Building roots for healthy smiles

Smile Train’s sustainable, local approach to cleft lip and palate treatment starts by sharing expertise.

One could say the work of this charitable endeavor ends with a smile, but that wouldn’t be quite accurate. Rather, it starts with a philosophy of change and ends with a sustainable system. The smiles – and there have been more than 1.5 million of them – are the product of that system.

Smile Train, the world’s largest cleft charity, was co-founded in 1999 by technology pioneer Charles B. Wang to address cleft lip and palate in the developing world. Every three minutes, a baby is born with a cleft. Children with clefts face many difficulties like eating, breathing, hearing and speaking. To help them, Smile Train remains focused on its cause and its unique approach: not just to heal people, but to improve local expertise so that others can be healed long after.

Give a man a fish and you feed him for a day, the charity’s guiding proverb states. Teach a man to fish, however, and you feed him for a lifetime.

Rather than running mission-based trips that bring volunteers into developing parts of the world for limited-time treatment clinics, Smile Train instead empowers local surgeons and healthcare professionals by providing ongoing funding and resources to treat cleft in their own communities; building hope and confidence for both patients and communities at large.

This sustainable approach, along with her personal connection to children who have been affected with a cleft, encouraged Dr. Mairead O’Reilly to contribute to Smile Train through a donor advised fund and to integrate her charitable example into her Annapolis, Maryland, practice, where she specializes in dentofacial orthopedics and orthodontics.

Each year, her practice buys back hundreds of pounds of candy from her patients after Halloween, earning each child a small reward that is representative of a larger contribution then made to Smile Train.

“The kids in the practice love seeing that balloon [donations tracker] filling up,” O’Reilly said, “and they see what it’s doing.” Her lobby is filled with photos of children treated through the charity. “It’s lovely for the kids to see who they are helping. This involves the practice in a mission and a goal I believe in, and our [patient] families believe in.”

Treating cleft lips and palates has been a major part of O’Reilly’s practice, ever since she started her career in London, working closely with children born with the condition.

In the industrialized world, treatment typically starts when a child is 2 to 3 months old. But in some places in the developing world, babies born with a cleft are forced into severe social isolation, and carry the practical burdens on breathing, speaking and eating that often come with having a cleft.

“There is often a stigma associated with having a baby born with a cleft in a developing country,” Smile Train President and CEO Susannah Schaefer said. “When you think about parents who are living in an austere location and have a baby who was born with a cleft, they sometimes think the child is cursed, that they did something wrong to cause their cleft.”

Treating the condition is life changing.

“Still, after many years, when I visit our local medical partners, there is something incredibly special about that ‘after’ moment that always touches me. The child comes out of surgery and then mom and dad see their child for the first time with their child’s cleft treated. Even with the stitches and the swelling, you can feel what they’re feeling. It’s very emotional. There are the moments when they give you a hug and you can feel it in every part of them and it’s like they are saying, ‘thank you, thank you for helping our child.’”

Smile Train’s sustainable model allows for more of that than a traditional mission-based approach, Schaefer said, allowing its donors to maximize the impact of their contributions and continue creating good long after the initial gift.

Cory Schauer, a managing director and client advisor of the Stafford Schauer Group in Boston, said his clients often get to a point in their lives and success where they start looking outward, starting locally, then looking beyond. Most are concerned with doing the most good as possible with their gifts.

“I think step one is education on how to use philanthropy appropriately and effectively to help society and to limit tax liabilities, especially in years where they have a liquidity event, such as when they sell a business,” Schauer said. “Then they want to know how they can create their own legacy and build a better world for their families and society. They quickly begin looking at philanthropy in a different light.”

Schauer, who has a master’s degree in taxation and uses a donor advised fund personally, said the vehicle “marries both philanthropy and tax savings especially well, and is not complicated to manage efficiently or effectively, which isn’t always the case with other charitable vehicles.”

Many of his clients take a great interest in determining the best use of their funds to create the greatest good, and are often looking at how much of each dollar is spent on services.

For Dr. O’Reilly, Smile Train fit her criteria. “What spoke to me when I was learning about Smile Train was its focus,” she said. “They found a need, they treat that need, and they hone it to a high art. They enable more cleft surgery than any other charity, and it’s become very efficient.”