It's very easy for those living in so-called developed countries to forget some of the miracles that our forebears have worked, which make our lives much easier than they would otherwise be.

This is true in many areas of life, but today I'm talking particularly about medicine. It hasn't been all that long since the word "polio" brought terror to the hearts of parents in the United States; now probably a quarter of the population has never even heard of it. And every day we wash our hands with antibacterial soap and drink our pasteurized milk, mostly without even noticing.

Sometimes, these things do trigger a moment of reflection in me, and I give thanks for the health advances that we've been the recipients of over the years. I hope you do, too. But today, I learned of one that I really didn't even know about before.

I've heard the term cleft lip before, though I didn't really know what it meant, and as is no doubt the case with virtually all of you reading this, I've never seen one. Today I learned that clefts (cleft lips and cleft palates), a birth defect, occurs in about one in 500 babies, and the pictures I'm looking at show me much more than the little scar that I'd always imagined a cleft lip to be (probably from seeing a few people in my life who had had them repaired). The reason they pass mostly unnoticed is that cleft lips are generally corrected surgically, either before the baby leaves the hospital or within three or four months thereafter; palates are corrected, usually with a series (sometimes twenty or more!) of operations usually before the teen years.

That's for us, the lucky ones.

In third world countries, babies with clefts often get no treatment for them. The cosmetic and social problems are not the only ones these babies have to contend with throughout their lives. Health problems begin immediately, as they are unable to nurse, and have a much greater than normal incidence of ear infections. As they grow, they may never learn to speak properly, and sometimes cannot even eat. Thousands are abandoned each year; communities shun them. Which may be okay by Darwin, but we like to think of ourselves as "advanced" when we turn that law on its head.

I learned all of this because of a pamphlet I received from TheSmileTrain, a charitable organization dedicated to treatment and prevention of clefts.

Operating in 52 countries around the world, running the gamut from China to Haiti to Russia and the United States, they provide free operations to correct clefts, performed by local doctors to whom they've given free training in this specialty. Unlike the thousands of dollars involved in a normal U.S. case, the simplest procedure (unilateral cleft lip repair) can be done for about US$250 on the average. Those procedures take less than an hour, and one of the most amazing aspects is the world of difference in the appearance before and after the operation; the healing time is literally measured in hours — a few mothers have failed to recognize their children afterward. And yet, particularly in the poor parts of the world, it can make all the difference in that person's entire life.

A feature of the way SmileTrain works, which is new to me and is certainly unusual if not novel in the world of charities, is that when you send a donation to them, 100% of it is used for their programs. This is possible because the overhead of the organization (office, salaries, even fundraising drives) is completely covered by endowments from the founding supporters (who include George Bush, Candice Bergen, and Walter Cronkite).

This is what made me glad to begin a monthly donation regimen. Other charities I support annoy me by sending newsletters and related items, or even receipts for my donations; I hate that my money is used, even in part, for such things instead of for the purposes for which I give it.

And even though the non-program expenses are covered by the founders, they still run lean and mean. Currently they operate with a staff of thirteen persons, and overhead is kept to less than 15% of donations.

Since 1999, they've trained over ten thousand doctors in cleft repair surgery and eighty five thousand children have had a lifetime of anguish pre-empted. About one hundred children every day are now being treated, but there are many times that many still to be reached.

We tend to think of high-tech cures for cancer or AIDS as the medical breakthroughs that would profoundly change our world. But the major health problems in the world are simple, and fixable if we have the will. (One of the biggest causes of death in the world is simple diarrhoea.) TheSmileTrain is a way you can help. I invite you to join me.

http://www.smiletrain.org

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