A man says to a young boy, “What do you see in the mirror?” The boy’s eyes fill with tears and he says he does not look at himself. Ever. Another child listens unprotestingly as her mother states, “She doesn’t go to school anymore because it scares the other children.” Yet another hears his parent say, “I wish he had never been born,” never to comprehend that the parent says this out of love and worry about what will be a lifelong struggle for normalcy.
I hit the Pause button on the award-winning documentary Smile Pinki and think about my conversation with Satish Kalra, Chief Programs Officer of Smile Train, a non-profit organization with a sustainable approach to cleft lip and palate repair. I am beginning to understand why Kalra has traded a successful corporate life to dedicate his efforts toward bringing smiles to these children.28

Understanding Cleft Lip and Palate
Every year, 1 out of 700 children in the developing world is born with a cleft lip or palate, a condition in which the roof of the mouth and/or top lip does not close properly. Treating a cleft can be routine, but for many families, it is unaffordable, and even to the medical community, a low priority compared to accident and trauma victims who need plastic surgery immediately.

Untreated clefts have significant health consequences, ranging from difficulty with breathing and eating, to death, in extreme cases. The psychological damage, however, is immeasurable. Speech is often affected, making it difficult for these children to be academically successful. Their physical appearance is a deterrent to making friends and developing a healthy self-image, and it leads to increasing isolation and shame.
Kalra’s eyes light up and his passion becomes contagious as he impresses upon me that the biggest tragedy is that “it is so curable!” It can take as little as $250 and 45 minutes to buy a child a smile, and, with it, a shot at a normal life.

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The Business Model
Smile Train partners with more than a thousand community-based hospitals that provide surgical interventions in over 85 countries. The doctors who provide the expertise are given unimpeded freedom to make medical choices, and the management team focuses solely on raising and distributing funds, and other operational decisions.The program’s continued success in providing scalable, long-term solutions comes from building local infrastructure. This means investing in safer, newer technology, and training local doctors. For instance, Smile Train developed the ground-breaking Virtual Surgery Simulator, a free, web-accessible resource that requires no specialized hardware or software. The Simulator provides instruction on complex surgical procedures from some of the world’s elite surgeons, using interactive animated graphics and actual surgical video footage.

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For patients, Smile Train goes beyond providing cost-free surgery. Children who appear too malnourished to withstand surgery are given food in the weeks prior. Small stipends are provided to families who do not have the means to travel to and from the hospital or lack basics such as food and shoes. In addition, post-surgical necessities, including dental care, orthodontics and speech therapy is made available where possible.

Success Stories
One story on the Smile Train website features a Rwandan genocide survivor, who, after living with cleft since birth, got a new lease on life when he and his daughter, born with the same affliction, underwent reparative surgeries.

Then there’s Divya, who, after being abandoned by her father, went from social withdrawal to being a Bharatanatyam dancer.  The stories span the globe, but the smile on each patient’s face tells the story of a life transformed.

Making a Difference
Smile Train assiduously seeks families in remote areas who need help. The staff educates and invites families to come to surgery camps in the larger cities, and encourages them to spread the word to other families in similar circumstances. The staff take time to answer parent questions, be playful with the children, and act like mentors, encouraging them to return to school and lead normal lives.

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How Can You Help?
SSmile Train continues to look for community support to further its efforts. You can donate directly to the organization via their website. You can also spread the word through social media channels, or create a community event using Smile Train’s fundraising kits. Smile Train also encourages schools, hospitals, faith-based institutions and corporations to partner with them.

For more information on how to volunteer or donate to this transformative organization, go to smiletrain.org., or contact Justin McCarthy, Director, Major Gifts, at jmccarthy@smiletrain.org.

Gayatri Subramaniam is a San Jose-based instructional designer and writer. She is an ardent tennis fan who believes that if she had only been taller, stronger, faster, and blessed with more talent, she would’ve been a Grand Slam champion.

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