The small village I am in rural India is about as far away as you can get from New York City.

It’s a 20,000-mile round-trip that begins with two back-to-back 9-hour redeyes, a three-hour layover, another two-hour flight within India, and then 2.5-hour drive up to a remote village called Jais.

After 24 hours of non-stop travel, I was pretty tired for the final two hour drive up a rural highway, but sleep was out of the question. The driver beeped his horn every 3-4 seconds as he attempted to pass every vehicle he could while also trying to avoid hitting donkeys pulling carts, herds of water buffalo, broken down trucks, families of five riding on a single motorized bicycle, camels, monkeys, cows sleeping in the middle of the road and potholes that could swallow a small car.

But it was terrifying because we were always passing trucks and slow cars on a two-lane road which meant we had to pull out into the oncoming traffic lane.

Our driver always drove way too fast and cut it very close when he would swerve back into our lane at the very last minute as we all held our breath and closed our eyes and prayed!

To make matters worse, there always seemed to be cars coming at us that were passing trucks and slow cars just like us and they would be in our lane coming straight at us until they swerved at the last minute! Passing cars on these roads was a terrifying game of Russian roulette. Now I understood why India leads the world in the number of road deaths.

After about an hour of this terrifying travel, I very politely told our driver — who looked about 16 years old – that he was an excellent driver and a very good swerver! But I had a question. What if the drivers who were coming at us would not as good a driver as he was? What if they didn’t swerve in time and they crashed right into us in a fatal head-on collision?

He told me that he understood my concerns but that I needn’t worry because, “In India, all the bad drivers are already dead.”

It was funny – but not that funny.

As I stared out the window, I got the surreal sensation that not only had I traveled a very great distance, but somehow, I had also traveled back in time.

I saw thousands of people working hard in 90-degree weather in vast fields of wheat but there were no machines. They were cutting it by hand with scythes the way it was done hundreds of years ago. And there were no animals helping them. Once the wheat was cut, they carried it on their backs or their heads. It was a very strange sight.

To see people farming as if the industrial revolution never occurred.

After two hours of white-knuckle travel and many near misses, we eventually reached a small village called Jais which is in a region of India that is exceptionally poor.

The literacy rate for males is 65%, for females, 35%.

There is virtually no industry here besides farming which is a cruel and inconsistent employer. No irrigation, which means when there is a rainless season, people starve.

Even when it does rain and there is work, an average farm laborer makes very little. I met a very nice, very proud man, very poor man named Sanjay, and his two friendly children and took this picture in front of their home. Life for them recently became even harder as their Mom just died.

Sanjay, who believe it or not is in his mid-thirties, can only find work as a farm laborer 15-20 days a month. He makes between 60 and 75 cents a day. Imagine being a widower and raising two children on $8 — $15 a month.

Their house is typical of the village; a crooked mud-walled hut with a low thatched roof that leaks. An open courtyard inside for cooking. No running water, no heat, no electricity. They get water from wells which are everywhere and unprotected. (A seven-year-old fell in and died the week I was there.)

For heat and cooking, fires, they burn animal dung that is provided by cows and cattle that sleep and live in and around all of the huts throughout the village. The smell (and sight) of the burning dung was a poignant reminder of the many health problems children in India face.

The lack of septic systems and clean water are just the beginning of a long laundry list of health problems including cholera, polio, blindness, tuberculosis and malaria.

500,000 children die every year from diarrhea in India because they don’t have access to clean water.

Half of all children under the age of three in India have stunted growth from malnutrition. I visited an orphanage and held a 2-year little girl who weighed only 15 pounds. I had a two-year-old girl at home who was twice as tall and weighed twice as much.

To make matters worse, India has a shortage of doctors. In some areas there are less than 100 doctors trying to take care of 3 million people.

The government of India spends a total of $4 per person per year on healthcare. The U.S. spends more than one thousand times that amount: $5,035 per capita.

It’s easy to see why India needs help from outside organizations like the World Health Organization and UNICEF which both have spent billions of dollars over the past few decades to help the children if India.

And it needs help from Smile Train. We are by far the largest cleft charity in India.

Working with local Indian doctors, The Smile Train provides free cleft surgery for tens of thousands of Indian children every year. Experts say there are millions of Indian children suffering with unrepaired clefts and 48,000 new babies a year are born with clefts.

