IMPORTANT: I co-founded Smile Train in 1999. As President and a Board member, I helped lead it Smile Train through its first decade, from 2001 until 2011 when I resigned. Although I still support Smile Train – and always will – I am no longer an employee or director of Smile Train – just a fan and a major donor. This is my personal website and it is not affiliated with Smile Train in any way.
SMILE TRAIN TODAY IS ONE OF THE MOST SUCCESSFUL, RESPECTED AND LARGEST CHARITIES IN THE UNITED STATES
Since I co-founded Smile Train in 1999, it has grown quite quickly into one of the largest charities in the U.S.. Today, one out of every 100 Americans is a Smile Train donor. Over the past 20 years, 3+ million Americans have donated almost $2 billion to Smile Train with an average donation of $50. Through thousands of partners and programs in 92 of the world’s poorest countries, Smile Train helps provide around 100,000 free cleft surgeries every year. Altogether. Smile Train has helped provide free cleft surgery for almost 2 million children no one else would help.
WHERE THE IDEA FOR SMILE TRAIN CAME FROM
I came up with the idea for Smile Train in 1996 while I was serving as a board member and volunteer of a small mission group from Virginia called Operation Smile. I spent almost five years helping Operation Smile raise millions of dollars but my favorite part, by far, was going on two-week medical missions to Asia and the Middle East. After watching Op Smile turn away thousands of children on these missions, year after year, due to a lack of resources and money, I was determined to find a better way to deliver surgery in developing countries.
away hundreds of children due to lack of resources and money.
During an Op Smile mission to Vietnam, I was surprised to learn that local Vietnamese surgeons and nurses were more than capable of performing safe, high quality cleft surgery. In fact, I learned that local surgeons in virtually all developing countries are often better at cleft surgery than American surgeons because they perform so many more cleft surgeries. Very few children in the U.S. are born with clefts while it is a huge problem in developing countries. (Most American surgeons who go on medical missions are not cleft surgeons and some haven’t done a cleft surgery since medical school.)
On that mission to Hanoi, I had an epiphany: why not empower local surgeons in developing countries to provide cleft surgeries instead of sending American volunteer surgeons on two-week missions? I wasn’t a doctor, but my economics degree from Harvard made me confident that this new strategy might be much safer, cheaper and more productive than sending American volunteers on two-week medical missions that help only 100 children at a time. By empowering local doctors, nurses and hospitals, local medical teams could operate year-round — not just two weeks a year — and the quality and safety of surgeries would go up as the costs would plummet.
The 2-week medical missions that Operation Smile had done for so many years cost a fortune because they required shipping 10,000 pounds of medical equipment half way around the world and flying 40+ volunteer surgeons, nurses and other medical personnel for just 5-6 days of surgery. Op Smile’s cost-per-surgery was $1,000 – $2,000. In contrast, a local Vietnamese surgeon at the time only made $300 – $500 a month. A Vietnamese nurse made $35 a month. You didn’t have to be a math genius to see just how much cheaper this new approach would be.
Around this same time, while we were searching for a new business-model for Operation Smile, I happened to meet a man who owned a steam locomotive. He wanted to host Op Smile fundraisers in major cities all over the U.S. – on his train. I wasn’t crazy about that idea but it got me thinking about using trains to deliver free training and surgeries in developing countries . Both China and India, the top two countries with the largest number of unrepaired clefts, run on trains. That’s how the idea for Smile Train was born.
KEY INDIVIDUALS WHO MADE SMILE TRAIN POSSIBLE
The person who did more to help us start Smile Train than anyone, was Swiss billionaire Walter Haefner. Mr. Haefner was our first, our biggest and our most loyal donor. To help us launch Smile Train, he gave us a 5-year, $35 million grant. After that, Mr. Haefner continued making large donations to Smile Train for many years. His total donations exceed $50 million.
Around 2005, I invited Mr. Haefner to come with us to China with former President Bush and his wife Barbara. He declined but he sent his son Martin and his wife Marianne instead. They were welcome additions to our trip and turned into enthusiastic donors and supporters of Smile Train and over time, very good friends. Martin and Marianne provided critical financial support that made it possible for us to start WonderWork. I never had the privilege of meeting Mr. Haefner as he lived in Switzerland and was somewhat of a recluse. But I always kept him up to date on our progress and results. He sent me a personal note once that said of all the accomplishments in his very storied and successful life, helping us start Smile Train was the one thing he was most proud of. That meant a lot to me and our small team of 20 people who worked so hard to start Smile Train.
