Operation Smile has provided surgery for over 3,660 patients in Paraguay.
THE NEED
One in 500 children are born with a cleft condition. It is estimated that, worldwide, a child is born every three minutes with a cleft condition — about one in every 500 to 750 births.
Shortfall of health workers. Paraguay has 21 specialist surgical workers per 100,000 people, which falls short of the average number of 71 specialist surgical workers in high-income countries. Many health workers who are originally from rural areas often decide to either move to urban centers or find employment in other countries, which leaves rural populations farther away from providers. Operation Smile’s survey revealed that 88% of patients arriving at Operation Smile programs in Paraguay could not have undergone surgery without the support of Operation Smile.
Shortage of hospital beds. With just 0.8 hospital beds per 1,000 people, Paraguay’s health system suffers from a shortage of critical infrastructure. In stark contrast, high-income countries have an average of 5.3 hospital beds per 1,000 people.
Financial burden. The lack of formal health insurance makes patients with cleft conditions even more vulnerable. According to Operation Smile’s survey, 66% of patients arriving at Operation Smile programs in Paraguay have no health insurance.
The uninsured are disproportionately impacted by out-of-pocket payments. A quarter of the population faces catastrophic expenditure for surgical care, while 16% is at risk of impoverishing expenditure. Our survey found that 62% of patients arriving at Operation Smile programs in Paraguay live in poverty. The financial burden is worsened by the fact that 39% of caretakers stay home with their children.
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 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 Paraguay, Operation Smile’s hub is based in the city of Fernando de la Mora.
We have identified three potential spokes to reach more patients across the country.
During Fiscal Year July 2024-June 2025, Operation Smile Canada has committed to invest $499,972 CAD, accounting for 62% of Paraguay’s total projected budget for the fiscal year, which will directly contribute to providing high-quality surgery and care for 300 patients and deliver training to 600 health workers.
Cleft Care Programs
Operation Smile will provide surgical care for around 300 patients and recruit 765 new patients in need of treatment. We will expand our comprehensive cleft care services by providing consultations in oral health (approx. 480 patients), nutrition (approx. 130 patients), speech therapy (approx. 300 patients), psychosocial care (approx. 200 patients), ENT (100 patients) and pediatrics (120 patients).
Education
Operation Smile will increase access to cleft care in Paraguay by providing training and education for around 600 health workers. Operation Smile will offer American Heart Association (AHA) courses to medical professionals across various fields. We will deliver training opportunities for anesthesiologists, surgeons, nurses, pediatricians, dentists, psychologists and speech therapists.
Research & Innovation
We have signed an agreement with Universidad Catolica to allow final-year speech students to perform hearing studies at Operation Smile’s hub under the supervision of professors. Operation Smile is conducting a research study to determine if the use of an obturator, a dental device that fills the gap in the palate, improves speech for adult patients with unrepaired primary cleft palate.
FIVE-YEAR VISION
Over the next five years, Operation Smile will provide surgeries for 1,700 patients and consultations for over 8,200 patients.
Operation Smile will upgrade the skills of existing volunteers and recruit new providers across various specialties, including speech therapy, dentistry, nutrition, biomedical engineering, anesthesia and pediatrics.
Operation Smile will train health personnel working in hospitals and clinics, with a special focus on pediatrics, nursing, dentistry and speech therapy. In addition, Operation Smile will provide American Heart Association courses and training in primary care.
We will ensure that our patients have access to the best possible care by upgrading equipment and furniture and building a third operating room at our Centre. To decrease barriers to cleft care, we will advocate for the creation of national clinical guidelines for comprehensive cleft care.
