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 cleft palate surgery. Since then, Operation Smile India has provided clinical care for over 40,000 patients.
But there is more to do.
During Fiscal Year July 2025-June 2026, Operation Smile will invest $2.9 million to provide care for 3,180 surgical patients and train nearly 260 health workers.
Over the course of the next five years, Operation Smile will deliver surgical care for approximately 22,510 patients.
Cleft Care Programs
Operation Smile will increase access to comprehensive cleft care and reach even more patients in need of treatment. Over the course of the fiscal year, Operation Smile India projects to provide surgical care for 3,180 patients. Operation Smile will expand comprehensive cleft care by providing consultations in oral health (∼1,010 patients), speech therapy (∼2,230 patients), nutrition (270 patients) and psychosocial care (∼1,720 patients).
Education Programs
We will mitigate the shortage of skilled health care professionals by providing top-quality education and training for approximately 260 medical providers in India. We will provide training in the areas of cleft surgery, anesthesia, nursing, biomedical technology, speech therapy and oral health. Operation Smile partners with the American Heart Association (AHA) to equip health care workers with the necessary skills to respond in an emergency. Through our partnership with the AHA, we will provide Basic Life Support (BLS) and Pediatric Advanced Life Support (PALS) training for medical professionals.
THE NEED
One in every 500 live births. In India, an estimated 28,000 to 35,000 children are born with cleft conditions each year, about one in 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 for 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.
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 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.
FIVE-YEAR VISION
Our Operation 100 strategy is driven by the goal of expanding access to safe, high quality surgical and comprehensive care closer to home for patients and families.
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 12of 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.
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 over 64,600 patients.
To mitigate the shortage of skilled health care professionals in India, Operation Smile will provide training in cleft surgery for surgeons who will be placed in district and spoke hospitals.
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 expand direct patientcare and provide education programs for medical providers. This will extend our reach to four additional states.