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Fort Worth doctor collaborates with Operation Smile to treat patients with cleft lip, palate

Growing up in South Africa, Dr. Gavin Fine’s parents and grandparents instilled in him a strong moral code. He saw his grandmother heavily involved in the Black Sash, a human rights organization advocating for social justice, which inspired him to always give back to his community.

Now, Fine, 57, sees himself as privileged to have received a higher education and work as a staff pediatric anesthesiologist at Cook Children’s Health Care System. He is also a medical volunteer with Operation Smile, a global nonprofit organization dedicated to treating patients with cleft lip and cleft palate. 

Cleft lip and cleft palate occur when a baby’s lip or mouth do not form properly during pregnancy, according to the Centers for Disease Control and Prevention. Cleft palate is formed when the tissue that makes up the roof of the mouth does not join together completely during pregnancy, which leaves the palate open. Cleft lip happens when the tissue that makes up the lip does not join completely before birth, resulting in an opening in the upper lip. 

Cleft conditions are not fatal, but they make it difficult to eat or speak clearly and can lead to hearing problems. Globally, a child is born every three minutes with a cleft condition, equalling about one in every 500 to 750 births, according to Operation Smile.

Pediatrician Teresa Gomez Rodriguez checks Pedro, 7, before his surgery during Operation Smile medical mission in Riohacha, Colombia on Aug. 24, 2019. (Contributed by Operation Smile – Rohanna Mertens)

Fine has always wanted to volunteer his skills as a doctor, but he was drawn to the cause of cleft conditions because it’s such a misunderstood condition, he said. People with facial deformities are often excluded from their communities on the simple basis of how they look. Children with cleft conditions are normal kids, Fine said, but without surgery they often live ostracized. 

“If you can correct the deformity that people see, (cleft patients) can become included in their communities, and instead of being a shunned member of society, they become a productive member of society,” Fine said.

As a medical volunteer with Operation Smile, he has treated about 200 patients with cleft conditions.

“When you can help someone that’s healthy with a deformity fit into society, I think that’s one of the greatest gifts you can give to that person,” Fine said.  

About Operation Smile


Address: 3641 Faculty Blvd. Virginia Beach, Virginia 23453

Phone number: 1-888-OPSMILE


By mail: PO Box 758588 Topeka, Kansas 66675

By phone: 1 (888) 249-3797

Online: here

Amber Leonti, Operation Smile’s director of U.S. philanthropy, said the organization has volunteered in 60 countries during its almost 40-year tenure. 

Last year, Operation Smile had 5,490 medical volunteers, who cumulatively donated 237,000 hours of work. Had they been paid for their services, the wages would have totaled more than $20 million, Leonti said. Fine is one of 28 medical volunteers with Operation Smile based in Texas. 

The numbers may seem high, Leonti said, but the organization has had to scale back operations during the pandemic. From 2019 to 2020, there were 7,723 medical volunteers donating 414,000 hours. 

Although volunteers aren’t paid, the surgeries are far from cheap. The surgeries used to cost as little as $240, but that figure has become outdated in recent years, Leonti said. Now, a cleft surgery costs about $1500 to $2000, although the exact total varies depending on the country the surgery is conducted in. 

Most children born with a cleft condition will need three to five surgeries during their lifetimes, Leonti said. Operation Smile is unique from other organizations dedicated to this cause because they follow up with patients to provide long-term care. 

Those surgeries come during various medical missions conducted by the organization and its volunteers. 

Fine’s first medical mission was to Lima, Peru, in 2010. Since then, he’s been on seven additional missions to the Philippines, China, Madagascar, Egypt and Morocco. 

The medical missions vary depending on the country, but Fine said they typically take about 10 days, counting travel. This period is entirely volunteer and unpaid time taken off from his job, although Operation Smile pays travel and housing expenses. 

On the arrival day of medical missions, he starts setting up operating rooms and evaluating patients. The next day is for relaxation, or as Fine calls it, a “get over your jet lag day.” Then, the next five days are designated for the actual surgeries, with 12-hour and more work days. The final day is for some form of celebration for the accomplished work. 

Since the pandemic, Fine hasn’t been able to volunteer with Operation Smile, partly because of travel restrictions and partly work restrictions. Amid COVID-19, the number of children requiring procedures seems to have doubled, leaving him with very little time for extracurricular volunteer work, Fine said. 

Video of cleft lip and palate patients (Contributed by Operation Smile)

However, Fine’s volunteer work is a passion for him, and he hopes to be able to go on his next medical mission early in 2022. The reward for Fine is traveling and working in these countries to personally cause a positive change in someone’s life rather than simply donate to the cause, he said.

“It’s easy to give money and say ‘look I donated to charity,’” Fine said. “I’m fine with that, but I prefer to give my time.” 

Fine’s friend Dr. Marty Clayman, a pediatric anesthesiologist based in California who also volunteers with Operation Smile, echoed a similar sentiment about their work. 

Clayman, 66, realized that children born with a cleft condition in the U.S. have an extremely high likelihood that they will be able to get it treated. But in low-income countries, access to this kind of surgery is virtually impossible to achieve without the help of organizations like Operation Smile. 

“This is a cosmetic defect that we can fix, and they can live normal lives,” Clayman said. “So you actually are doing more good for more people by fixing cleft lips and palates.” 

And it’s not just children who need this surgery. Many adults live their entire lives shunned because of their condition. He recalled a 70-year-old cleft lip patient he treated years ago. After the man had his surgery, the volunteers took a picture to show him. 

“And the grin on his face was just phenomenal,” Clayman said. “So you do these missions, and I now realize that they get more out of it then I do.” 

He used to think he was getting as much out of his volunteer work as his patients because of how good it made him feel, but that patient showed Clayman how much the volunteer work can truly impact a patient’s self-esteem, happiness and overall quality of life. 

Many people view this type of volunteer work as inspirational, Fine said. But for him, it’s important to remember that these patients are human beings with lives of their own, and he strives to treat them with the same ethical code and dignity as any patient he would treat in the U.S. In Fort Worth, he wouldn’t stay in touch with a patient for the inspirational value of ensuring their ongoing well-being, so he wouldn’t do that in any other country he visits on a medical mission. 

“I wouldn’t do that here, and I try to practice the same way on the missions as I would here, with the same respect and the same dignity given to the patients there as I do here,” Fine said. 

Fort Worth Report fellow Cecilia Lenzen may be reached at or via Twitter. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.

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