The Quality Series presents:

Operation Smile Morocco is Making a Huge Impact on the Lives of Children Born with Cleft Palate and Cleft Lip

The Organization has branched out to other countries, and is finding new ways to save lives and serve the poor

King Tut was born with a cleft palate
What do King Tut, Joaquin Phoenix, Peyton Manning, Tom Brokaw, and Jesse Jackson have in common? All of them were born with cleft lips.

A Devastating Condition, More Common than you might Think

Approximately 1 in 500-600 children are born with a cleft lip every year. Cleft lip and cleft palate are birth defects where there is an opening in the lip or the roof of the mouth or both. A cleft lip occurs when the separate tissues that form the upper lip in a fetus do not properly join together; a cleft palate occurs when the two sides of a palate do not join together, resulting in an opening in the roof of the mouth. A child can suffer from a cleft lip, a cleft palate or both. The condition disfigures the faces of its victims, sometimes severely. Because the deformity suffered appears on the face, children with cleft lip or cleft palate encounter psychological problems related to their appearance. Especially in the case of a cleft palate, children may face other difficulties such as eating, drinking, speaking and smiling. They are often hidden from the gaze of others, and in some parts of the world they are murdered.

In ancient Sparta and Rome, people believed that children born with cleft lip or cleft palate (and other birth defects as well) were possessed by evil spirits and therefore had to be killed. In Egypt, on the other hand, King Tut had a partially cleft palate and at least one other mummy has been found with a cleft lip.

The earliest known surgery to repair a cleft lip was performed on a Chinese adolescent about 390 BC. The patient went on to become a general in the imperial army, then governor of six provinces. Wey Young-Chi often told others that he would never have become a success had it not been for the repair of his lip. On the other hand, Fang Kan, the Chinese poet of the tenth century, was so ashamed of his cleft lip that he spent almost his entire life alone and apart from the rest of society.

Few records of successful cleft palate or cleft lip surgery survive until the late Middle Ages when French and German surgeons began to perform the operations. The great Mozarabe physician Abū al-Qāsim Khalaf ibn al-‘Abbās az-Zahrāwī (936–1013), known as Abulcasis in the Latin texts, performed cleft lip surgery near Córdoba in southern Spain, and Bald’s Leechbook, written about the same time in Anglo-Saxon England, describes a procedure for repairing cleft lip but, given some of the rather fanciful remedies described in it (like using a whip made from dolphin skin to cure lunacy, or a paste of boars gall and honey to cure deafness), it isn’t clear whether such a procedure was successful or even performed.

By the fifteenth century some pioneering surgeons were sewing together the cleft lips of hardy patients who had to endure the procedure with no anesthetic. The lack of anesthetic probably contributed to the delay in performing cleft palate surgeries until the nineteenth century.

Transforming Lives in 45 Minutes

Today, surgeons can often repair cleft lips in less than an hour, and the results are remarkable. In the developed world these interventions take place often within the first six months of life, and scarring can be so minimal that it is hard to detect a couple of years later. In fact, early intervention is so common that many people in first world countries don’t realize how many people are born with the condition. In the developing world, however, many do not have access to adequate services to address the problem.

Awareness of the problem of cleft lip and palate is being raised by Operation Smile and other international organizations. One of the most interesting campaigns has come out of Chile, where famous actors, musicians and sports figures had photos of their faces retouched to show what they would look like with the condition.

Creating Smiles in Morocco

Operation Smile works through volunteers as part of a global alliance of Operation Smile Foundations and Resource Chapters dedicated to providing free treatment to children and adults suffering from cleft lips, cleft palates, other facial deformities, and burns. Since 1998, Operation Smile Morocco has performed more than 9200 procedures using donations of time and money. These surgeries change lives. And in addition to the surgeries, Operation Smile volunteers have performed about 15,000 free medical evaluations.

Surgeries are performed when a team of credentialed medical professionals from around the world travels to an Operation Smile partner country to treat children during a period of one or two weeks. Typically, the team, with local professionals working by their side, performs 150-250 medical examinations per week and 50-75 surgeries. In-country doctors and nurses also receive training. The goal is for local organizations to become self sufficient. Since 1998, Operation Smile has conducted 150 medical missions and 25 dental missions in Morocco, and the home organization in the United States will be sending a team to Fkih Ben Saleh, Morocco in November 2015, to Guelmim in March 2016, El Jadida in April, Bouizakarn in May, Beni-Mallal in June, and Tiznit in July.

The year 2008 was very important for Operation Smile Morocco as it opened its first permanent Care Center in Casablanca. From here, the organization is able to provide year-round care to hundreds of children each year. The Care Center also has a dental clinic, the Angus Lawson Dental Care (ALDC) Department. Dental care is often a critical component of cleft lip and cleft palate remediation because the underlying failure of certain tissue of the mouth to fuse implicates misalignment or teeth. The Care Center has cutting edge technology and a staff of more than 100 dental volunteers to treat hundreds of children each week.

The importance of the Care Center cannot be overstated. Not only are dental problems routinely implicated in cleft palate and cleft lip patients, but lack of dental care is a continuing challenge for the poor of Morocco, where some families have to choose between food and fuel or a toothbrush. Furthermore, recent studies have shown a correlation between oral health and diabetes and arteriosclerosis, and there is mounting evidence that there is a correlation between gum disease and obesity, arthritis, and lung conditions. Addressing oral health issues early, even when there is no need for cleft lip or palate treatment, makes for a healthier population.

To make the Care Center convenient for patients, the Operation Smile Morocco staff located it close to a bus station. Additionally, the Care Center treats local orphans, other clients of charities, and the poor where they can be found. Many of its young patients are visiting a dentist for the first time in their lives.

Since 2004, Operation Smile Morocco has partnered with the American Heart Association to provide basic, advanced and pediatric life saving skills to professionals and laypeople. To date, more than 3000 people have been trained to save lives under the program. And in August, 2015 Operation Smile performed its first Orthognathic surgeries, 11 in all, a much more complicated procedure involving the cutting and resetting of bones in the face.

Operation Smile physicians attend the annual Physicians’ Training Program in the United States, and Operation Smile Morocco has also branched out, working to establish programs in the neighboring countries of Algeria, Libya, Mauritania and Senegal. The registered NGO is able to perform a cleft lip repair for as little as 300€ and 45 minutes of time, but the effects last forever.

All of these recent efforts are strong indicia of an organization committed to Continuous Quality Improvement. The committee was particularly impressed with Operation Smile’s efforts to expand its services to the poor, to other countries, and to include related surgeries and therapies.

Because of its commitment to continuous quality improvement, Operation Smile Morocco has been selected to receive the BID Quality Crown Award for 2015 at the convention in London.


BID is a private and independent organization founded in 1984, whose primary activity is business communication orientated towards quality, excellence and innovation in management. A leader in the broadcasting of Quality Culture, BID recognizes those companies and organizations which lead the most important activities in the business world, and is considered the founding organization in the broadcasting of the Culture of Quality, Excellence and Innovation in 179 countries. The trophy symbolizes a pledge to the principles of Quality Culture. The QC100 Total Quality Management Model, together with the Quality Mix program, media coverage of the convention and its impact on the community and business sector, create an unmatched platform for continuous improvement within the organization and awareness of the achievements of the company at an international level. Awards are given only to those who are committed to improving their Quality Culture based on the principles of the QC100 Total Quality Management Model. Candidates are proposed by the leaders of previously awarded companies who they consider worthy of the award. Especially meritorious candidates may also be nominated. The International BID Quality Award Selection Committee then chooses the winning companies who will receive the award in New York, Paris, Geneva, Frankfurt, Madrid and London.