Rose and her father felt excited at the thought that this could be the opportunity for which they’ve been waiting.

“I am very happy to be here,” Eutigio said. “There are so many children here with the same problem. I thought it was only our family.”

After the screening process, medical volunteers were thrilled to tell Eutigio the good news.

Operation Smile medical volunteers check Jane Rose's vitals during screening to ensure that she's healthy enough to undergo anaesthesia for her surgery during a 2015 medical mission in Cebu. Photo: Jörgen Hildebrandt.

“I am so happy she passed all the health examinations since this is the third time we’ve tried. I am very happy and very thankful,” Eutigio said.

It was finally time for Jane Rose to receive the surgery she always deserved.

A surgery that can take 45 minutes changed her life forever.

The day after her cleft repair surgery, Jane Rose stared at her new smile in the mirror, not taking her eyes away from what she saw.

“I’m so happy that she looks so beautiful. Thank you!” said Eutigio.

Eutigio sees Jane Rose's new smile for the first time. Photo: Jörgen Hildebrandt.
Photo: Jörgen Hildebrandt.

Years have passed since Jane Rose’s surgery, and so many aspects of her life have changed during that time.

Today, Jane Rose continues to excel in her studies at school. According to her teacher, Jane Rose is very involved and intelligent. She even received a medal for the time she spent studying.

With her newfound confidence after surgery, Jane Rose participated in a school mini pageant and has gained many friends.

But the greatest and most noticeable change is how the children who once bullied her now call her by her real name. At last, she’s living out her dream that once occupied the lines of her notebook.

Jane Rose plays with friends at her home one year after receiving surgery from Operation Smile Philippines. Photo: Jorgen Hildebrandt.

Eutigio hopes that Jane Rose will now be able to follow her dreams, finish school, and become a teacher.

“She will have a better future now,” he said.

Today, nobody bullies or teases her – many have no idea that Jane Rose was born with a cleft lip.

“I am not a ‘bungi’ anymore, I am just beautiful,” Jane Rose said.

Jane Rose, today. Photo: Jörgen Hildebrandt.

A long-awaited transformation

Rong Zhen, 57. Photo: Zute Lightfoot.

Looking around, Rong Zhen stared in wonder at the children who surrounded her during a medical mission in Dafang, China.

Part of her felt sorry for them. Undergoing a medical procedure is scary, no matter what age, and many of the children she saw were just a few years old.

But at the same time, she was overjoyed that their families found Operation Smile. It meant that they wouldn’t be forced to grow up and endure the consequences of living with an unrepaired cleft condition, an experience that Rong Zhen was all too familiar with.

Worldwide, it’s estimated that every three minutes, a child is born with a cleft condition. Barriers to care cause many patients in developing countries with cleft conditions to go untreated – patients like Rong Zhen, who lived 57 years with a cleft lip.

Until just a few months before attending an Operation Smile China mission, Rong Zhen never knew that surgery to repair her cleft lip was even a possibility.

She lived every day believing that her cleft lip – and the harmful mistreatment she received from others – was permanent.

Rong Zhen was often laughed at and teased because of her appearance. Finding work was a constant struggle. She suspected that many employers refused to hire her because of her cleft condition.

Despite these challenges, Rong Zhen’s life was filled with family and love. As a mother of three adult children and a grandmother to three grandchildren, she feared that the people she loved most in the world would suffer from the same condition. Fortunately, none of Rong Zhen’s children or grandchildren were born with a cleft condition.

But living with the burden of an unrepaired cleft lip prevented her from being truly happy.

It wasn’t until a village leader told Rong Zhen about Operation Smile China that she learned surgery and a brighter future for herself were possible.

She was amazed at the fact that a global medical organisation was providing these life-changing surgeries for free.

This news changed Rong Zhen’s life. She had never imagined herself with a new smile.

Rong Zhen begins the health screening process during a 2016 Operation Smile China medical mission in Dafang. Photo: Zute Lightfoot.

The mission dates arrived in no time, and she and her husband, Cailong, set out on the two-hour bus ride to Dafang. Their children were overjoyed that soon their mother would have her cleft lip repaired.

When they arrived at the mission site, Rong Zhen and other patients underwent their comprehensive health screenings. This evaluation ensures that each patient is healthy enough to become a candidate for safe surgery – the highest priority for Operation Smile.

The Operation Smile China mission lasted only a few days, but during that time, hundreds of children and adults received surgery that changed their lives forever.

Rong Zhen was among them.

A huge grin appears on Rong Zhen's husband's face when he sees her new smile for the first time after surgery. Photo: Zute Lightfoot.

Rong Zhen’s cleft condition never prevented Cailong from finding his wife beautiful.