When I was a member of the Operation Smile Board, I met NBC Anchorman and renowned journalist, Tom Brokaw. A couple years earlier, I’d written a cold-call letter to Mr. Brokaw when I was raising money for Op Smile and he responded. Over time, I got to know Mr. Brokaw so when I asked him for a meeting to discuss a “big, new idea” that could change many lives he said sure. Mr. Brokaw loved the Smile Train idea and he did a lot of things that really helped us turn it into reality. He encouraged his good friend Bill Gates to help us and later Bill and Melinda Gates gave us a $1 million grant.
Brokaw also arranged a meeting for Ann Ziff and I with his good friend Candice Bergen. At the time, Candice was starring in her hit show Murphy Brown and she was one of the most popular and respected actors in America. Candice became one of our major donors, hosted many of our events and even visited our partner hospitals in Ethiopia. Her daughter Zoe spent a summer working at a Smile Train partner hospital in India.
One of the best things Brokaw did was get us on The Today Show. The Smile Train Project was featured on The Today Show the same day Hillary Clinton appeared defending her husband Bill as the Monica Lewinsky scandal unfolded. An extra large audience of 6+ million viewers watched Hillary and our segment which had an animation of a Smile Train racing around the Chinese countryside. More than 500 viewers called NBC asking for more info about Smile Train.
I met Ann Ziff in 1994 and told her all about my New York charity Operation Smile, which helped provide free plastic surgery for indigent children in New York city who couldn’t afford it. As a former social worker, Ann was very interested in our work and started helping us. When I merged my charity with Operation Smile Virginia, Ann joined the Op Smile Board and continued to help us raise millions of dollars. When Charles Wang and I resigned from the Op Smile Board after two young children died out of negligence on an Op Smile mission to Beijing, Ann joined us and helped us start Smile Train. She was our first Chairman of the Board. Ann was a critical part of Smile Train’s early success. She not only gave us very generous donations and led our board of directors, she travelled around the world with us, helping us grow the charity.
Right around the time we came up with the idea for Smile Train, the President of China, Jiang Zemin, came to the United States for an historic visit. It was perfect timing for us as we we saw the Smile Train Project as a US-Chinese partnership that would not only bring hundreds of thousands of free surgeries to China but also would help foster goodwill between our two countries. President Clinton hosted a state dinner for Chinese President Jiang Zemin and everyone wanted to be there – especially hundreds of CEOs of Fortune 500 companies who were doing business in China. After the New York Times printed the list of attendees, I wrote to every CEO, almost 500, and asked for their help. Only one responded, Maurice “Hank” Greenberg of AIG. Mr. Greenberg was one of America’s most successful and admired CEOs and no one knew China like he did. He arranged for me to meet with his C.V. Starr Foundation and this led to almost $20 million in grants over the next decade. I got the opportunity to thank Mr. Greenberg personally for his generous support many times and I’m still in touch with him.
After former President George H.W. Bush told China President Jiang Zemin about our Smile Train idea, we were asked to to meet with China’s Minister of Railways. We immediately scheduled a trip to China. We chose China as the country to test our Smile Train concept because China had the world’s largest train network AND because Charles Wang, the man I hoped would fund our pilot program was born in Shanghai, China.
Charles Wang was the co-founder, Chairman and CEO of Computer Associates, my ad agency’s largest client. For 4 years in a row, Wang was the highest paid CEO in America. He had just received a $700 million bonus when I pitched him on my Smile Train idea. At the time, he was getting a lot of very negative press about his pay so the timing was perfect. I had been cultivating Wang as a donor for years. Every time I went on an Op Smile mission to China, I’d send Wang letters and photos of kids we helped. He had already started giving us donations but I knew he could give much, much more. Wang loved our Smile Train concept and the fact that we’d chosen China as our first country. He got his company to pledge $10 million for our Smile Train Project.
As President, I led Smile Train through its first decade, from 2001 until 2011. I almost didn’t take the job. In April , 2001, we had just fired our 2nd executive director in 2 years. Morale was low. Anxiety was high. And everyone was frustrated that two years after we launched Smile Train, we had millions of dollars in the bank but we weren’t providing any surgeries. After all our talk about running a charity like a business, it looked like we were running our charity out of business. It was embarrassing. We had no business plan. No business model. No surgery programs. No partners. No fundraising program. No donors. Nothing. But I still very much believed in the idea of Smile Train. So, I, very reluctantly agreed to serve as Interim President of Smile Train for one year.
What I discovered after becoming President, was that Smile Train had one asset that was invaluable: a small team of employees who were exceptionally talented, experienced and dedicated….
