Operation Smile

Operation Smile is a nonprofit medical service organization founded in 1982 by Dr. William P. Magee, Jr. and his wife Kathy Magee. It is headquartered in Virginia Beach, Virginia.

Operation Smile
Formation1982 (1982)
FoundersWilliam P. Magee Jr.
Kathleen S. Magee
TypeNonprofit
HeadquartersVirginia Beach, Virginia, U.S.
William P. Magee Jr.
Kathleen S. Magee
Websitewww.operationsmile.org

In addition to providing cleft lip and palate repair surgeries to children worldwide, Operation Smile works as a non-governmental organization to reduce the occurrence of cleft lips and palates worldwide; develops ambassadorships to raise awareness of cleft issues; sponsors a world care program for international cases requiring special care; organizes foundations worldwide to assist countries in reaching self-sufficiency with cleft surgeries; hosts a U.S. care network to assist families in the U.S. with cleft issues and develops and administers worldwide education programs related to cleft issues; and organizes student leadership programs.

Operation Smile has provided over 220,000 free surgeries for children and young adults born with cleft lips, cleft palates, and other facial deformities in over 60 countries since 1982.[1] As of 2018, Operation Smile provided on-going care around the world at 34 smile centers.[2] According to its own tax report, Operation Smile completed 156 medical missions in 80 sites around the world, including 13 new sites in some of the poorest regions of the world - and provided free surgical care for over 12,000 children and adults. [2] During missions, over 35,000 dental procedures were performed in the year 2018. [2]

Early History of Operation Smile

Chittagong, Bangladesh – Operation Smile team members aboard the Military Sealift Command (MSC) hospital ship USNS Mercy (T-AH-19), perform a cleft lip surgery

Operation Smile was founded by Bill and Kathy Magee (Dr. William P. Magee Jr., D.D.S., M.D. and Kathleen S. Magee, B.S.N., M.Ed., M.S.W.). In 1982 Dr. Magee, a plastic surgeon, and Kathy Magee, who was then a social worker and a nurse, were invited to join a Philippine cleft repair mission with a group of medical volunteers.[3][4] When they realized that this group would not be returning to the Philippines even though there were hundreds of children who needed surgery, they established Operation Smile. Dr. Magee said,[3]

It was guilt ... We saw hundreds of children and saw many more turned away. We knew that this group was not planning to return. So we planned another trip, but when we saw how many people were suffering because of their facial deformities, we had to keep on going back. You can't help but be touched by things that we take as completely normal and all of a sudden become a monumental event in a child's life.

The Magee's kept their promise and completed two trips back to Naga City, which resulted in treating 400 children.[5] The scope of the organization increased after Mother Teresa invited Operation Smile to come to India to treat deformed children.[6] In 1987, Operation Smile launched the Physicians’ Program, which brought doctors from the countries in which Operation Smile conducted medical missions to Norfolk, Virginia, to train with Co-Founder Dr. Bill Magee. That same year Operation Smile completed its First medical mission to Kenya. [5] Within the next two years, Operation Smile received a Presidential Citation for Private Sector Initiatives from President Ronald Reagan, and was adopted as a service project by the General Federation of Women’s Clubs. [5] In 1995, Operation Smile opened its first care center, offering patients cleft treatments year-round, in Duitama, Colombia. After establishing the Global Headquarters location in Norfolk, VA, Operation Smile began foundations in different countries like Australia, UK, Italy, Vietnam, and Ireland. [5]

Dr. Magee is currently employed as the Chief Executive Officer of Operation Smile and is a faculty member of both the Children's Hospital of the King's Daughters and Eastern Virginia Medical School. His wife, Kathy Magee, serves as the president on a full-time, volunteer basis and is a lifetime member of the Board of Directors.

Programs

Operation Smile organizes international volunteer missions to provide cleft lip and cleft palate repair in developing countries, coordinates programs for training physicians from around the world, manages programs to assist host countries in reaching cleft lip and cleft palate repair self-sufficiency, supports education and research programs to eradicate cleft lips and palates, and organizes global volunteer programs for high-school and college students.

Surgical missions

For each mission, Operation Smile verifies the credentials and organizes the participation and travel arrangements for a team of volunteers.[7] The team typically includes a mission site coordinator, plastic surgeons, anesthesiologists, a pediatrician, an intensive care physician, head or coordinating nurse, pre- and post-op nurses, child development specialists, speech pathologists,[8] dentists and/or orthodontists.

