Since 2005, Operation Smile has provided surgical care to over 3,900 people in Ethiopia.
But there is more to do.
During Fiscal Year July 2025-June 2026, Operation Smile will invest $1.2 million to train 110 health worker sand provide surgery to over 1,500 patients.
Within the next five years, Operation Smile will provide ~4,000 patients with cleft surgery and ~6,200 patients with general plastic and reconstructive surgery.
Cleft Care Programs
This year, Operation Smile plans to provide surgery for over 1,500 patients. We will expand comprehensive cleft care in Ethiopia by providing consultations in oral health (∼200 patients), nutrition (200 patients), psychosocial care (250 patients) and speech therapy (∼ 110 patients).
Short-term surgical programs are planned, beginning with the newly inaugurated Ayder Specialized Comprehensive Hospital, with a second program at Hawassa University Comprehensive Specialized Hospital, which will serve as the primary surgical center for the southern region.
Education & Training
Operation Smile will train 110 health workers in plastic surgery, anesthesia, nutrition, psychosocial care, nursing, post-anesthesia care unit support, pediatrics, speech care and community health care. We plan to launch an educational program integrated into our routine surgical program at Jimma University Medical Center and Saint Paul Millennium Medical College.
We will deliver Life Support courses in collaboration with the American Heart Association for health workers from all our partner hospitals, as well as patient advocacy training for health extension and community workers. Externship programs will be offered for five plastic surgery residents and one plastic surgeon.
Operation 100, our bold strategy to bring essential surgical care closer to patients’ homes, will impact Ethiopia this year as we equip cleft operative teams at Ayder Specialized Hospital in Mekele and Hawassa Comprehensive Specialized Hospital in Hawassa with advanced skills, essential equipment and enhanced health care infrastructure. Over the course of two rounds of specialized educational training, we will develop highly skilled cleft-competent professionals, including surgeons, anesthesiologists, nurses and pediatricians. Each discipline will contribute five newly trained experts per round, ensuring a balanced, multidisciplinary capacity. These providers will not only strengthen the country’s healthcare system but also serve as a vital resource for the wider region, creating a lasting impact in delivering life-changing cleft care to those in need.
The Need
One per 500-750 cases. It is estimated that, worldwide, a child is born every three minutes with a cleft condition — about one in every 500 to 750 births. There is no official cleft registry in Ethiopia.
Strained Health System. While Ethiopia has made important strides in health security, several challenges remain. Gaps in emergency response, preventive care and sustainable financing continue to affect the health system. These challenges are compounded by ongoing conflicts, which have led to large numbers of internally displaced persons (IDPs). Together, these factors present ongoing barriers to building a fully resilient health system.
Shortfall of Health Workers. Ethiopia has just one specialist surgical worker per 100,000 population, falling short of the minimum target of 20 providers set by the Lancet Commission on Global Surgery.
Limited Access to Surgery. The Lancet Commission on Global Surgery proposed that countries should perform 5,000 surgical procedures per 100,000 population. In stark contrast, Ethiopia achieves just 43 procedures per 100,000 people. According the Lancet Commission’s recommendation, the majority of the population should be within two hours of a facility with essential surgery and anesthetic services. Operation Smile’s survey found that 64% of patients arriving at Operation Smile programs do not have a hospital within two hours of their home. On average, patients travel 284 kilometers to access surgical services at specialized hospitals.
Financial Burden. Ethiopia faces significant financial challenges in its health sector. These include low government budget allocation to health and inefficient resource utilization. Ethiopia’s Community-Based Health Insurance (CBHI) scheme, which aims to provide health insurance to those not covered by formal employment-based insurance, provides limited coverage for people engaged in informal employment.
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 Ethiopia, Jimma University Medical Center (JUMC) in Jimma, St Paul’s Hospital Medical College in Addis Ababa and Ayder Comprehensive Specialized Hospital in Mekele serve as our hubs, providing year-round care to our patients.
Hawassa University Comprehensive Specialized Hospital in Hawassa serves as our new hub this year.
Five-Year Vision
Within the next five years, Operation Smile will expand training opportunities for the health workforce and enhance the quality of cleft care in Ethiopia. Operation Smile will provide education and training to approximately 2,000 health workers across various specialties.
Operation Smile will provide ~4,000 patients with cleft surgery and ~6,200 patients with general plastic and reconstructive surgery. Additionally, we will deliver comprehensive cleft care to approximately 3,200 patients.
Operation 100, our bold strategy to bring essential surgical care closer to patients’ homes, will impact Ethiopia as we equip cleft operative teams at Tibebe Ghion Specialized Hospital in Bahir Dar, Adama General Hospital in Adama and Mizan General Hospital in Mizan‑Aman with advanced skills, essential equipment and enhanced health care infrastructure over the next five years.
