Smile Train

Smile Train
Formation	1999 (1999)
Type	501(c)(3) nonprofit
Headquarters	New York, New York, United States
Chief Executive Officer	Susannah Schaefer
Website	www.smiletrain.org

Smile Train is a 501(c)(3) organization based in New York City, USA . The organization was founded in 1999 and has grown into the world’s largest cleft charity^[1] with a mission of empowering local medical teams to provide free, safe surgery for poor patients with cleft lip and/or palate. Smile Train has carried out free, corrective cleft surgery for children in 87 developing countries. Smile Train differentiates itself with a focus on providing financial support to local medical personnel who are trained in cleft surgery and helping to support the costs so that local doctors can provide 100% free cleft care to patients. Smile Train also focuses on building sustainable cleft programs within each of their more than 1,100 partner hospitals with a strong focus on education and training opportunities. The organization reports that it has assisted with over 930,000 surgeries to date.^[2]

History

Smile Train was formed in 1999 with a model aimed at supporting professionals locally in developing countries and supporting them directly to carry out cleft surgeries. The idea was that it would be more efficient, less expensive, allow for proper follow-up care, and be a more sustainable solution than sending in Western medical mission teams.

Smile Train’s first operation took place in China when the organization worked with former U.S. president George H. W. Bush^[3] to gain access for training local surgeons and supporting surgeries in hospitals in some of that country’s poorest regions. In early 2012, Smile Train celebrated 250,000 surgeries in China and has partnerships in 397 hospitals covering every province.^[4]

India was the second country where Smile Train started work and it has become the most productive—the South Asia region celebrated its 300,000th surgery in late 2011.^[5] Smile Train’s program in India now does more surgeries each year than there are new cleft births, which is a pivotal milestone to address the backlog of clefts in the country. Smile Train partnered with Bollywood actress and former Miss World, Aishwarya Rai,^[6] for her to serve as an ambassador, increasing awareness and garnering financial support to help the plight of children born with cleft.

Smile Train’s Africa programs are among the youngest. Smile Train helped to create the Pan African Congress on Cleft Lip and Palate and has sponsored bi-annual conferences^[7] as well as initiating and sponsoring the 2008 Pan African Anaesthesia Symposium^[8] after identifying a need for improved anesthesia and post-operative care among partner hospitals. Smile Train Africa has also designed a special training course on post-operative nursing care that has been implemented throughout Africa and other parts of the world.

Technology

Smile Train created training videos that present advanced cleft surgery techniques demonstrated by experts, to doctors stationed in remote, impoverished areas of the world.^[9] The DVDs were the result of a collaboration with world-renowned surgeon, Dr. Court Cutting, who served as Chairman of the organization’s Medical Advisory Board, and a company called Biodigital.^[10] The DVDs were produced in English, Spanish, and Mandarin language versions and more than 39,000 copies have been distributed to date for free around the world.^[11] An updated, interactive, web-based version is expected for release in the first half of 2013.

Smile Train maintains a database of all of the cleft surgeries that it has supported around the world. In addition to data collection, it is used to monitor safety and quality and ensure proper use of grant funding by partner hospitals around the world. The records have also been the source for several research projects by experts hoping to better understand clefts and find a cure, as well as measuring the long-term impact of providing cleft surgery and care to the hundreds of thousands of Smile Train patients, providing them with the opportunity to contribute productively to their own communities.^[12]

Smile Train also boasts a large medical research library with more than 1,000 articles related to clefts accessible online for free.^[13]

Partnerships

Smile Train helps the cause of cleft care through its funding of 1,000+ active partners representing nearly 1,200 hospitals and 2,300 partner surgeons in the world’s poorest nations; through these local partnerships, the organization is able to provide free surgery for children any day of the year, with more than 120,000 surgeries each year.^[14]

In addition to partnerships with cleft care organizations, Smile Train has partnered with other individuals organizations in an effort to improve safety and quality at their partner hospitals, such as Dr. Atul Gawande, World Health Organization, World Federation of Societies of Anesthesiologists^[15] and Lifebox.^[16]

Smile Train has a number of corporate partnerships, including Artisanal Cheese,^[17] Dubai Duty Free,^[18] Estée Lauder, FedEx,^[19] QBE^[20] The Queens Flowers,^[21] Mars Retail Group ^[22] and Vertu^[23][24] These partnerships - in addition to those in partnership with donors on grassroots efforts - serve to both raise money and spread awareness.

Awards

In a 2008 New York Times article, economist Steven Levitt of Freakonomics fame indicated that the organization's model and its technological innovations "likely make Smile Train one of the most productive charities, dollar for deed, in the world." ^[25]

In 2008, Smile Train was the runner-up in the Health-Care IT category of the Wall Street Journal Technology Innovation Awards in recognition for their surgical technique training videos.^[26]

In 2009, the documentary Smile Pinki, won the 2008 Oscar® for Best Documentary (Short Subject).^[27] The documentary was sponsored by Smile Train and directed by Megan Mylan. The film shows the story of a poor girl in rural India whose life is transformed when she receives free surgery to correct her cleft lip. Free copies of the film are available through Smile Train’s website.^[28]

Criticism

Charity Watch has questioned some of the company's financial claims, also criticizing the $420,209 compensation package of Smile Train's former President & Co-Founder, Brian Mullaney.^[29] Although the charity responded that "100% of Mr. Mullaney's compensation, benefits and all travel expenses are paid for from the temporary restricted funds set up by the founding board members to cover overhead and fundraising (non program) expenses," Charity Watch asked: "How can 100% of his salary be paid for by a fund that is restricted for only non-program expenses? All else aside, if Mullaney's compensation were lower, then more of the temporarily restricted funds could be available for other expenses."