Teams work with local volunteers from the host nation as well as from other nations. Many of the volunteers provide important logistical (non-medical) support to the mission; they may serve as translators, medical records technicians, photographers, or help in such areas as food services, lodging, procurement of supplies, or transportation. The teams also typically include two high school students who fulfill various functions, including giving presentations on health maintenance and dental hygiene to families living near the mission site. Operation Smile coordinates the donation, purchase and delivery of medical provisions (equipment, medications, supplies) for each mission.

During the fiscal year of 2018, Operation Smile hosted 156 medical missions in 80 unique sites around the world and provided free surgical care for over 12,00 children and young adults. Nearly 82% of medical professionals volunteering with Operation Smile were from low and middle income countries. The medical volunteers provided approximately 397,312 hours of free care for Operation Smile's patients. [2]

Operation Smile's partner countries include:

Ambassadors

World Care Program

Patients with conditions too serious to treat in their own countries can become World Care patients and come to the United States.[23] On a case by case basis, Operation Smile will bring extraordinary craniofacial cases to Norfolk, Virginia, and all around the U.S. when mission conditions are inappropriate for the severity of the case. As of June 2007, approximately 200 world care patients had been treated.[24]

Foundations

Operation Smile has in-country global foundations that raise funds and awareness to support its programs. Mission teams are hosted by international foundations that are responsible for all in-country mission logistics and raise funds and awareness throughout the year. [2] Through partnerships with the American Heart Association, as well as with medical and teaching institutions, healthcare professionals from developing countries receive evidence based education, and hands on training and mentoring. Operation smile also has sponsored conferences, seminar workshops, rotation programs, visiting professorships, and short and long term fellowships. [2]

To aid countries in becoming self-sufficient at caring for cleft patients, beginning in early 2007 the organization planned to open comprehensive care medical clinics in Colombia, Honduras, Morocco, China, India, the Philippines and Vietnam.[25] The centers provide surgeries and treatment, educate local volunteers, perform local development activities and manage local communications / administrative services. The center in Vietnam expected to treat 2,000 patients annually and to train about 1,000 medical professionals.[25] As of 2018, Operation Smile now offers over 30 comprehensive care clinics around the world. [2]

U.S. care network

Operation Smile provides a network of resources to assist families in the U.S. with children born with facial deformities. This network is accessed through the Operation Smile website and includes a listing of referral websites and a physicians resource list with the names of doctors available to review a case.

Education

Operation Smile provides a framework for its partner countries to come together to share knowledge, technology and skills through the use of programs customized to each country's specific medical infrastructure. University partnerships offer Operation Smile medical volunteers training in advanced techniques and provide opportunities including fellowships, emeritus professorships and visiting professorship programs. Education exchange programs are also offered through partnerships with leading medical teaching institutions.

The annual Operation Smile Physicians' Training Program (PTP) brings surgeons from around the world to the United States for training in specialized surgical skills. The program has helped train more than 650 international physicians in advanced craniofacial techniques.[26]

Operation Smile has hosted two global summits on medical standards in Norfolk, Virginia.[27][28] Operation Smile attempts to hold yearly summits to offer medical training and advancement for medical workers around the globe. In 2017, they partnered with St. Luke's Medical Center in the Philippines to offer medically-focused skills workshops to its participants. [29]

Student programs

Operation Smile student programs encourages students to lead clubs and raise awareness of health in other countries.[30] Operation Smile engages students from around the world through an annual International Student Leadership Conference (ISLC) which convenes high school freshmen, sophomores and juniors who want to make a difference in global health. The International Student Leadership Conference (ISLC) is a big aspect of the Operation Smile student programs. Once every year, 500-700 students from around the world meet to discuss the world's issues and how to solve them with a specific focus on medical care equity. In 2018, the ISLC that took place in Seattle, WA included more than 300 students from across the globe, including China, Vietnam, Ireland, Panama, South Africa and Canada that learned how to advocate for children born with a cleft lip, cleft palate or other facial deformity. During the conference, students also learned about global health, joined in peer-to-peer leadership training and participated in service projects to benefit Operation Smile patients, as well as staff at Seattle Children’s Hospital. [31]

