Nonprofit Addresses Health Equity by Providing Safer Surgeries

4 min read

By Susannah Schaefer, executive vice chair, president, and chief executive officer of Smile Train


As the global health care community considers how to create health care systems that work for everyone – including the most vulnerable among us – a topic that sparks widespread conversation is health equity. Health equity means everyone having the opportunity to achieve their full health potential, and specifically ensuring that no individual’s social circumstances prevent them from this.

Most recently, we’ve sadly seen through the ongoing COVID-19 pandemic how social inequities can create a disproportionate impact on various populations due to the uneven distribution of resources. Even in the U.S., a recent study found that “your ZIP code can carry more weight on your potential health outcomes than your genetic code, due to disparities among low- and high-income populations, including access to care.”


Smile Train, a cleft-focused nonprofit, has, for more than 20 years, centered on improving health equity around the world by offering those born with cleft lip and palate access to safe, quality cleft treatment and comprehensive care in more than 85 countries. We advance a sustainable solution and scalable global health model for cleft treatment, drastically improving children’s lives, including their ability to eat, breathe, speak, and ultimately thrive. Rather than flying doctors into low-resource regions to perform cleft surgeries, we provide funding and infrastructure so our medical partners are able to provide quality surgery, dental care, speech therapy and more, which allows for follow-up care, and strengthens local health systems.

We believe that we all have a voice in this conversation, and a role we can play. We see firsthand every day the power of dedicating the proper resources to making access to better health care more equitable globally. Through our work, we’ve proven that technology and forging like-minded partnerships are impactful ways to advance health equity, with outcomes that can inspire more innovation and action from our global communities.

Technology is a key factor with limitless potential to advance health equity, build health care capacity, and improve outcomes. For example, around the globe, lack of access to ongoing surgical training threatens the quality of surgical outcomes and the availability of life-saving care. These challenges have only grown during the pandemic as traditional training and care became nearly impossible in many regions. Smile Train, together with its Medical Advisory Board, has dedicated research to exploring ways to improve accessible virtual training options and provide what is essentially “the most modern textbook available” via virtual tools such as our Virtual Surgery Simulator and other offline resources for free to surgeons in low-resource countries worldwide. 

Telemedicine can also bring long-term health equity improvements as providers can reach more people, especially in remote regions or where patients avoid care due to fears of stigma. During the pandemic, even while some surgeries were on hold, Smile Train’s health partners were able to provide thousands of hours of critical care, including speech therapy and nutritional support via telemedicine.

An estimated two-thirds of the world's children lack access to safe surgical care. In 2020, Smile Train also partnered with Kids Operating Room to supply new state-of-the-art operating rooms across Africa, and has  provided essential, life-saving surgical care to thousands of children within the first year. Through this powerful partnership, we’ve been able to directly address the critical importance of providing safer surgery to further reduce health disparities.

While social determinants of health – defined by the World Health Organization as “the conditions in which people are born, grow, live, work and age” – directly influence many individuals’ health outcomes, we at Smile Train know we can all work together toward making the world a healthier, happier, and more equitable place.

Susannah (Susie) Schaefer is executive vice chair, president, and chief executive officer (CEO) of Smile Train, the world’s largest cleft-focused organization with a sustainable and local model of supporting surgery and other forms of comprehensive cleft care.  In her role as president and CEO, she oversees Smile Train’s vision to expand access to health care and increase local cleft care capacity in countries where Smile Train has active programs. 

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