Effectiveness of International Surgical Program Model to Build Local Sustainability

Background. Humanitarian medical missions may be an effective way to temporarily overcome limitations and promote long-term solutions in the local health care system. Operation Smile, an international medical not-for-profit organization that provides surgery for patients with cleft lip and palate, not only provides surgery through short-term international missions but also focuses on developing local capacity. Methods. The history of Operation Smile was evaluated globally, and then on a local level in 3 countries: Colombia, Bolivia, and Ethiopia. Historical data was assessed by two-pronged success of (1) treating the surgical need presented by cleft patients and (2) advancing the local capacity to provide primary and ongoing care to patients. Results. The number of patients treated by Operation Smile has continually increased. Though it began by using only international teams to provide care, by 2012, this had shifted to 33% of patients being treated by international teams, while the other 67% received treatment from local models of care. The highest level of sustainability was achieved in Columbia, where two permanent centers have been established, followed by Bolivia and lastly Ethiopia. Conclusions. International missions have value because of the patients that receive surgery and the local sustainable models of care that they promote. 1. Background Humanitarian medical missions often utilize international surgical teams to provide specialized surgical care to a large number of patients in a short period of time. It is an effective way to temporarily overcome limitations of the local health care system in order todeliverimmediatecare to patients in need. Despite some obvious benefits to the patients, short-term international surgical missions receive ample criticism. Some primary concerns include the failure of this model to provide sustainable solutions or ongoing access to care for appropriate medical followup. This paper examines whether the model of short-term international teams may be valuable on two different levels. It not only illustrates how this model meets a surgical need, but it examines whether this model of short-term international teams is effective in providing opportunities towards long-term, sustainable solutions in that locality and in the overall field of global health. 2. Introduction Operation Smile, Inc. (OSI) is an international not-for-profit organization that specializes in treatment of patients with cleft lip and cleft palate. The organization was founded in 1982 by Bill and Kathy Magee. Since this time, Operation Smile