Brian Mullaney has a big goal — to put himself out of business! As co-founder of The Smile Train, his mission is to provide free surgery and free training to doctors until the more than four million children worldwide who suffer because of unrepaired cleft lips have been treated and there are no more children who need help.

‘If you are born with a cleft in a developing country your life is a nightmare,’ Mullaney says. ‘The cure is a simple surgery that takes 45 minutes and costs $250. The only reason children in developing countries don’t receive the cure is because they are poor. Clefts are an economic problem not a medical problem.’

Brian Mullaney was a successful New York advertising executive with his own agency when he noticed the number of local children, mostly from poor or immigrant families, who had facial disfigurements. He started a program, Operation Smile, offering free surgery by linking the children to some of his agency clients who were cosmetic surgeons. After reading about a charity doing similar work, he phoned them up and the two groups merged. 

Mullaney says his values were ‘fundamentally reset’ during an Operation Smile visit to China where he attended an operation on a nine-year-old girl. “When she woke up in the recovery room they brought in a mirror and handed it to her—and I will never forget how her hands were trembling and she stared into the mirror and didn’t say a word, and nine years of tears ran down her face,” he told Harvard Magazine. 

Then, in 1994, he was travelling with the medical team from Operation Smile when he was brutally struck by the number of children being turned away, about four kids for every child they helped.

In a poor village in Vietnam there was a young boy who played soccer every day with the volunteers. They nicknamed him Soccer Boy. When the mission was over and Mullaney and the others drove away, he saw Soccer Boy chasing after the group’s bus, his cleft lip still unrepaired.

“We were in shock — how could he not have been helped?” Mullaney told The New York Times. He realized that they urgently needed a new business model.

Mullaney and philanthropist Charles Wang devised a model that trained and equipped local doctors to perform cleft surgery all year round instead of flying in medics from the United States. The Operation Smile group didn’t like the approach and in 1999 Charles Wang and Mullaney left to set up The Smile Train.

With no expensive offices, low overheads and a small staff, The Smile Train has assisted over 500,000 children in 75 countries. Financially supported by more than a million donors, they continue to help local surgeons and hospitals to become self-sufficient. They also make virtual surgery training films which are available free to any doctor anywhere in the world.

‘It’s much easier than you think to make a difference,’ says Mullaney, who likes to quote the following remark by Margaret Mead: ‘Never doubt that a small dedicated group of people can change the world. Indeed, it is the only thing that ever has.’