Operation Smile is a longstanding, non-profit organization that has been helping children diagnosed with a cleft palate for almost four decades. Their vision and mission statement is "every child suffering from cleft lip or cleft palate deserves exceptional surgical care." Even with financial support and endorsements from many celebrities, including Annette Bening and George W. Bush, you need to know how this organization would spend your hard-earned dollars. The following is a comprehensive look at the organization and an overall Operation Smile Charity Rating.

While their commercials often bring tears to your eyes, it is important to know how much of each dollar donated to Operation Smile goes to helping the precious children displayed on your television screen. As more and more information comes out about fraudulent charities, it's important to do your research before cutting that check. Read on to find out if Operation Smile is a good fit for your charitable giving.

What Is Operation Smile?

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Operation Smile, Incorporated is a non-profit, 501 (c) (3), that provides corrective surgery and dentistry services to children and young adults around the world. Most of their patients have been diagnosed with cleft palates or other facial deformities. Headquartered in Virginia Beach, Virginia, it is one of the oldest and largest volunteer-based organizations dedicated to improving the health and lives of children in over 60 countries worldwide. They accomplish this enormous task using volunteer surgeons, pediatricians, medical doctors, nurses, and student volunteers.

History of Operation Smile

Dr. William P. Magee, Jr., a dentist and plastic and craniofacial surgeon, founded Operation Smile in 1982, with his wife, Kathleen Magee, a nurse and clinical social worker. Before establishing Operation Smile, the Magees traveled with a team of volunteers to the Philippines to perform free cleft palate surgeries for children in need. While there, nearly 300 parents brought their children to the volunteer medical team hoping someone could help them. The team could only perform 40 surgeries during the visit. After seeing this, William and Kathleen promised to return.

With donations of medical equipment in hand, they took a team of 18 volunteers back to the Philippines, where they performed 100 cleft palate surgeries. As of 2018, the organization has performed over 220,000 surgeries worldwide.

Operation Smile Organization and Management

A major component of the Operation Smile charity rating is how well the company is managed. The organization is lead by a Board of Trustees, with Dr. William Magee sitting as the founder and Chief Executive Officer, his wife Kathleen as the co-founder and President, and their daughter, Kristie Porcaro as the Senior Vice President of Global Philanthropy. In addition, the organization is governed by four independent oversight boards, Medical Specialty Advisors, Special Programs, Medical Officers, and Quality Assurance. These boards oversee various facets of the non-profit and its operations.

In addition to the four governing boards, the company created an 11 point code of conduct that helps to self-regulate all internal dealings. These are listed below:

  1. The organization has no affiliation with any political or religious groups.
  2. There is a zero tolerance for fraud or corruption within the organization.
  3. They strive for transparency in every department.
  4. They work to protect and value their employees and volunteers.
  5. They promote whistleblowing for any employee or volunteer who discovers fraud or misdealing.
  6. They focus on transparency and accountability with all financial information.
  7. The board vowels to act as stewards of all the organizations' assets.
  8. The organization will strive to only work with companies who respect human rights, take responsibility for children, and responsibility for the environment.
  9. Operation Smile pledges to be environmentally responsible.
  10. The organization has created a Child Protection Policy that all staff and volunteers must follow.
  11. They commit to upholding a global standard of care.

What Are Operation Smile's Financial Details?

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Before donating your hard earned money to any charity, you want to make sure they will use it wisely. Charities that spend more money on fundraising and administration than they do on program services quickly lose the trust of their donors. The following financial data was collected regarding Operation Smile from a 2018 financial audit. The organization's fiscal year ends on June 30th each year.

Percentage of Donations Spent on Services

Percentage of Revenue Spent on Fundraising

Administrative and Overhead Costs

A 2017 audit report revealed that Operation Smile earned $96,616,665 in total revenues, almost all of which was unspecified donations. $70,764,755 (73%) of that total was spent on program services. These services include medical equipment, setting up temporary medical missions, establishing permanent care centers, research programs, and training and education. Nineteen percent or $18,345,047, the money raised, went to fundraising efforts. For 2017, 8%, or $6,182,639 was spent on administration expenses.

As you can see, the organization allocated almost 10% less to program services for 2018 than they did for 2017, even though total revenues increased by $8,008,293, or 8.28%. Typically, the rule of thumb for fundraising is that it should cost between 12 and 20 cents to raise $1 of funds, or it should cost between 12%-20% of total revenues.

Is Operation Smile Filling a Need?

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It is estimated that one in every 700 babies born worldwide will have a cleft palate condition. On average, 6,800 babies born each year in the United States alone will be diagnosed with cleft palate. While a simple surgery performed between 6 months to one year of age will correct the problem, the medical expertise and equipment needed for the procedure are not readily available in developing countries.

During 2018, the volunteer medical teams of Operation Smile conducted 12,000 surgeries and over 35,000 dental procedures in 80 sites around the world. These procedures took place in North America, South America, Africa, and Asia. Operation Smile can accomplish this with their extensive practice in mobilizing volunteer medical teams worldwide.

Each year, Operation Smile conducts hundreds of medical missions while also managing many care centers around the world. Besides the medical procedures performed, they also invest in research programs, training, and education. Because of this massive network of facilities, equipment, and volunteers, it costs them only $240 per cleft palate surgery.

As of 2018, 63 countries are represented within their medical professional team. As of 2015, 73% of their medical professionals were from low to middle-income countries. Volunteering with Operation Smile gives these doctors experience and opportunities they might otherwise not receive.

What Is the Operation Smile Charity Rating?

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Overall, Operation Child provides much-needed services to many under-served parts of the world. Some might argue that helping just one child with this condition is worth spending the extra money on fundraising, but with so many charities asking for donations, you want to make sure you get the most bang for your buck. While their effectiveness is important, you also need to analyze how they conduct business to get an accurate Operation Child charity rating.

The Better Business Bureau has stated that Operation Smile is a registered and legitimate charity according to the current standards. Overall, the organization passes the standards in most all categories including, board oversight and size, effectiveness in policy and reports, spending on fundraising (the standard is no more than 35%), minimal conflicts of interests, and promptness in responding to complaints.

The one area where Operation Child does not meet the standards of the Better Business Bureau is related to board member compensation. The standard for the BBB is that no more than 10% of board members be compensated directly or indirectly by the company. Operation Child has 3 out of 9 board members who are compensated.

While Operation Smile spends 36% of its earnings for administration and fundraising costs, this is still within the acceptable limits established by the industry and the Better Business Bureau. One red flag regarding these expenses is the CEO's salary. When last reported, Dr. William Magee earned $500,000 in this position, while the average salary for a CEO of a not-for-profit is just over $100,000.

How Do You Get Involved with Operation Smile?

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If Operation Smile seems like a charity you'd like to help, you can donate on their website at, www.operationsmile.org. If you are a medical professional and would like to pursue an opportunity to help on a medical mission visit their website and click on the link labeled "Become A Medical Volunteer" under the "Act Now" tab.


When we consider all facets of the organization, we place the Operation Smile charity rating at a strong B-. While they have some areas needing improvements, the organization is still providing a specialized and life-saving service to 12,000 children around the world each year. While there are more efficient charities out there, this one deserves a look.

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