Around the world, an estimated 1.7 billion children don’t have access to safe, affordable surgical care. This staggering number includes the 200,000+ babies born with clefts each year. These patients and their families often live in the world’s poorest, most remote communities, marginalised and unable to give input on the issues and policies that affect their lives the most.
At Smile Train, we know that the patients and families our partners serve every day, and the patients that still need our help, deserve to have their voices heard. By advocating at the local, national, and international level, we raise awareness amongst decision-makers on the rights and needs of children with clefts in order to bring about changes in policies and practice.
Smile Train representatives have joined global health advocates in meeting with US leaders on Capitol Hill, attended and hosted events and policy meetings at the UN General Assembly in New York, and travelled to Geneva to advocate to policymakers at the World Health Assembly. In the countries where we work, Smile Train staff members have forged relationships with local governments and partners to advance the rights of patients with clefts — particularly their right to safe, quality health care that enables so many other rights, like education and economic independence. This is the time to advocate and act for patients with clefts on a global scale.
Health for All: The Road to 2030
This year, the 74th UN General Assembly raised the stakes for all global health advocates as leaders from 193 countries around the world gathered to make a historical commitment to achieving Universal Health Coverage (UHC) by 2030. UHC, a global health movement that has gained unprecedented momentum alongside the Sustainable Development Goals, is the idea that everyone, regardless of where they are born, should be able to access quality healthcare when they need it, without financial risk. This commitment includes a pledge to prioritise the poor, vulnerable, and marginalised segments of the population, those who are often most in need of health services and least able to access them.
Now, as the ink dries on the Political Declaration for UHC, the country leaders that committed to its realisation will return home. Many will begin working with their governments to build national health insurance that covers a basic package of essential health services for their citizens. Others will continue efforts that have already been underway. Achieving the ambitious goal of UHC amidst endless priorities and limited budgets, however, is much easier said than done, and success will only come through coordinated action from everyone in the health system — including non-profits like Smile Train, whose partners work with patients living in areas where accessible, affordable care is otherwise non-existent, known as the “last mile of health”. Similarly, reaching and treating every patient with cleft will require action from a multitude of actors, including country governments.
Leading the Conversation: Cleft Care and UHC
In advance of this years’ UN General Assembly, Smile Train began a partnership with Devex, a media platform for the global development community, to bring the story of patients with clefts and the work of Smile Train to a broader audience and ensure that paediatric surgery was included in the conversation on UHC. As part of the partnership, Devex reporters visited Smile Train programmes in Kenya and in the Philippines, showing the scope of our partners’ work and demonstrating how sustainable comprehensive cleft care connects to the broader health landscape to raise the level of care for all. In Kenya, reporters spoke with community health volunteer Gianaphina Mwende Nguta, a health worker from Kenya who visits homes in Makeuni County, Kenya. Gianaphina helps to identify and refer patients with clefts to Smile Train partner treatment facilities — and with every patient reached, every health worker trained, and every community uplifted, progress towards UHC is made.
In the Philippines, reporters followed the journey of Smile Train patient Arvie Papa, a 4-year-old with a cleft lip and palate. The piece explores the Philippines Universal Health Coverage plan, PhilHealth, and how civil society organisations like Smile Train are working with governments and treatment facilities to ensure that there are no gaps in care for patients.
Convening the Child Health and Global Surgery Communities at UNGA
The day after country leaders made their historical commitments to UHC at the UN General Assembly, Smile Train hosted a UN General Assembly Side Event, bringing together experts from the child health and global surgery community to offer insights on the importance of child health within UHC as well as practical strategies for implementing surgical care as a part of UHC.
“Side events” are events held by organisations alongside major conferences. Often consisting of a panel discussion, a TED-style talk, or a roundtable discussion, side events highlight perspectives from different sectors of healthcare, government, and business, and they serve as opportunities for organisations like Smile Train to galvanise discussions, engage partners, and bring a message to external communities on why the work we do is essential. It’s a chance to invite those who share similar visions and priorities to partner with us in sending a message to policymakers and leaders about what we value — and why they should value it too.
At the Smile Train-hosted side event on child health, surgical care, and UHC, we welcomed event partners from the global surgery and child health communities, including the American Academy of Pediatrics, the Harvard Program in Global Surgery and Social Change, NCD Child, the G4 Alliance, and the Global Initiative for Children’s Surgery, for an insightful panel discussion at our headquarters in NYC.
Panellists included Pape Gaye, President and CEO of IntraHealth International, Dr. Ebelechukwu Obiano, First Lady of Anambra State, Nigeria and founder of Caring Family Enhancement Initiative, and Dr. Gagan Gupta, Maternal and Newborn Health Specialist at UNICEF. The panellists shared their insights on the challenges that families and children face in accessing safe surgical care as well as the successes they have seen and the best practice they recommend. CBS2 news anchor Maurice DuBois moderated the discussion, which addressed the shared roles of the health workforce, communities, organisations, and governments in prioritising the unique health needs of children and elevating global surgery as an essential part of UHC.
While the events themselves spark important conversations, the real value of side events come from the partnerships forged and the action taken in the ensuing months and years. Smile Train is grateful to the organisations that joined us for this event and is looking forward to the future partnerships and joint advocacy that will allow us to raise the profile of all children in need of safe surgical care, including those with clefts.
The Path Forward
The next 10 years will require unprecedented action if UHC is to be achieved by 2030. The path to UHC and the path to a world where every child with a cleft thrives are one and the same — you cannot have UHC without comprehensive cleft care. For 20 years, Smile Train partners have been providing outstanding care for our patients with clefts while strengthening surgical systems through our sustainable partnership model of care. Smile Train will continue to work with our partners to reach cleft patients living at the last mile of health — and will continue to serve as a platform where our patients’ voices are heard and valued by all.