Since 2006, Operation Smile has delivered high-quality surgical care for over 520 patients in South Africa.
But there is more to do.
During Fiscal Year July 2025 – June 2026, Operation Smile will invest $253,800 to provide surgical care for over 150 patients and train nearly 540 medical providers.
Over the course of the following five years, Operation Smile will deliver surgery to approximately 1,210 patients and comprehensive cleft care to approximately 2,280 patients.
Cleft Care Programs
Operation Smile will provide surgical treatment for 150 patients. We will also deliver consultations in oral health (600 patients) and speech therapy (40 patients).
Education Programs, Infrastructure & Equipment
Operation Smile will provide training and education for nearly 540 health workers in South Africa. Health workers will receive specialized training across various areas of cleft care. In collaboration with the American Heart Association, medical providers will receive Basic Life Support training to strengthen their ability to respond to critical emergencies. Additionally, Operation Smile will equip 65 caregivers in South Africa with the knowledge and skills needed to support their child throughout the cleft care journey.
THE NEED
0.3 per 1,000 births. The estimated prevalence of cleft conditions in South Africa is 0.3 per 1,000 live births. Operation Smile’s survey revealed that 83% of patients arriving at Operation Smile programs in South Africa could not have undergone surgery without the support of Operation Smile.
Unequal access to care. In South Africa, 80% of medical providers serve 15% of the population in the private sector, even though 84% of South Africans depend on the public health sector for their health care needs. Patients at public health care facilities often face limited health care services, long wait times, old infrastructure and inadequate disease control and prevention practices. This puts patients born with cleft conditions at an even greater risk.
Barriers to treatment. South Africa has just 11 specialist surgical workers per 1,000 people, which falls short of the target set by the Lancet Commission on Global Surgery of 20 surgical providers per 1,000 people. Specialist surgeons are concentrated in tertiary and academic hospitals whilst non-specialists provide three times the number of surgeries mainly in district and regional hospitals.
Financial barriers. The shortage of medical providers is exacerbated by financial barriers to health care. 78% of patients arriving at Operation Smile programs in South Africa live below the poverty line and 97% have no health insurance. Out of pocket health expenses often prevent people from reaching the care that they need. 28% of the population is at risk of impoverishing expenditure for surgical care, while 15% faces catastrophic expenditure in case of surgical care. The unemployment rate in South Africa stands at 32%, making it difficult for many families to afford medical treatments, including surgeries for cleft conditions.
Barriers to education and employment. Without surgery, patients face challenges in school attendance and performance. Many caregivers stay home to provide the necessary support for their child. In South Africa, 42% of patients arriving at Operation Smile programs reported that their condition affects their school performance. 39% of surveyed caregivers remain at home to care for their child.
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 South Africa, our hubs are based in Eastern Cape (Nelson Mandela Academic Hospital), Mpumalanga (Rob Ferreira Hospital), Gauteng (Nelson Mandela Children’s Hospital) and Kwa-Zulu-Natal(Inkosi Albert Luthuli Central Hospital).
The spokes are located in Mpumalanga (Witbank, Tintswalo, Themba and Piet Retief) and Eastern Cape (Mthatha Regional, St. Elizabeth, Zithulele, Madwaleni and St. Patrick’s).
FIVE-YEAR VISION
Operation Smile’s partnerships with National and Provincial Departments of Health have allowed us to effectively plan and carry out surgical programs across the country.
We partner with the South Africa Speech Language and Hearing Association to deliver education and training for health workers. Through our collaboration with Igwiba Lesizwe, we distribute basic supplies such as toothpaste and toothbrushes, necessary for maintaining oral health.
Operation Smile collaborates with top-ranking medical universities in South Africa, including University of Cape Town Global Surgery and University of Pretoria.
