Smile Train-Lifebox Safe Surgery and Anesthesia Initiative



The Smile Train-Lifebox Safe Surgery and Anesthesia Initiative is a multi-year strategic partnership to elevate the quality and safety of cleft and pediatric surgery in more than 70 countries. Through capacity building, innovations, and research, the Initiative will strengthen the surgical systems of over 1,000 hospitals around the world.

See the joint press release announcing the partnership December 8, 2020.

Lifebox co-founder and Chair, Dr. Atul Gawande, will support the strategy and vision as Global Ambassador of the Initiative.

“As a surgeon, I’ve seen the impact that high-quality training, resources, and equipment can have in the operating room for providers and patients alike.I am honored to support the Safe Surgery and Anesthesia Initiative to bring better, safer care to cleft patients and strengthen surgical systems around the world. It will change lives. It will save lives.” Dr. Atul Gawande.

Lifebox and Smile Train, the world’s largest cleft-lip and palate organization, have worked together since  2011, distributing more than 2,000 pulse oximeters across Smile Train’s networks. During the COVID-19 pandemic, the two organizations partnered to distribute 500 pulse oximeters for COVID-19 care and – along with the World Federation of Societies of Anaesthesiologists – developed the COVID-19 Surgical Patient Checklist to keep surgical teams safe from infection. 


Cleft-lip and palate is a common pediatric surgical condition which causes difficulty eating, breathing, hearing, and speaking, and often leads to a child’s marginalization. More than 90% of children with untreated clefts will die before they reach the age of 19. The Initiative, through training and technological innovations, will address the gaps in cleft and pediatric surgical and anesthetic care –  strengthening the wider surgical system as a result. 

“With a shared dedication to supporting safe, high-quality surgery and anesthesia, and a shared passion for scaling innovative technologies that can transform surgical care, Smile Train and Lifebox are now expanding on our history of fruitful collaborations. As a nonprofit whose goal is to empower local medical professionals to treat patients with clefts in their own communities, we are thrilled to be working with Lifebox to bring additional training, education, and other critical resources to our global network of partners.” Smile Train President & CEO Susannah Schaefer. 

This work will initially focus on Sub Saharan Africa before scaling across 70 countries to eventually impact 120,000 cleft surgeries and improve the safety of surgery and anesthesia for more than 2.6 million surgical patients through access to pulse oximetry.

“In regions of Sub Saharan Africa, there is only one pediatric surgeon for every 7 million people. Lifebox is hugely proud of this Initiative to bring a much needed focus on pediatric surgery and anesthesia: thousands of children will receive safer surgery and anesthesia as a result.” Kris Torgeson, Lifebox CEO.