Today I am in Kigali, Rwanda where more than 400 leading global academics, policy makers and health care experts are gathering at the Pan-African Surgical Conference to address a major global health problem: bringing access to comprehensive surgical care closer to patients’ homes. This important gathering has me reflecting on a trip I took with my husband, plastic surgeon Bill Magee, more than 40 years ago to the Philippines to help children in need of life-changing surgeries. We dreamed of using our health care expertise to bring new smiles to children who needed cleft lip and palate surgeries. We operated on 40 children but had to turn away 300 more. The need was overwhelming—not just for cleft care, but for all surgical procedures in the Philippines and dozens of other countries worldwide. We also realized that in many places, there was a lack of trained physicians, nurses, equipment and infrastructure, not just for cleft care but for safe surgeries of all kinds. What started with a child with a cleft condition led us to a community, which showed us the need for a movement. That moment sparked Operation Smile, which was founded on the belief that when you see a need, you take action to address it. Today, we have helped over 400,000 patients worldwide with surgical care, while supporting thousands more who received free comprehensive care services. What started in a village in the Philippines has become a global organization that works permanently in 37 countries. But the need is still so great. Worldwide, over 5 billion people—more than two-thirds of the world’s population—lack access to safe, affordable surgery. Real change happens when care is local. That’s why we have evolved our strategy to focus on training and equipping in-country surgeons and medical teams to deliver life-saving procedures in their own communities. We work closely with local medical leaders, health ministries, universities, accrediting institutions, NGOs and international organizations. We listen to our in-country professionals, we support them, and we learn from them to drive impact. In Africa, we operate in 12 countries, working with top surgical and anesthesiology institutions to build a sustainable workforce. Our work in Africa started in Kenya back in 1987, and in 2025, we’re expanding to Tanzania. Our key partners—COSECSA, CANECSA, the American Heart Association, and the World Federation Society of Anesthesia—help us train and equip Africa’s next generation of surgeons and anesthesiologists. In Rwanda, a nation of 13 million, there were just two plastic surgeons when our work here began. Families seeking cleft surgery traveled hundreds of miles—only to be turned away. To change this, we partnered with the Rwandan government, introducing a hub-and-spoke model that trains medical professionals locally. Today, Rwanda is scaling this model nationwide, and we’re proud to support this effort alongside the Rwanda Surgical Society, the University of Rwanda, and the Ministry of Health. Our impact is real: from two plastic surgeons to nearly two dozen, and from one country to a continent-wide movement. Across Africa, 55 universities and institutions are training the next generation of surgeons, decentralizing care, and cutting costs for patients. This work is more than surgery—it is system change that will future-proof access to surgery. By strengthening local expertise, reducing reliance on out-of-country medical support, and equipping governments with real-time health data, we’re creating a sustainable future for surgical care in Africa. At the Pan-African Surgical Conference in Kigali, global experts will come together to push this agenda forward. Because only by bringing safe, reliable surgery closer to home can we deliver hope, affect lasting impact and ensure that no patient is left behind. Kathy Magee is the Co-founder, President and CEO of Operation Smile, and a registered nurse.
