In the 1990s, I merged my New York charity, Operation Smile, with another charity called Operation Smile in Virginia.

While my charity was focused on helping poor children in the U.S. who needed surgery, Op Smile Virginia was focused exclusively on helping provide surgeries to children in developing countries. They sent American volunteer surgeons, nurses and other professionals on two-week missions.

Shortly after we agreed to merge our two “Operation Smiles”,  I was lucky enough to go on one of those missions.   Nothing could have prepared me for what I was about to experience – I had never traveled to a developing country before.

It took 24+ hours of non-stop travel to get to Hong Kong. Then we took a  train to the Chinese border where we climbed into a van that was going to take us to our final destination.

All of us were sleeping when we were jerked awake as our driver swerved around a serious car accident. You could see bodies strewn in the road. It was gruesome, and enough to keep me awake for the rest of our eight-hour drive along the uneven dirt roads of rural China. Around 4 a.m., we finally arrived at our destination: a poor, tiny village in Guangdong province.

After only a couple hours sleep, we were back in the van headed to the local hospital.

The roads were clogged with bicycles, horses pulling carts filled with hay, oxen pulling wagons overloaded with wood or barrels filled with God knows what. What few cars that were on the road were old and rusted. The van we were in must have been more  than 30 years old and needed new shocks.

The homes we passed were very modest. Some were just shacks made out of tin or  aluminum. Some were made out of brick or cinderblocks. There were open sewers running on the sides of the road. And animals running loose everywhere. Chickens, goats, horses, donkeys and sheep, you name it.

Everyone we passed was staring at us. Lots of children were waving to us. Most of them had no shoes. I am sure they were all wondering what a van filled with Caucasians was doing in this rural village. I’m sure they don’t get many tourists here.

When we arrived our team was busy unpacking the 10,000 pounds of medical equipment we had brought with us. Essentially we would create 2 to 3 operating rooms that looked just like they do in the United States. This was expensive of course since we were only going operate for five days., Like a movie set.

But it was the only way to do it because all of our surgeons and nurses were from the US and used to certain equipment and protocols.

In the front of the hospital there were hundreds and hundreds of children with their parents or grandparents could come from all over the place. When word spreads that there is a medical mission from the US offering free surgery for the poor it is big news. And many families realize this may be their only chance to get surgery for the children so they will take time off of work, borrow money from neighbors to pay for transportation, so a cow or goat or some chickens to raise money for the trip. They will do anything and everything they have to to get to our hospital and pray that their child will be accepted for surgery.

The majority of children we see a suffering with clefts.  A cleft is a birth defect that leaves a child with a hole and then let and bore a hole in the roof of their mouth. It’s a pretty common condition that is pretty easy to fix.

In America and in Europe, every baby born with a cleft receives reconstructive surgery within a few months. The surgery is so good it’s almost impossible to tell if someone was born with a cleft anymore.

But in most developing countries, babies born with clefts never receive surgery at all. Because their families cannot afford it and their local hospitals can’t afford to provide surgery for free and the government’s are too poor to provide surgery. often the government will say they don’t provide surgery because the cleft isn’t life-threatening.

That may be true but living with a cleft in a developing country isn’t much of a life.

Kids with clefts, eat, drink or speak properly. They are not allowed to go to school. Get a job. Or get married or raise a family when they grow up. They are usually complete outcasts and totally isolated from society. It’s a curse that begins at birth and lasts an entire lifetime.

All of this suffering and heartache is completely unnecessary. Because there is a quick, safe surgery that cost as little as $250 that can completely fix a cleft and give a child not just a new smile, but a second chance at life.

Right away the sheer volume of patients waiting to be helped was overwhelming. There were dozens of children inside a small waiting room and hundreds more waiting outside with their families.

I’d seen photos of children with clefts before, of course, but it was utterly bizarre to stand in a room where every kid has a gaping hole in their upper lip.

The children were looking around them too—they couldn’t believe their eyes. A translator explained to me that most of them had grown up in villages where they were the only kid with the defect. Now they were realizing that they weren’t alone.

I decided to walk down the line, asking our translator to help me communicate with the families waiting to be screened for surgery. For the most part, the parents had heard about the free surgery by word of mouth or they’d seen flyers. Many of them had traveled many miles in the hope their child would be picked for surgery.

One little girl I met was called Li Yin Kan, or “Colorful Cloud” as name roughly translates to in English.

At nine years old, Colorful  Cloud was beautiful, with bright eyes and shiny black hair. But it was hard to look at her face from the nose down. Her cleft was severe. Colorful Cloud was waiting patiently in line for surgery.

Together with her father, she had traveled 240 kilometers to get here, walking much of the way and hitching rides when they could. I learned that her father was a rice farmer. He introduced himself as a “poor peasant” and explained how he made only 20 cents a day tending fields.

Before seeing the flyer for our mission, he never imagined he’d be able to provide reconstructive surgery for his daughter. At home, he said, the other children teased his daughter viciously. Colorful Cloud was never allowed to go to school and instead stayed home helping her mother with chores.

Without surgery, there was little hope of Colorful Cloud being able to grow up and get a job, get married, or lead a normal, independent life. It was like hearing about a modern-day Hester Prynne, except that Colorful Cloud’s scarlet letter was written all over her face.

When it came time for Colorful Cloud’s operation, I was able to scrub in and observe her surgery in the operating room. The little girl quickly fell asleep from the anesthesia, but as the surgeon prepared to get started, I found myself feeling woozy. I never liked the sight of blood, and here I was dripping with sweat under a suit and scrubs and feeling light-headed after 36 hours of travel. Embarrassed, but wanting to avoid passing out in the OR, I quickly left and took a breather in the waiting room.

When I came back in, I was in time to watch as the surgeon slowly disassembled the jangled mess that was Colorful Cloud’s mouth, then skillfully stitched it all back together from the nose down.

I was so fascinated by what the surgeon was doing that I forgot all about my lightheadedness. Sure enough, the whole thing was over in just under 45 minutes. I was amazed. Afterward, I carried Colorful Cloud to the recovery room.

I sat with her dad and together we waited for his daughter to wake up from the anesthesia. I couldn’t wait to see her reaction. After about 15 minutes, Colorful Cloud opened her eyes and asked, “Is it over?” A nurse ran to get a mirror and came back and handed it to Colorful Cloud. Her upper lip was stitched and swollen, but already she looked entirely different.

Her little hands trembled as she slowly raised that mirror so she could see the result. I fully expected her to shout for joy, jump around, do a little victory dance. But instead, she was completely silent. She just sat staring at her reflection. I was starting to think something must be very wrong when I noticed a single tear slowly roll down Colorful Cloud’s right cheek, followed by another. And another. And then nine years’ worth of tears.

To my surprise, I realized was crying too.

Watching this little girl look at her new future was one of the most powerful things I have ever witnessed.

That surgery didn’t just change her life – it changed mine too.