Looking at her after surgery, Cailong saw the same woman who he’d been happily married to for the last 34 years. She was still the same person who he loves and the same mother who helped raise their children. But now, there’s one significant difference.

Rong Zhen is finally, truly happy when she looks at her new smile.

Rong Zhen and her husband, Cailong, share a special moment the morning after her surgery. Photo: Zute Lightfoot.

People like Rong Zhen who don’t have access to basic surgical care can endure years of bullying, social isolation and health problems from an untreated cleft condition.

Fortunately, cleft surgery can bring immediate transformation to a patient’s life in as little as 45 minutes.

After a successful surgery, Rong Zhen could not have been happier.

“I love to smile now,” she said. “Thank you Operation Smile. I would never have been able to smile if Operation Smile had not come to Dafang.”

Rong Zhen, after. Photo: Zute Lightfoot.

Meet our patients: Nicaragua

Jimena, 11 months old, received her new smile during Operation Smile Nicaragua's first medical mission of 2021. Operation Smile photo.

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.

Marling arrived at Operation Smile Nicaragua’s first local medical mission of 2021 with her 11-month-old daughter, Jimena.

As Jimena went through the screening process, Marling was cautious but tried to remain hopeful.

This wasn’t the first Operation Smile mission Jimena and Marling had attended.

Even from the beginning, the journey toward a new smile for Jimena was long and often filled with heartache and disappointment.

None of Marling’s prenatal check-ups indicated that she should be concerned with the development of her baby.

It wasn’t until Jimena was born that everything changed for Marling.

“When my little girl was born, the doctors told me she had cleft lip,” said Marling, thinking back on the day. “This was unexpected. But they said there was a foundation that provided free surgeries for children with this type of condition.”

Marling’s doctors were talking about Operation Smile Nicaragua.

Two months after Jimena was born, Marling travelled to Operation Smile Nicaragua’s care centre. But at that time, the COVID-19 pandemic had already hit the country hard.

“I got to the centre, and I was told it was closed,” Marling said. “I only wanted information about my daughter’s condition.”

Despite the centre’s temporary closure, the local volunteer team knew there were patients like Jimena who still needed care.

The courageous volunteers and staff created opportunities to ensure that they could still reach patients and families even though they were physically apart.

“They offered me the option of virtual consults,” Marling said.

The medical volunteer team followed up with Jimena and her family digitally until the day when it was deemed safe to resume in-person consultations.

“I felt welcomed when I visited the centre,” Marling said. “The doctors gave great service and gave my daughter a small disk that helped her for feeding.”

With this additional care, Jimena’s health continued to improve while her mother’s hope grew stronger.

Following strict health guidelines and safety protocols, Operation Smile Nicaragua announced that it would host a small-scale local mission in October 2020.

After learning that Jimena was a candidate for receiving surgery during that mission, Marling didn’t hesitate to make the journey.

However, an unforeseen health issue arose on the day of Jimena’s surgery that prevented the volunteer medical team from going through with the operation.

But even after Jimena’s surgery was cancelled, Marling didn’t lose hope that her daughter’s smile would one day be healed.

In December 2020, it appeared that Jimena’s second chance was within her grasp.

But surgery evaded Jimena once again.

After contracting a fever, she and Marling were informed by medical volunteers that undergoing surgery was too unsafe. Jimena’s family returned home disappointed but more determined than ever.

Jimena is ready to enter the operating room during Operation Smile Nicaragua's local 2021 medical mission in Managua. Operation Smile photo.

With her mother’s support and perseverance, Jimena arrived at Operation Smile Nicaragua’s first local mission of 2021.

After a comprehensive health evaluation, nothing stood in the way of Jimena and her brighter future.

She became one of 10 patients to undergo their long-awaited surgeries during the February mission.

“I feel happy because my daughter received her first surgery,” Marling said. “I thank those involved that made my daughter’s smile possible.”

Help us to continue keeping our promise to patients like Jimena 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.

Operation Smile Nicaragua medical volunteers perform surgery on 11-month-old Jimena. Operation Smile photo.

“Some day” finally arrives for Seth

Seth, before surgery. 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.

In Ghana, a country known for having deeply rooted and widespread social stigma surrounding cleft conditions, many people like Seth endure lives filled with pain.

Constantly living in isolation and being fearful of harassment from members of their communities, some people affected by cleft grow up feeling hopeless and unworthy of love or happiness.

Lacking awareness of the cause of cleft conditions, people in Seth’s community often insulted him. In school, he struggled to make friends and would often choose to skip break time with hopes of avoiding the harmful treatment from some of his classmates.

Throughout his childhood, Seth frequently asked his mother, “Why am I like this?”

Born with a cleft lip in rural Ghana, neither Seth nor his mother knew that there were organisations like Operation Smile devoted to helping people like Seth.