Charity Watch's criticism goes on to say: "Money is fungible, regardless of its source; what is spent on one function is not available for another function. The bottom line is that more donations could go toward treating children with cleft palates if the charity were operating more efficiently, regardless of whether or not some donors earmarked their donations for overhead."

More criticism appeared in an article in The Examiner (June 25, 2009), entitled "Smile Train's tactics with Oprah, financials raise serious questions."

Givewell expressed concern on the company's lack of transparency and accountability, stating: "We do not have the information we would need to be confident in the effectiveness of Smile Train's programs, particularly regarding quality control of surgeries and education in the developing world. We also do not have a clear breakdown of how funding is spent by program (as over 30% of program expenses are spent on a program that we can't identify a description for)."^[30]

Supporters

A number of celebrities and world leaders have pledged varying forms of support for Smile Train.^[31]

• Tatyana Ali ^[32]
• John Bishop
• Christie Brinkley ^[33]
• Dean Cain ^[34]
• Stephen Colbert
• Kevin Connolly ^[35]
• Walter Cronkite ^[36]
• Erik Estrada ^[37]
• Sammi Hanratty ^[38]
• Rebecca Herbst^[39]
• Jane Kaczmarek ^[40]
• Howie Mandel
• Mary McCartney ^[41]
• Reba McEntire ^[42]
• Bette Midler
• Jimmy Pardo ^[43]
• General Colin Powell ^[44]
• Aishwarya Rai Bachchan ^[6]
• Carly Simon
• Hilary Swank^[45]

Key personnel

The organizations key personnel are:^[46]

• Susannah Schaefer, Executive Vice Chair and Chief Executive Officer

• Robert T. Bell, Executive Director, Charles B. Wang Foundation
• Michael J. Dowling, President and CEO, Northshore-LIJ Health System
• Ed Goren, Founder and CEO, Goren Media Group
• Arthur J. McCarthy, Chief Financial Officer, NeuLion
• Roy E. Reichbach, General Counsel, NeuLion
• Richard A. Ruderman, President and CEO, Krieger Ruderman & Co., LLC

• Robert K. Smits, Counsel, Salans
• Charles B. Wang, Founder and Chairman, Smile Train

Medical Advisory Board

• Ian Jackson, MD, DSc(Hon), FRCS, FACS, FRACS(Hon), Emeritus Craniofacial Surgeon, Craniofacial and Cleft Palate Clinic, William Beaumont Health System
• Dr. H.S. Adenwalla, MS, Head of the Department of Charles Pinto Centre for Cleft Lip and Palate, Jubilee Mission Medical College and Research Institute
• Dr. Shi Bing, Vice President, West China Stomatology Hospital of Sichuan University
• Philip Kuo-Ting Chen, M.D., Director, Craniofacial Center, Chang Gung Memorial Hospital
• Alvaro Figueroa, DDS, MS, Co-Director, Rush Craniofacial Center, Rush University Medical Center
• Dr. Arun Gosain MD, FACS, Chief, Division of Plastic Surgery, Lurie Children's Hospital, Northwestern University
• Larry Hollier, Jr., MD, FACS, Professor of Plastic Surgery, Baylor College of Medicine, Texas Children's Hospital
• Eric Hubli, MD, FACS, FAAP, FICS, Medical Director of Craniofacial and Cleft Services, Cook Children's Medical Center
• Ethylin Wang Jabs, MD, Vice Chairman, Department of Genetics and Genome Sciences, Mount Sinai Medical Center
• E. Heidi Jerome, M.D., Associate Professor of Anesthesiology and Pediatrics, Department of Anesthesia, Columbia Presbyterian Medical Center
• Jan Lilja, M.D., D.D.S., Ph.D., Department of Plastic Surgery, Sahlgrenska University Hospital
• M. Samuel Noordhoff, MD, FACS, Supt. Emeritus & Chief of Plastic Surgery, Noordhoff Craniofacial Foundation
• S. Anthony Wolfe, M.D., Chief of Plastic Surgery, Miami Children's Hospital

Financials

According to Smile Train’s 2008 990 IRS report, management and general expenses are less than 1.5% of total expenses.^[47]

Smile Train complies with all the 20 Standards for Charity Accountability established by the BBB (Better Business Bureau) Wise Giving Alliance. These standards were developed to assist donors in making sound giving decisions based on how Smile Train is governed, how Smile Train spends its money, the truthfulness of Smile Train’s representations and Smile Train’s willingness to disclose information to the public.^[48]

According to the Smile Train's most recent financials, 79.5% of total expenses goes toward program services, with 19% going to fundraising. The organization's 2011 Form 990 (fiscal year ending June 2011) indicated revenues of $105.7 million, while total expenses were $86.3 million, of which program expenses were $67.3 million. Some $18 million was marked for fundraising expenses.^[49]

See also

• List of non-governmental organizations in the People's Republic of China
• Cleft lip and palate organisations

References