Operation Smile also offers students to travel internationally once they have experience. Before the students go on a mission, they must apply and be selected to attend the Mission Training Workshop (MTW), which is held twice a year. At MTW students are taught four health modules: dental hygiene, oral re-hydration therapy, nutrition, and burn care and prevention. Students make posters for each of these modules and present them on the missions, delivering critical information teaching families simple things that can save lives. While spending time at OpSmile headquarters in Virginia Beach, they will be trained as Operation Smile ambassadors in developing countries. Upon completion of this training they will be selected for an international mission. [30]

Global Essential Surgery Initiatives

In rural northeastern Nicaragua, this work is underway through a pilot project called Cirugía para el Pueblo – “Surgery for the People.” Operation Smile and the Ministry of Health seek to improve the surgical infrastructure of the hospitals and to spread awareness about surgically-treatable conditions to the people of the region. [32] The project will provide places like Nicaragua with education and awareness of common surgical diseases. These manuals will be used at the local health clinics in the remote villages, so people will be able to understand that their condition can be cured by surgery. Another part of this project is to provide needed equipment supplies and possible solutions to the lack of human resources, space to operate, and overall clean water.

Operation Smile is also working toward safe surgical conditions in Ethiopia and Rwanda. The organization offers surgical training rotations in Ethiopia and Rwanda. They've been conducting these educational rotations, which train general surgeons skills in reconstructive plastic surgery techniques, since 2012 in Ethiopia and since 2015 in Rwanda. [33] The two-week training courses for Ethiopian surgeons, anesthesiologists and nurses take place at JUSH (Jimma University Specialized Hospital), the only hospital serving the 15 million-plus people living in Ethiopia’s southwestern region. The focus of the rotations isn’t only on cleft surgery, but also teaching general surgeons a wide range of techniques to better heal burn, trauma and surgical wounds, which represent the bulk of the hospital’s need for plastic surgery. [33]

Starting in 2015, Operation Smile partnered with the University of Rwanda, Partners In Health and the Rwandan Ministry of Health to host twice-annual surgical training rotations.[34] Since then, 17 Rwandan general surgery residents have received hands-on training and education through the rotations. Operation Smile has also been working to improve the skills of anesthesiologists, which is an apparent need in Rwanda. Through a grant secured by Operation Smile Sweden through the Swedish Postcode Lottery, Operation Smile will help establish the country’s first-ever postgraduate reconstructive plastic surgery certification program in partnership with the University of Rwanda and Rwanda’s ministries of education and health. The program is scheduled to begin in September 2019 with its first graduates receiving certifications in 2022.[34]

On April 2nd, 2019 in the Vietnam Ministry of Health hosted a conference on patient safety and surgical safety that involved Operation Smile's participation. The achievement of collaboration between the Medical Services Administration of Vietnam MoH and Operation Smile comes after a Memorandum of Understanding was signed in 2014 with a goal to increase access to quality standards for safe surgery in Vietnam [35] During the recent conference, Operation Smile worked with the MoH, World Health Organization, and other organizations, to implement the set of eight Quality Standards for Safe Surgery. [36] The project started with the assessment of current surgical capacity in the country and included hospitals representing all socio-economic zones in Vietnam. The assessment results served as the baseline information for specialists to develop appropriate and feasible safe surgery standards for Vietnam. The drafting team used WHOs' document "Safe Surgery Saves Lives," as well as Operation Smile's Global Standards of Care as references for development of the Standards. The adoption of Safe Surgery Standards will have potential to impact three million surgeries annually throughout Vietnam.[36]

Awards and milestones

In 1996, Operation Smile was the first recipient of the Conrad N. Hilton Humanitarian Prize.[37] In 1997, Dr. Bill Magee and Kathy Magee receive the Servitor Pacis Award from The Path to Peace Foundation.[38][39] In 1999, Kathleen Magee was awarded the World of Children Award for her contributions to helping vulnerable children through her efforts with Operation Smile.[40] Dr. Magee received the 2001 Antonio Feltrinelli Prize (Premi "Antonio Feltrinelli") awarded by the Accademia Nazionale dei Lincei, which represents the National Academy of Science in Italy, for Exceptional Endeavors of Outstanding Moral and Humanitarian Value.[41] Dr. Magee presented the Honorary Kazanjian Lecture to the American Society of Plastic and Reconstructive Surgeons, and in 1998 received the Distinguished Service Award from the American Society of Plastic Surgeons.[26] Kathleen Magee received the 1997 Servants of Peace Award from the U.N. Representative to the Vatican.[42]