The years following his childhood were full of dark times for Seth.

Believing that being alone was his only escape from the insults and abuse, Seth isolated himself, which deepened his self-doubt and unhappiness.

Seth shared that the worst part of living with an unrepaired cleft condition was looking into a mirror because he said it reminded him that he was “not complete.”

To him, this meant he’d never have a fulfilling life.

Seth spent years battling depression, often asking God to forgive him for whatever it was that he believed he’d done wrong and to heal his smile.

There were even instances throughout his life that Seth considered suicide. But in those moments, he reminded himself of his mum, who continually reassured him that they’d one day meet someone who will help him.

Seth waited 34 years for that day to arrive.

The course of Seth’s life changed in March of 2015 when he saw a flyer for Operation Smile Ghana.

Patient coordinator Clement Ofosuhemeng carries Operation Smile Ghana posters as he travels throughout remote villages recruiting patients and raising awareness for the organisation. Photo: Zute Lightfoot.

Marvelling at the before and after pictures of others born with cleft conditions like him, he realised that a solution was possible, and it gave him a renewed hope that his “someday” may come soon.

There was an upcoming medical mission in Cape Coast. It was a long 10-hour journey from his home, but everything he experienced leading up to that moment made him determined to go.

After hours of travelling, he finally reached what he hoped was the beginning of his new life.

But there were hundreds of potential patients living with cleft conditions who attended the mission, all seeking life-changing surgery.

During a 2018 medical mission in Ghana, families of patients gather at the patient shelter on the second day of surgery. Photo: Zute Lightfoot.

Unfortunately, due to the high demand for cleft care in Ghana, Seth was not placed on the surgical schedule at that time. There were too many patients in need.

Seth was devastated, but he refused to give up.

While he knew it wasn’t his turn yet, Seth also knew he was getting closer to his day and said that he believed God would find him another opportunity to get the surgery he deserved.

A few months later, Seth received a phone call from Operation Smile Ghana telling him about another mission in Ho.

The mission site was a little more than two hours from his home. So, once again, he bravely travelled away from his community, hopeful of finally receiving his transformative surgery that he’d waited on for 34 years.

Once Operation Smile medical volunteers deemed him healthy enough for surgery following his comprehensive health evaluation, Seth nervously waited to hear his name announced.

That day, when Seth was told he’d be receiving his new smile, he felt in his heart that the hardships he endured were coming to an end. Finally, Seth could be truly happy.

“I’m not worried because I know everything will be okay,” Seth said. “I will be able to go everywhere with confidence.”

Seth smiles wide alongside his friend. Photo: Margherita Mirabella.

After returning home, Seth felt inspired by Operation Smile’s work in Ghana and wanted to be a part of it.

He hopes to become an advocate for the organisation and share his experience with others to help recruit more patients in need.

With his new smile, Seth gained confidence to chase after his dream.

“Before my surgery I never wanted to talk to people, now I am happy to talk to everyone,” he said. “I’m now in school to learn how to become a pastor. Before my surgery, I would never ever have considered becoming a pastor.”

Help us to continue keeping our promise to patients like Seth 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.

Seth, after surgery. Photo: Margherita Mirabella.

From loneliness to acceptance

Justin, 53 years old. Photo: Rohanna Mertens

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 he returned home, Justin was met with kindness and acceptance from members of his community for the first time in his life.

This was a sharp contrast to how many people in his village treated him before he received surgery from Operation Smile Madagascar to repair his cleft lip.

At 53 years old, Justin had spent his life feeling abandoned and alone because of his appearance.

His only son didn’t want to be seen with his father, and his wife left him due to the stigma associated with his unrepaired cleft lip.

The years of being called names like “sima,” a derogatory term meaning cleft lip, had caused Justin to become shy.

Then one day, Justin saw a poster for Operation Smile Madagascar in his village hall with pictures of patients before and after surgery.

That was the first time Justin had seen another person who looked like him, and the first time he saw someone whose cleft lip had been repaired.

While the thought of having his smile repaired was exciting, Justin also knew he would have to take a chance and travel somewhere far from his home.

But after speaking with a local health worker, Justin mustered up the courage to attend an upcoming Operation Smile medical mission.

He made the long 24-hour journey with his niece, Rasoa, and a large group of other families from the Ifanadiana area. None of them knew for certain if they would receive surgery once arriving in Antsirabe, but they felt hopeful for the possibility of a new beginning.

Patients from across Madagascar arrive for screening during a medical mission in Antsirabe. Photo: Rohanna Mertens.

Arriving at the mission site, Justin was shocked after witnessing the scene before him: There were hundreds of people who looked like him.

Rasoa carefully documented Justin’s entire cleft care process.

Taking photos every step of the way, Rasoa, without even realising it, was creating a record of events that would one day have the potential to change the lives of more people like her uncle.