THE INCREDIBLE TEAM THAT BUILT SMILE TRAIN INTO THE WORLD’S LARGEST CLEFTY CHARITY
Delois Greenwood quit Op Smile after 15+ years to help us launch Smile Train and we were so lucky she did. I’ve never met anyone with more experience in providing surgeries for the poor in developing countries. Delois wore a lot of hats. She drove programs, raised money, managed the team, you name it. Everyone loved her from the partners, surgeons and nurses in the field to the staff and all the employees and all the donors also. Right from the start she was one of the critical ingredients that made Smile Train a success. Without Delois, Smile Train never would have have succeeded.
Karen Lazarus worked as my personal assistant at my ad agency, Schell/Mullaney but quickly grew up and out of that position at Smile Train as she became an excellent senior manager. Karen is by far the most dedicated and hardest working person I have ever met. Like Delois, she also wore many “hats” as she helped build Smile Train into the world’s largest cleft charity in just a few years. Karen helped create our fundraising machine which went from raising a couple hundred thousand dollars a year to raising more than $100 million dollars a year. The donors loved her as did the entire team as she was great to work with, smart, and incredibly dedicated.
Hana Fuchs had decades of international auditing experience at Avon, Hana was the perfect person to be our CFO and VP of administration. Hana was unflappable, cool, calm and collected, she oversaw a tiny financial and admin team that expertly managed and guided Smile Train’s meteoric growth from 200 donors to 2 million and from 2,000 surgeries a year to 125,000 surgeries a year as we scaled our programs and partners from one country to 92 countries. Hana did a flawless job of managing our growth from a $2 million a year budget to $150 million a year.
Melody Farrin was our very first program manager and helped us design, build and grow all of our surgery and partner programs around the world. Melody was very smart and professional, all of the employees and partners really liked and respected her.
Michele Sinesky: she was the best donor relations person I have ever met in my life. She connected with literally thousands of our donors and helped us earn their trust and support.
Priscilla Ma was extremely hard-working, intelligent and passionate about our work. She helped create, build and manage one of the most successful direct mail/fundraising programs in history. We scaled our first direct mail effort of 50,000 letters to mailing annually more than 100 million letters a year in the U.S. and the UK.
Troy Reinhart started out as our receptionist but quickly grew out of that job becoming a superb donor database guru and talented manager.
Satish Kalra was our first major country manager and single-handedly built Smile Train India into our largest program in the world which today provides 50,000+ surgeries a year for the poorest children in India. Satish was integral to the success of Smile Train’s programs not just in Asia but all around the world.
Mike Schell was my advertising agency partner, an award-winning creative and immensely talented art director. He created the Smile Train logo and graphics that helped us pitch the idea and raise $50+ million in start-up donations. And for our first decade, Mike designed and produced virtually all of our fundraising materials including advertising, direct mail, brochures, websites, etc.
SMILE TRAIN’S FOUNDING PRINCIPLES (FROM 1999)
More than two decades ago, before we developed our business plan or any programs, or raised any money, we developed Smile Train’s Founding Principles. They are still as relevant today as they were then. And they reflect our goals, attitudes and what we hoped would make Smile Train different, more effective and productive than any other cleft charity.
Insure the safety of the patient is always our #1 priority.
Focus exclusively on the problem of clefts.
Provide free surgery for children who can’t afford it.
Foster self-sufficiency through free training and education.
Embrace an inter-disciplinary team approach.
Invest in research to find a way to prevent clefts.
Empower local surgeons, anesthesiologists, nurses, medical professionals, social workers, speech therapists, etc. to solve the problem themselves.
Partner with other cleft organizations and share resources.
Operate the most cost-efficient cleft organization in the world.
Leverage technology as much as possible.
Run our charity like a business.
Work ourselves out of a job.
One of the reasons we chose clefts as our one and only focus was because we knew there were 1-2 million children suffering with unrepaired clefts and if we did our jobs right we could solve this problem in our lifetime. And we did. Today, in 95% of the developing world, every baby born with a cleft now has access to the life-changing surgery that can repair it. In addition, with the 1.5+ million cleft surgeries Smile Train has helped make possible, it has cleaned up the enormous backlogs of unrepaired clefts amongst teenagers and adults. Smile Train’s annual cleft surgeries peaked around 2010 and have been declining ever since. Smile Train truly is working itself out of a job. For 200,000 years, the number of people with unrepaired clefts in the world has gone up every single year – until Smile Train came along.
SMILE TRAIN WAS ONE OF THE BEST-MANAGED, MOST PRODUCTIVE CHARITIES IN AMERICA
We took great pride in managing Smile Train like a business – not a charity. We had a solid business plan, an innovative business model and we held employees accountable. If you did a good job you got a bonus – if you didn’t you went to work for some other charity. We leveraged all the latest technology and built an electronic patient record database long before any American hospitals did. We created virtual surgery software that’s been used to train thousands of cleft surgeons.