Few of these children will ever receive surgery. Most of them will spend their entire lives suffering with a birth defect that could be totally corrected by surgery that takes as little as 45 minutes and costs as little as $250. Hundreds of children and their parents came to our clinic in Jais when they heard we were offering free cleft surgery.

There are no hospitals in this very poor, very rural area so our partners brought in a special hospital train. It has first-rate operating rooms and post op areas. All ofo the screening and post op recovery was done at a local school but all the surgeries were performed on the train.

I met Amhula, a 21-year-old Mom who was very worried about her 18-month-old baby girl who was undergoing surgery. She told me she was horrified when her baby was born. I asked her what causes clefts. She said it happens when a “pregnant woman uses a knife during an eclipse.” This is a very common myth in rural villages.

Amhula feared her daughter would never marry and face a lifetime of shame and ridicule. When she heard about our free cleft surgery program, Amhula didn’t hesitate. With her daughter on her back, she traveled about 20 miles by foot to our clinic.

Amhula was very thankful. Obviously, without our help her daughter would never receive any surgery. He husband is a “casual” laborer like Sanjay and makes just $15 a month. They have another 3-year-old boy at home and Amhula was pregnant again. Life for them as with everyone here is a struggle.

I wished Amhula well and then visited our operating rooms to see how surgery was going. The best part about visiting the O.R.s was seeing the Indian doctors delivering first-class care to Indian children.

This is what makes The Smile train different than all other charities that help children with clefts.

Unlike other charities though, we don’t send teams of American doctors for two-week missions. Instead we empower local doctors and hospitals to help their children themselves.

Watching the teams of Indian doctors operate, I thought of all the advantages of having local docs perform the surgery:

• Our cost per surgery is 80% less than mission groups. That means for every dollar we can help five times more children.
• We don’t help children just once a year during a two-week mission – we help them every day of the year.
• At each location, instead of helping a few hundred children, we help a few thousand.
• By empowering local doctors and hospitals, we are helping very poor but very proud communities become self-sufficient.

After thanking the doctors and nurses for doing such good work and for being part of our Smile Train program, I moved on to the post-op ward where hundreds of children were recovering after surgery.

Moving from bed to bed, I met literally hundreds of children and their parents. Through an interpreter, I asked them about themselves.

I wish that you could have been there to hear their stories – it would have made you proud to be helping them.

All their stories were different and yet in many ways they were all the same. Few of them had any idea what a cleft was when their child came out of the womb.

Many thought it was an evil curse or sign of the devil. Some women blamed themselves.

Almost nobody was aware that surgery could correct the problem. When they did hear about surgery, they realized they could never afford it. So, most of these kids and their parents resigned themselves to never getting their clefts repaired.

For the girls it meant no hope of ever marrying and being dependent on their parents for life. For the boys it meant facing a very hard time finding a job.

Both boys and girls could not attend school because of their clefts. It also meant ridicule and teasing and being ashamed to go out in public. Many of the children I met were kept at home in shame behind locked doors. Their parents didn’t know what else to do and many were afraid of reprisals from angry neighbors worried about evil omens and bringing bad luck to their village.

Each child and parent was very appreciative of this once-in-a-lifetime opportunity to receive free cleft surgery.

Many of them couldn’t understand why anyone would want to help them. Most were so used to suffering and being ignored and left to fend for themselves. I repeatedly had to answer the question why the Smile Train was doing this.

Many wondered why I had come to such an isolated, forgotten place and why anyone would want to help them.

At the end of my visit to the post-op ward, I came across Amhula and her baby girl. I was relieved to see she was smiling this time, and very happy with the way surgery had gone.

Seeing Amhula smile as she stroked her baby’s tummy was a perfect way for me to end my visit. This picture is really what The Smile Train is all about. Just as a pebble sends ripples across a pond, the “ripples” of what we’re doing goes far beyond the simple 45-minute cleft surgery that we provide.

• For the children who receive surgery, just as if they were born again, they get a second chance for a normal life.
• For their parents, the heavy burden and heartache of raising a child with a severe deformity is erased in under an hour.
• For the thousands of doctors and nurses who participate in the Smile Train program, it’s a chance to help children they never could before.
• For our donors, it’s a rare opportunity to really make a difference, and change a child’s life forever with a single donation.

Like Amhula, all of us who are part of The Smile Train have a lot to smile about. Especially me. I couldn’t be prouder of the way our programs are running and the good work we and thousands of our partners are doing.

This trip was exhausting but even after my 26-hour marathon to get home I came home exhilarated and inspired.