In 2002, Operation Smile conducted its first-ever medical program in India, hosted by the Kasturba Medical College in Manipal, Karnataka where 110 patients received high-quality cleft lip and palate surgery. Since then, Operation Smile India has provided clinical care for over 40,000 patients.
THE NEED
One in every 500 live births. In India, it is estimated that between 28,000 and 35,000 children are born with cleft conditions each year. This is around one out of every 500 to 800 live births. There is a backlog of 600,000 patients living with cleft conditions.
Financial burden. Out-of-pocket expenses often prevent patients with cleft conditions from accessing treatment. 24% of the population is at risk of impoverishing expenditure for surgical care, while 31% faces catastrophic expenditure in case of surgical care.
Shortfall of health workers. Many families face barriers to obtaining health care for their children due to the uneven distribution of health workers across rural-urban settings. Although rural India constituted approximately 71% of the total population in 2016, only 36% of all health workers work in rural areas.
There are only seven specialist surgical workers per 100,000 people, which falls short of the target set by the Lancet Commission on Global Surgery of 20 providers per 100,000 population.
Limited access to surgery. The Lancet Commission proposed that at least 80% of a country’s population should be within two hours of a facility with essential surgery and anesthetic services.
India faces inequalities in accessing health care, with most people in the rural areas of the northern and northeast regions living farther than two hours from a surgical facility.
OUR FORMULA FOR TRANSFORMATION
Operation Smile’s formula for transformational impact combines care delivery & capacity-building.
Education programs are at the center of Operation Smile’s strategy to increase access to surgery closer to the patient’s home.
Each surgical program brings together providers from all over the world for a unique opportunity to share knowledge and innovate. This type of bi-directional learning is essential to redistributing knowledge between providers and building capacity in the areas of greatest need.
Our work in health policy & advocacy and health infrastructure & equipment addresses structural barriers to care and helps build robust health systems. Operation Smile’s research & innovation efforts inform all aspects of our decision-making and allow us to have a comprehensive understanding of the impact our programs have on patients.
HUB & SPOKES
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 build the needed capacity by harnessing the talent and resources that exist within the country, usually in the bigger cities, the hubs, to train providers in under-resourced areas, the spokes, where most patients lack access to care.
In 2019, Operation Smile launched the Durgapur Cleft Center at the IQ City Medical College and Hospital. The Center serves as one of India’s hubs, providing year-round surgical care, dentistry, nutrition counseling, speech therapy, psychosocial care, ENT services and orthodontics. We also have hubs in Bangalore and Rishikesh.
Operation Smile’s spokes in Siliguri, Hazaribagh, Srinagar, Belgaum and Mumbai deliver cleft services to patients living in India’s remote areas.
Operation Smile has hospital partners in Jhansi, Raipur, Vijayawada and Kochi that provide surgical and comprehensive care for patients.
During Fiscal Year July 2024-June 2025, Operation Smile Canada has committed to invest $260,924, accounting for roughly 8% of India’s total projected budget for the fiscal year, which will directly contribute to providing care for 3,105 surgical patients and train approx. 210 health workers.
Cleft Care Programs
Operation Smile will increase access to comprehensive cleft care and reach more patients in need of treatment. Over the course of the following year, Operation Smile India projects to provide surgical care for 3,105 patients. Operation Smile will expand comprehensive cleft care by providing consultations in dentistry (~4,270 patients), speech therapy (~4,000 patients), nutrition (100 patients), ENT (~110 patients) and psychosocial care (2,400 patients).
Education Programs
We will mitigate the shortage of skilled healthcare professionals by providing top-quality education and training for approximately 210 medical providers in India. Operation Smile will provide American Heart Association courses and deliver training for psychologists, dentists, pediatricians and specialists in other medical fields.
FIVE-YEAR VISION
Our Strategy
Our “last-mile” strategy is driven by the need to provide quality cleft care for patients living far away from any hospital care.
The existing health system’s inability to reach rural populations and the concentration of cleft charities in major cities create barriers to care for rural populations. Given the vast geographic expanse of the country, we will focus on 12 of the 28 total states in the country over the next five years.
Our prioritization of states is determined by the state’s overall health outcomes as seen through health indicators and a mathematical modeling study showing trends in regional disparity of unmet need for cleft surgery.
Our Programs
Over the next five years, Operation Smile aims to deliver cleft surgical care for approximately 22,510 patients. Operation Smile will provide comprehensive cleft care consultations to around 64,610 patients.
To mitigate the shortage of skilled healthcare professionals in India, Operation Smile will provide training in cleft surgery for surgeons who will be placed in district hospitals and spokes.
We will use surgical programs as a strategic tool to deliver surgical services in rural geographies and to build strategic local partnerships. Operation Smile will partner with six new hospitals (two hubs and four spokes) to increase direct patient care and deliver education programs.