With our tiny staff of less than 50 people, we managed 1,000+ partner hospitals in 92 of the world’s poorest countries. In just a few years, we scaled our cleft surgeries from zero to up to 100,000 surgeries a year. Our direct mail program quickly became one of the best-managed and cost-efficient fundraising programs in America. Our cost-to-raise-a-dollar was less than 5 cents for our donor mailings. We quickly scaled up to 100 million direct mail letters a year and a newspaper/magazine advertising program that reached 100+ million Americans every year. Through direct mail and innovative, remnant advertising that we bought for 10 cents on the dollar, we earned the trust and support of millions of donors and raised more than half a billion dollars in donations with an average donation of just $50.
In 2007, The New York Times called us “perhaps the most productive charity dollar-per-deed in the world” and two years later we won an Oscar for movie we produced about clefts. More than 25 million people saw it. For a decade, we produced record-breaking results every single quarter as one of America’s fastest growing charities. But then disaster struck….
AFTER A DECADE OF RECORD GROWTH, UNPRECEDENTED INNOVATION AND ACCOMPLISHMENTS, DISASTER STRIKES
In 2010, Smile Train ran into a problem we never imagined: we had too much money.
Beginning in 2006 – and continuing to this day — Smile Train has ended every year with a large surplus of unused donations, sometimes the surplus was tens of millions of dollars. By 2010, Smile Train’s total surplus of unused donations had soared to $135 million dollars. Around that time, our surgeries plateaued which made our surplus grow even faster. I believed that if we didn’t act, our surplus of unused donations would grow to $200, $300, perhaps $500 million. So my staff and I decided to find a way to put all of these unused donations to good use. We did a lot of research and found several other “miracle” surgeries that, like cleft surgery, were extremely inexpensive but could give desperate children a second chance at life.
We developed a comprehensive plan to use Smile Train’s massive surplus of unused donations to provide surgery for millions of children who were burned, crippled or blind. The surgeries that solve these major global health problems are incredibly cheap. A $250 surgery can cure clubfoot and enable a crippled boy or girl to stand up and walk, stand and run. A $300 surgery can rebuild the face and body of a severely burned child. And a $250 surgery can give a blind child their eyesight back. In 15 minutes. Our surplus could have provided literally millions of these surgeries at the same partner hospitals that were now doing cleft surgeries at. Everyone loved this idea. Our staff, our partner hospitals, our medical advisory committee, our vendors, our donors, even our lawyers! (They told us we could add new surgeries as long as we notified our donors so we changed the language in all of our solicitation materials – which we did.)
Everyone loved this idea of using our massive surplus to provide millions of additional surgeries – except my co-founder, Charles Wang. He wouldn’t even discuss it. He ordered us to stop all efforts to expand Smile Train’s mission. He told us he had “signed up for clefts and that’s all” and he had no interest in helping support any other surgeries. When we showed him projections of huge surplus of unused donations growing to half a billion dollars it didn’t bother him at all. In fact, he said that he wanted the money to “pile up.” I was speechless. I had known Wang for 22 years and that was the last thing I ever thought I would hear him say. I spent months trying to show him how our plan would double, triple, quadruple the number of children we helped every year. I told him how it was unethical to keep amassing a massive surplus of unused donations we didn’t need and might never spend. And it was very unfair to our donors who were led to believe their donations would be used “immediately”. (In 2010, we still had millions of dollars of unused donations going back to 2006.) It was also unfair to our 1,200+ partner hospitals around the world who were all desperate for more financial support.
But the more I tried to change his mind, the angrier Wang got. He made it abundantly clear that that under no circumstances would he allow us to use a nickel of Smile Train’s $135 million surplus of unused donations for any other kind of surgery. For all of us on the staff who had worked so hard for more than a year coming up with all these plans to expand our surgeries and help many more children, it was a very bitter disappointment. And none of of us could understand why Wang was acting this way. But we soon found out.
CHARLES WANG TAKES OVER SMILE TRAIN IN OCTOBER, 2010
Just a few months after Wang ordered us to stop all plans to expand Smile Train’s mission, he orchestrated a board coup and surprise takeover of Smile Train. Wang secretly hired Smile Train’s own lawyer to help him take over the charity. He secretly recruited an independent Smile Train board member, a financial executive who wanted to manage Smile Train’s $135+ million dollar investment account. And then Wang filled the Smile Train board with his personal employees including his secretary, accountant, lawyer and CFO. After he did that, Wang controlled five votes on a 9-person board. After he won control of the Smile Train Board, Wang forced me and my entire senior management team out of Smile Train – without any cause. All the independent directors tried to stop Wang – but we failed. After I was forced out of my job as President, I stayed on the board for more than a year.
It was painful to watch what happened next.