You smile 30 times a day, and normally, you don’t even think about doing it. It happens involuntarily when you hear a funny joke. While it is easy for many to smile, I saw firsthand that for children around the world who suffer from cleft lip and palate deformities, including one-year-old Matias, smiling is almost impossible, and other vital functions like eating and breathing can be just as hard.

Matias, a child from Venezuela, before (left) and after (right) his cleft lip repair by GSF.

Cleft lip and palate deformities impact about one out of every 1,000 babies born per year in the United States. Internationally, that number increases to about one out of every 700 babies born per year. Both cleft lip and cleft palate deformities pose serious problems for the development of babies born with these conditions. Medically, cleft palates cause difficulties in breathing, speaking, and eating, which can lead to malnourishment. Psychologically, patients with a cleft lip struggle socially due to a lack of confidence in their appearance.

Cleft lips and palates are a birth defect in which the upper lip and the roof of the mouth, known as the palate, do not develop completely. During normal development, at about seven weeks, when we’re still embryos, the two sides of the lip grow from the sides of the face and come together. This is why we have a small indentation between our nose and upper lip. For a patient with a cleft lip, however, the two sides of the lip do not connect, creating a noticeable cleft in the patient’s upper lip.

In the United States, for the most part, modern medicine has been able to combat the problems associated with cleft lips and palates. Cleft lips and palates can be almost completely cured before the patient turns two years old. Normally the surgeries can be done before the patients turn one, and in those cases, patients are able to eat and talk normally. As the scars heal, patients who have undergone this surgery will also look similar to people without these afflictions. In many other countries however, especially in developing nations, the incidences of cleft lips and palates are higher, mainly due to environmental factors such as poor parental nutrition. Not only are cleft lips and palates more common in developing nations, but also the international standard of care is not on par with that of the United States. In these international cases, patients may not have their lip repaired correctly and may still have facial deformities.

That’s where the Global Smile Foundation (GSF) comes in. Based near Boston, Massachusetts, the GSF is a nonprofit organization that sends doctors and students on mission trips to treat patients suffering from cleft lips and palates around the world and organizes educational workshops to better instruct the international medical community on the current United States standard of cleft lip care. 30 years after their first mission to South America, the foundation now organizes trips to Ecuador, El-Salvador, Lebanon, and Peru annually. For the past three years, I have had the privilege of traveling to Ecuador with the Global Smile Foundation.

On my first day volunteering in Ecuador on the way to Hospital Leon-Becerra, I sat on a bus, taking in the beautiful scenery of Guayaquil as we navigated alongside the bank of the Guayas River. Although the route was tremendously picturesque, I was too nervous to take in any of it. I had absolutely no idea what to expect as we pulled into the hospital parking lot. My fears quickly subsided, however, because as soon as I walked into the hospital, I was immediately bombarded by a barrage of cuteness. 150 babies, all of whom were patients of the GSF, were waiting for us.

Of all the babies I held and parents I talked to in broken Spanish, Matias was the patient that seemed to stick in my head. At just over one year old, he was older than many of the other patients, and he had particularly severe cleft lip and palate deformities. The severity of cleft lips is dependent on the degree of separation between the two sides of the cleft and the number of clefts. In most cases, only one side of the lip is cleft—known as unilateral cleft lip. In many other cases, however, there are two clefts—known as bilateral cleft lip—which separates the middle segment of the lip and teeth from the sides. In Mathias’ case, his lip was cleft bilaterally and significantly separated.

A visual representation of the most common types of cleft lip alongside a comparison to a normal lip. Source.

His family is from Venezuela, and they were severely impacted by the collapse of the economy. His mother told me that, for the past year, they had traveled for several days to Guayaquil in order to receive this treatment. His family struggled to afford his baby formula, and the previous year, Matias had been screened in the hope that GSF could operate in order to repair his lip.

His cleft lip and palate were so severe, however, that they were impacting his ability to feed correctly, so he was underweight. At 15 months, the average healthy toddler weighs around 24 lbs. However, at the same age, Matias weighed just under 19 lbs. While this may not sound like a big weight difference, those 5 pounds meant Matias was not a candidate for surgery due to the potential risks of anesthesia for underweight children. In response to these challenges, a GSF board member sponsored Matias, donating the money necessary for Matias’ family to buy the baby formula he needed. After a year of proper nourishment, Matias and his family took the journey to Guayaquil and returned to the GSF. After being screened, Mathias was cleared for surgery. Later that week, Matias was operated on successfully, and, after a full year of waiting and hoping, his lip was fully repaired. Two months removed from the surgery, Matias is eating better than ever and looks like he’s never even had a cleft lip.

Matias’ story is the case for many other cleft lip patients. Every day, new patients are born with a cleft lip or palate, and, without the generosity of donors and the GSF volunteers, positive outcomes like this one would be impossible.

Click here to donate to the GSF and learn more about the organization, its patients, and its volunteers. Even a small donation will contribute immensely to the positive outcomes of patients treated by GSF. Not only will donations go directly to patients, but they also enable medical professionals to volunteer their time and knowledge to patients all around the globe. These donations will also go to fund the medical supplies necessary for the volunteers to effectively perform the surgeries. Without volunteers or donations, GSF would be unable to bring the resources and medical expertise to those who need it the most.


  • Amer Mansour

    Amer Mansour is currently an undergraduate at the University of Chicago studying Biology. He has worked as an EMT with Boston EMS and he is an aspiring doctor. He loved volunteering for GSF and hopes to travel on many more missions with them in the future!

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