Scalable, sustainable cost-effective surgical care: a model for safety and quality in the developing world, part I: challenge and commitment

J Craniofac Surg. 2014 Sep;25(5):1674-9. doi: 10.1097/SCS.0000000000001209.


Background: With an estimated backlog of 4,000,000 patients worldwide, cleft lip and cleft palate remain a stark example of the global burden of surgical disease. The need for a new paradigm in global surgery has been increasingly recognized by governments, funding agencies, and professionals to exponentially expand care while emphasizing safety and quality. This three-part article examines the evolution of the Operation Smile Guwahati Comprehensive Cleft Care Center (GCCCC) as an innovative model for sustainable cleft care in the developing world.

Methods: The GCCCC is the result of a unique public-private partnership between government, charity, and private enterprise. In 2009, Operation Smile, the Government of Assam, the National Rural Health Mission, and the Tata Group joined together to work towards the common goal of creating a center of excellence in cleft care for the region.

Results: This partnership combined expertise in medical care and training, organizational structure and management, local health care infrastructure, and finance. A state-of-the-art surgical facility was constructed in Guwahati, Assam which includes a modern integrated operating suite with an open layout, advanced surgical equipment, sophisticated anesthesia and monitoring capabilities, central medical gases, and sterilization facilities.

Conclusion: The combination of established leaders and dreamers from different arenas combined to create a synergy of ambitions, resources, and compassion that became the backbone of success in Guwahati.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Charities
  • Cost of Illness
  • Cost-Benefit Analysis
  • Craniofacial Abnormalities / economics
  • Craniofacial Abnormalities / surgery*
  • Delivery of Health Care, Integrated / economics
  • Delivery of Health Care, Integrated / organization & administration
  • Delivery of Health Care, Integrated / standards
  • Developing Countries*
  • Facility Design and Construction
  • Financial Support
  • Fund Raising / economics
  • Global Health
  • Health Facilities / economics
  • Health Facilities / standards
  • Healthcare Disparities
  • Humans
  • India
  • Medically Underserved Area
  • Needs Assessment
  • Patient Safety*
  • Plastic Surgery Procedures / economics*
  • Plastic Surgery Procedures / standards
  • Public-Private Sector Partnerships
  • Quality of Health Care / standards*
  • Rural Health Services / economics
  • Rural Health Services / organization & administration