Operation Smile has been working in Paraguay since 2005, delivering high-quality care to children born with cleft conditions. To date, we have provided more than 4,200 surgeries, helping transform lives through surgical and comprehensive care support.
But there is more to do.
In Fiscal Year July 2025-June 2026, Operation Smile will invest $304,000 to perform life-changing surgeries for nearly 330 patients and provide training and education for nearly 630 health workers.
Over the next five years, Operation Smile will provide surgeries for ~2,000 patients and deliver ~24,500 consultations for ~12,220 patients.
Cleft Care Programs
Operation Smile will provide surgical care for nearly 330 patients. We will expand our comprehensive cleft care services by providing consultations in oral health (over 690 patients), nutrition (over 340 patients), speech therapy (nearly 510 patients) and psychosocial care (approximately 330 patients).
Education Programs
Operation Smile will expand access to cleft care in Paraguay by providing training and education for approximately 630 health workers. These specialty training opportunities will cover cleft surgery, anesthesia, pediatrics, nursing, biomedical technology, speech and oral health. In addition, 590 caregivers will be equipped with the knowledge and skills to support their child throughout the cleft care journey. Operation Smile will also offer American Heart Association (AHA) courses to medical professionals working across multiple disciplines.
As part of Operation 100, Operation Smile’s Center in Asunción will serve as a hub for comprehensive care and advanced training. The first spoke is projected to launch in late fiscal year 2026 through a partnership with Hospital Pediátrico Acosta Ñu in San Lorenzo, the region’s leading pediatric referral center. While the hub will focus on equipping and training cleft teams, the spoke will play a vital role in expanding access to care.
THE NEED
Cleft prevalence. On average, one child is born with a cleft condition per 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 barriers. 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.
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.
Our hub in Asunción, located at Operation Smile’s Care Center, is equipped with operating rooms and provides year-round surgical and nonsurgical cleft care for patients.
FIVE-YEAR VISION
Over the next five years, Operation Smile will provide surgeries for ~2,000 patients and deliver ~24,500 consultations for ~12,220 patients. As part of our effort to increase access to high-quality cleft care, we will strengthen strategic alliances with key hospitals. Hospital Acosta Ñu in San Lorenzo, the region’s leading pediatric referral center, and Hospital Cenquer in Asunción, Paraguay’s national center for burns and reconstructive surgery, will serve as spokes in our care delivery network.
Our capacity-building strategy focuses on positioning the hub as a training center for surgical and non-surgical specialties. Equipped with high-capacity operating rooms, the hub will provide structured education pathways to develop cleft operative teams. Investments in essential equipment and health infrastructure across the hub and spokes will ensure sustainable, high-quality care.
Partnerships with universities will support workforce development, while a targeted patient recruitment strategy will help us identify children in need of cleft care.
