Operation Smile has been working in Ecuador since 1995 to deliver top-quality care to children born with cleft conditions. Over the past 20 years, Operation Smile has provided around 28,000 surgeries in Ecuador.
But there is more to do.
In Fiscal Year July 2025-June 2026, Operation Smile will invest $622,100 to perform life-changing surgeries for over 300 patients and provide training and education for nearly 260 health workers.
Over the course of the next five years, Operation Smile will provide surgery for approximately 2,000 patients.
Cleft Care Programs
Operation Smile will provide surgical care for more than 300 patients in Ecuador. Comprehensive cleft care services will also be expanded by providing consultations in oral health (∼970 patients), nutrition (510 patients), speech therapy (690 patients) and psychosocial care (450 patients). In addition, patient recruitment campaigns and community engagement efforts will help ensure more families can access cleft care services.
Education Programs
Operation Smile will train nearly 260 health workers in Ecuador in the fields of surgery, anesthesia, nursing, post-anesthesia care unit support, oral health, psychosocial support and speech therapy. We will credential over 70 health care workers in Basic Life Support training. Additionally, Operation Smile will enroll five Ecuadorian students in a Master’s program in Speech Education at the University of Ghana, supporting our “Train the Trainers” initiative. We will equip 180 caregivers with the knowledge and skills needed to support children throughout their cleft care journey.
Volunteer commitment drives our local initiatives and sustains our programs, while Operation Smile’s education initiatives increase access to quality cleft care. Specialty educators and volunteer management have jointly created structured training modules to guide new volunteers, ensuring clarity on their progress, competencies and next steps.
THE NEED
Cleft prevalence. In Ecuador, one child is born with a cleft condition for every 400 births. Patients living with cleft conditions often wait for over a year to receive the care that they need. Operation Smile’s survey revealed that 81% of patients arriving at Operation Smile programs in Ecuador could not have undergone surgery without the support of Operation Smile.
Shortage of medical providers. 86% of public health care providers and 96% of private providers work in urban areas, leaving rural regions insufficiently covered. Ecuador has 59 specialized surgical workers per 100,000 people, which falls short of the average number of 71 specialist surgical workers in high-income countries. The Lancet Commission on Global Surgery proposed that, to meet the populations’ needs, countries should achieve 5,000 surgical procedures per 100,000 population. In Ecuador, medical providers perform just 1,552 procedures for 100,000 population.
Financial burden. 48% of patients arriving at Operation Smile programs in Ecuador live below the poverty line and 77% have no health insurance. Out of pocket expenses prevent individuals from accessing the care that they need. 15% of the population is at risk of impoverishing expenditure for surgical care, while 23% faces catastrophic expenditure for surgical care. A study found that many people working in agriculture and animal farming could not afford to take time away from work to spend money on travel, appointments and medications.
Barriers to education. In Ecuador, 20% of patients arriving at Operation Smile programs reported that their condition limited their school attendance, while 26% said their school performance was affected.
BRINGING CARE CLOSER TO HOME
To ensure that every child has access to care close to home, we equip the providers within our patients’ communities with skills and resources to deliver high-quality care. We strengthen health system capacity by harnessing the talent and resources concentrated in larger cities, the hubs, to train providers in under-resourced areas, the spokes, where access to care is most limited.
In Ecuador, Operation Smile provides quality cleft care at our hub, Hospital North in the city of Quito.
Operation Smile currently has spokes in Guayaquil at IESS Los Ceibos, Manta at Hospital General Manta IESS and Loja at Clinica San Jose.
FIVE-YEAR VISION
Over the next five years, we will deliver over 2,000 surgeries and approximately 80,000 consultations. Additionally, we will identify 2,800 patients for ongoing future care.