After undergoing his comprehensive health evaluation, Operation Smile medical volunteers deemed that Justin was healthy enough to receive surgery.

He shared with volunteers that he wasn’t nervous going into the operating room. He simply felt anticipation to see the change in his appearance after the procedure.

Rasoa was thrilled to call her mother, Justin’s sister, and tell her the surgery was a success.

When Justin saw his new smile for the first time, he was delighted with the result.

“Thank you for caring for me,” he said to the Operation Smile team.

After surgery, Justin smiles wide beside his niece, Rasoa, who remained by his side throughout his journey. Photo: Rohanna Mertens.

Returning home, he no longer felt the need to cover his mouth when talking to people or hide from interactions with others.

Even those who’d abandoned him in the past were willing to reconcile and join him in celebration of his life-changing surgery.

His once estranged 26-year-old son reunited with him.

Even his ex-wife, who left him because of his cleft condition, wanted to reconcile and try again at their marriage, but he declined. Justin said that he would rather start a relationship with someone new.

Today, Justin hopes to help more people like him.

With the photos Rasoa took during the medical mission, he can do just that.

“We want to help Operation Smile Madagascar find more patients,” Rasoa said. “We have photos, so we can explain what happens at the mission.”

Justin now happily lives his life as a subsistence farmer and refuses to let his cleft condition define him any longer.

Help us to continue keeping our promise to patients like Justin 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.

Justin, after surgery. Photo: Rohanna Mertens.

It’s never too late for a new beginning

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.

Yohana spent most of her life without the acceptance of her community. 

As an adult living with a cleft condition, she’d endured decades of people calling her hurtful names.

In addition to the torment she experienced, Yohana became even more isolated with the passing of her husband. Losing someone who’d loved and cared for her despite her cleft condition was almost too much pain for her to bear.

But Yohana refused to give up.

With a sister who was also born with a cleft condition, Yohana knew she wasn’t alone. But growing up wasn’t easy for her.

Having never learned about the actual causes of cleft, which can be hereditary or environmental, members of their village believed that God put a spell on Yohana’s mother, causing the sisters to be born with cleft conditions.

With beliefs and misconceptions like these deeply rooted in the minds of people living in communities around the world, harmful stigma leads to people like Yohana and her sister experiencing severe emotional pain and social isolation.

Just like Yohana, millions of people living in low- and middle-income countries are still enduring needless suffering because they’re unable to receive surgery early in their lives.

Not only are families unable to afford to travel to the nearest hospital, let alone the cost of an operation, they are also facing the barrier of local communities not having enough skilled surgeons and nurses to meet the medical demands.

Photo: Margherita Mirabella.

Having witnessed her sister receive cleft lip surgery from another organisation years before, Yohana felt relieved to know that a solution existed, but she feared she’d never be able to afford the cost of surgery.

As a subsistence farmer, she cultivates only enough food and livestock to meet her needs.

After living 51 years with an unrepaired cleft condition, Yohana never imagined she’d ever receive the surgery she deserved.

Then one day, everything changed.

Just days after Yohana heard a radio announcement promoting Operation Smile Ghana, a medical non-profit that provides free surgeries for people living with cleft conditions, a patient coordinator from the organisation arrived in her village.

For the first time in her life, Yohana had hope, and she happily registered for the upcoming medical mission.

Two months after learning about the possibility of free and safe surgery to repair her cleft lip, Yohana and other potential patients boarded a bus that took them to the mission site in Ho.

The following day, medical volunteers performed her comprehensive health care assessment to determine if she was healthy enough to undergo anaesthesia.

With patient safety as our greatest priority, all people seeking care during a mission must pass a comprehensive health evaluation, which screens for any potential health issues that could impact their procedure and ensures that each patient receives the highest quality medical care.

Yohana marveled at the love shown to her by everyone at Operation Smile.

Their kindness made her feel comfortable and helped to quell her anxiety about surgery.

Hearing that she was placed on the surgical schedule, Yohana couldn’t wait to embrace her brighter future. Instead of feeling alone and being called hateful names, she would finally be known as Yohana to everyone.

Before surgery, Yohana was relaxed and confident that her lifelong struggles with her image would soon change. What she looked forward to the most was for the people who once mocked her to see her new smile.

Yohana, one year after surgery. Photo: Margherita Mirabella.

Yohana’s only son accompanied her to the mission and was eager to call the whole family to tell them about the successful surgery.

After Yohana returned home, the community that once shunned her celebrated her transformation.

“I used to be laughed at, but now, nobody laughs at me,” Yohana said. “Thank you, Operation Smile, for changing my life.”

Help us to continue keeping our promise to patients like Yohana 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.

Photo: Margherita Mirabella.