  • In 2001 a documentary on the work by Operation Smile won the Best Medical Documentary at the US Circle of Excellence Media Awards and was a finalist in the New York Film Festival Awards for Best Humanitarian Documentary. The Facemakers: Operation Smile is a co-production by BBC One and the Discovery Channel in conjunction with Century Films. It documents the remarkable changes that occurred in the lives of three children as a result of Operation Smile's visit to Davao City in the Philippines in 1999.[43] The fifty-minute programme was first aired on 21 June 2001. Two of the children received surgery during the mission. Nine-year-old Rozal Garces was treated for her cleft lip, and four-year-old Amorjoy Felipe had a cleft lip and palate revision. The third child, Abel Gastardo, had a condition too severe to be treated during the time of the mission. Abel suffered from a nasofrontal facial encephalocele, an extreme protrusion of brain tissue from the front of his skull. The film follows Abel to the United States to receive corrective surgery, seven months later. He was brought over by Operation Smile to receive major surgery in Virginia at the Children's Hospital of The King's Daughters.[44]
  • To mark its 25th anniversary in November 2007, Operation Smile undertook the World Journey of Smiles (WJOS), a single campaign that included 40 simultaneous missions over a period of two weeks in 25 countries—beginning with the return to the site of Operations Smile's first mission.[45] During WJOS, Operation Smile completed 4,200 cleft lip/palate surgeries with 1,700 volunteers from 43 countries. The World Journey of Smiles also collected DNA samples from 4,200 children—the largest sampling ever made and now housed at Yale University.
  • Bill and Kathy Magee were honored on March 1, 2008, with the Norfolk First Citizen Distinguished Service Award.[6]
  • Bill Magee was awarded the American Society of Plastic Surgeons’ Honorary Citation Award in 2014, and the American Society of Maxillofacial Surgeons’ Tagliacozzi Award in 2013. [46]
  • In 2014, Kathy Magee received a prestigious honorary doctorate from the Karolinska Instituet in Sweden. She has also remained active in the World of Children organization and serves as a member of the Executive Committee for the Hilton Laureates Collaborative.[46]

1999-2002: Criticism and response

In November 1999, specific patient deaths[47] brought criticism on Operation Smile's medical procedures, suggesting the organization prioritized publicity and volume over patient welfare and safety.[48][49] In response, Operation Smile conducted an internal review. Initially, the organization "promised to make public the full findings of the review", though later chose not to release the findings, considering the review an internal matter. Several directors disagreed with this choice and left the board. Four months after announcing the review, the organization publicly acknowledged organizational flaws.[50] By 2002, the organization also established medical credential standards, improved medical monitoring of patients, and implemented quality and financial controls.[51]

