Global Smile Foundation

Global Smile Foundation (GSF) has reached a pivotal point of growth. To guide our efforts towards international sustainable cleft care in resource-limited regions of the world, we have proposed a Sustainability Road Map that focuses on standardization of surgical outreach missions and capacity-building initiatives.

Recent milestones include:

• Being a founding member of the Worldwide Cleft Coalition (WCC) and publishing international program standards for outreach cleft care that prioritize patient safety and quality of care.
• Establishing an internationally-acclaimed Comprehensive Cleft Care Workshop (CCCW) to build global capacity.
• Utilizing Telehealth to deliver cleft care during the COVID-19 pandemic via our two Cleft Centers in Ecuador and Lebanon.
• Tele-proctoring surgeries remotely via Augmented Reality to overcome geographic and resource limitations.

Elevate Prize funding would enable us to continue our outreach cleft care programs while expanding our sustainability initiatives to a wider audience. GSF has been able to reach this point with minimal staff and resources, but taking our solution to the next level will require a broader infrastructure and investment.

Dr. Usama Hamdan and other founding members share a belief that first-class comprehensive cleft care should be accessible regardless of geographic or socioeconomic barriers. Their vision for the future has been honed over the past 34 years of involvement in outreach cleft care.

From the beginning, we prioritized quality—an integrated, individualized approach that provides long-term, continuity of care—so that increasing access to these underserved areas gives patients the best outcomes. Beyond improving children’s lives, returning annually created partnerships with local stakeholders, allowing our capacity-building efforts to establish Cleft Care centers and develop local provider skills, improving overall community health. 

GSF's transformative belief is that we can expand our global reach beyond what any NGO can accomplish alone through our commitment to unity, collaboration, and sustainability. 

Our goal is to promote sustainability in Low- and Middle-Income countries (LMICs) through a process we term as “capacity-building,” focusing on a diagonal model of care to achieve optimal patient outcomes and maximize our long-term efforts. While a vertical model tackles short-term solutions without sustainability and a horizontal model requires significant investment to achieve long-term impacts, a diagonal model enables GSF to lay the groundwork for sustainable practices while conducting surgical outreach programs.

One in every 700 babies around the world will be born with a cleft lip and/or palate. Children with cleft often suffer devastating consequences, including higher infant mortality rates, greater risk for malnutrition, poor physical and mental health, and poverty. The social stigma associated with cleft keeps children and adults hidden away at home, unable to access education, employment, and community support.

Inequity and inequality within our global health system means that cleft is a problem in LMICs, where access to essential health services—including primary, prenatal, and surgical care— is limited. This means that not only does cleft occur more often in these areas, but treatment is often out of reach for families; even if care is available, it can often be too expensive for families to afford. 

Based on more than 3 decades of experience, the work of GSF has evolved to address the urgent need for cleft care in underserved areas in two ways. First, we meet the immediate need for care by providing the highest quality, multi-disciplinary care at no cost to families in these areas. Second, we contribute to sustainable long-term availability of skilled medical professionals by equipping providers in LMICs with education and training.

Prevention and treatment of cleft have been established and ongoing for some time now. Outreach organizations, such as GSF, have evolved over the years—from simply delivering services to incorporating capacity building efforts.

To make a measurable impact for the future, WHO and other global stakeholders have called for an improvement of communication and coordination among outreach programs. GSF's goal is to catalyze this transformative effort. With the power of working together, we can elevate vulnerable areas worldwide, beyond what any organization can accomplish alone.

 We have begun this effort:

• In 2018, we launched our international Comprehensive Cleft Care Workshop (CCCW), uniting world leaders in the cleft field to provide hands-on training, skills lab and simulation sessions, team discussions, and detailed review of cases with the new generation of cleft care providers. 
• As a founding member of the World Cleft Coalition (WCC), we have worked with other organizations to develop worldwide standards for high-quality cleft care.
• Our Comprehensive Cleft Care Fellowships and Advanced Nonalveolar Molding (NAM) therapy training programs, create opportunities for students worldwide.
• Utilizing and promoting technological/medical advancements —including augmented reality, simulation training, and telehealth— we can increase accessibility and availability with low-cost, effective programs.

There is a pressing need for high-quality sustainable cleft care in LMICs. GSF's goal for addressing this need is two-fold. The first is to conduct 6-7 annual outreach cleft care programs for underserved patients. The comprehensive and long-term cleft care that our volunteer teams provide is life-changing for our patients and their families. GSF found that by repairing 1,500 primary clefts, we averted almost 13,000 years lost due to ill-health, disability, or early death (DALYs). These procedures have provided an economic gain estimated at $65-$124 million, which translates to approximately $43,000-$82,000 per patient. 

Our outreach cleft care is a conduit for the second part of our goal: to build capacity for sustainable cleft care globally. We know that the need for cleft care goes beyond what any NGO can deliver. By equipping providers in LMICs with education and training through our educational initiatives, we can help reach patients on a global scale. The Comprehensive Cleft Care Workshop has grown from 100 attendees (20 countries) to 300 (39 countries). The impact of this training is far-reaching. For example, a single provider can treat 200 patients annually and over the course of a 20-year career that provider will treat 4,000 patients.