The Philippines are ranked 5th in the world in the number of cleft births every year. There are an estimated 180,000+ Filipinos living here with unrepaired clefts today. The vast majority of these are children who will never be helped because they’re too poor.

While the average income per capita in The Philippines is about $2 a day, the children we help are the poorest of the poor and their families make nowhere near that amount.

Strange isn’t it that there are places in the world where some families are so poor that they dream about making $2 a day? (In America, the average income per capita is about $110 per day.)

Once you land in Manila, you don’t have to travel far to find thousands of poor children with clefts. A 15-minute drive brings you to one of the largest slums in Asia, an infamous garbage dump called Smokey Mountain.

The name comes from a methane-heavy mist that hovers over the dump.

From a distance it looks ominous. As you get closer, it gets worse. You begin to see animals swarming over this mountain of garbage. Then you realize they’re not animals at all, but children, thousands of children, teenagers, mothers, fathers, grandmothers, grandfathers — entire families crawling and scavenging over and enormous, steaming, stinking, rotting garbage dump.

The stench is overwhelming. The air is hard to breathe. The heat never ends as half of Smokey Mountain is always smoldering on fire. Many children suffer major burns as they mine this burning inferno for food and valuables they can sell. Dante would surely have given this place its own level in his inferno.

Competing with armies of rats and mice and millions of maggots and other insects, poor children and adults work on Smokey Mountain from sunrise to sunset. Some days they find nothing at all. But they come back the next day and do it all again. What choice do they have? Scavenge or starve. This is their fate. This is their life.

In the shadow of this giant pile of misery, and many other areas of desperate poverty throughout the Philippines, The Smile Train has been working quietly for 4+ years.

Working with project director Jesus Perez Cardenas, our partner, The Philippine Band of Mercy and a network of volunteer Filipino surgeons, we have brought our free cleft surgery programs to Manila, Pasig City, Quezon City and San Juan. To date, our partnership has provided free surgery for 1,188 children who would otherwise never have received it.

I would like to quickly tell you about one of these children.

Just a few days after giving birth to a baby girl with a horrible cleft lip and palate, a single mother knocked on the door of a tiny house owned by a complete stranger named Virginia Navarro.

Mrs. Navarro was a poor seamstress who worked at a tailor shop and supported her entire family on $1 a day. The mother promised Mrs. Navarro she would return for her baby girl in a few days and begged her to care for her.

Needless to say, her mother never returned. Mrs. Navarro was very poor herself and caring for a paralyzed husband – she was in no position to adopt a baby girl.

After six days she brought the crying baby to the Bethlehem House of Bread Orphanage, a place for abandoned children, where they gave the baby the name, Juliana de Bethlehem.

A missionary nurse named Jenie Isidro heard about The Smile Train’s free cleft surgery program and brought Juliana to our partner hospital in Manila and asked for help. We operated on Juliana to fix her cleft lip and a few months later, to fix her cleft palate. As you can see, the results are pretty amazing.

Since she received her corrective surgery so young, Juliana won’t need speech therapy and she will never know the pain of living with an unrepaired cleft.

Today, Juliana is smiling and laughing for the first time in her life. With her lip and palate repaired, she has much better prospects that someday, someone might adopt her or at least, find her a good foster home.

After I sent this letter out to thousands of our donors one of them called me up and offered to travel to The Philippines and adopt Juliana. I couldn’t believe it!

Right away, I put him in touch with the folks who are taking care of her and they told him that it was too late – Sister Jenie Isidro had already adopted her.

I have witnessed a lot of miracles over the years but this one is at the very top of my list.