Financial information

  • Operation Smile’s 2018 digital annual report shows total revenue of $104,624,958.    The report indicates fundraising and administrative expenditures of $27,000,246 (28.7% of expenses).[52]
  • Operation Smile's 2017 digital financial report shows cash revenues of $59,215,636. The report shows fundraising/administrative expenditures of $26,016,760 (43.9%). [53]
  • Operation Smile's 2013 financial overview report shows an income of $49,516,821 in cash contributions. The report indicates an expenditure of $23,189,296 for fundraising and administration.[54]
  • In 2011, Forbes ranked Operation Smile as the tenth "least efficient" large U.S. charity, tied with the Alzheimer's Association and just ahead in efficiency of the American Cancer Society.[55] Forbes noted that "financial efficiency is far from the whole story when it comes to assessing a charity's vitality or even effectiveness."[55]
  • Operation Smile spends 42% of the money donated to the charity on fundraising and administration, including a salary of $350,000 (and an additional $27,915 in other compensation) for its chief executive.[56][57]
  • The NGO raised $35,024,864 during the fiscal year ending June 2008. They spent 41% of the cash revenues on fundraising and administration; $11,905,507 on fundraising (33.9%) and a further $2,710,783 on management (7.7%).[58]
  • Operation Smile also operates the Operation Smile Foundation, a separate registered non-profit whose sole purpose is to raise funds for Operation Smile. The Foundation spent $7,267,834 on fundraising and raised $8,387,513 in the tax year ending June 30, 2007. The Foundation transferred a total of $781,858 to Operation Smile.[59]
  • The organization was listed with the Forbes 2005 200 Largest U.S. Charities.[60]
  • Operation Smile is a member of the Independent Charities of America.[61]
  • Operation Smile meets 19 of the 20 standards for charities established by the Better Business Bureau Wise Giving Alliance,[62] but fails to meet the "Compensated Board Members" standard, because two of the eleven board members (the husband and wife co-founders) are compensated directly or indirectly, which exceeds the standard's limit of 10%.
  • A 2007 multimedia project featured a seven-story sphere at South Street Seaport in New York, NY. Microsoft worked with Operation Smile, Digital Kitchen (a design firm) and the Wexley School for Girls (Seattle, WA) to have photographic images of visitors projected onto the sphere.[63] [(See also: Case Study)]
  • A 2005 movie, Smile, directed by Jeffrey Kramer was loosely based on the experiences of a student Operation Smile volunteer.
  • Singer Jessica Simpson, and television hosts Billy Bush and Nicole Lapin[64] volunteer on behalf of Operation Smile.
  • Actress Roma Downey[65] has been an ambassador for the Virginia-based nonprofit Operation Smile for 20 years.
  • Singer Mariah Carey volunteered for The Smile Collection fundraising event in New York in 2006.[9]
  • Operation Smile was featured on NBC's reality show The Apprentice, Thursday, April 15, 2004.[66]
  • Operation Smile is referenced repeatedly on Bravo's teen reality show NYC Prep.[67]
  • Operation Smile is referenced in episode 3 of TNT's television series Franklin & Bash.
  • Celebrity plastic surgeon Michael Obeng began his career with Operation Smile in Ghana.
  • In January 2014, Gawker published an article regarding Operation Smile's interviewing process, which includes throwing a party for 40 people.[68]
  • Chrissy Metz and Milo Ventimiglia, actors on the famous This Is Us television show, are supporters of Operation Smile. [69] [70]
  • In 2016, Kate Hudson accepted the Universal Smile Award for her long time support with Operation Smile. [71]

Co-branding

See also: Co-branding and Marketing co-operation
  • In 2002, Operation Smile was featured in a Mr. Potato Head contest, with proceeds to benefit the NGO.[72] Hasbro donated Mr. Potato Head toys for Operation Smile missions.[73]
  • An ongoing co-branding campaign between Operation Smile and Sephora combines the NGO's name with the companies products, raising over $400,000 for the NGO.[74] The Operation Smile Sephora Lip Baume was listed at number five on Lara Spencer's "Lara's Hot Shopping List, Hot Products for Women".[75]
  • An ongoing co-branding campaign between Operation Smile and AriZona Iced Tea features the tea company's three best selling (one liter) products' labels replaced with Operation Smile branded messaging, mission statement and photos of children with cleft repairs. [76]
  • In 2007 Lladró unveiled a collection of porcelain, including a piece inspired by Gustav Klimt's painting The Kiss, proceeds from which were to benefit the NGO.[77]
  • In February 2018, Operation Smile partnered with Lay's potato chips that allotted a 1 million dollar cap for donation. The bags that hit the shelf on February 12th displayed a happy smile at the opening. The bags will appear only once more on the shelves on April 7th. [78] Lay’s has also engaged fans with its Lay’s Smile Experience, a three-day pop-up in New York’s Time Square from Feb. 8-10, and has the support of musician, actress and Operation Smile ambassador Jordin Sparks.

Film producer, director, producer, and author Perry Moore (The Chronicles of Narnia, Executive Producer; author of the LAMBDA award-winning HERO) was a student volunteer in 1988 and, trained as a scrub and health care advisor. He was part of the team that traveled to Manila, and then to Naga City in the Philippines.

Headquarters relocation

Operation Smile announced in late 2007 that it would relocate its world headquarters approximately 16 miles (26 km) from its location in Norfolk, Virginia to a new building in Virginia Beach.[79] The projected 65,000-square-foot (6,000 m2) building is sited adjacent to a projected regional health profession center to be built by Tidewater Community College. The headquarters occupies land owned by the city of Virginia Beach and received funds from the city for site improvements, including landscaping, utility service and sidewalks.

As of May 2014, the Operation Smile website listed the new address at 3641 Faculty Boulevard, Virginia Beach as its headquarters.

See also

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