375 University Ave, Suite 204
Toronto, ON M5G 2J5
CEO: Mark Climie-Elliot
Board Chair: Ken Wilson

Charitable Reg. #:84064 3605 RR0001


Ci's Star Rating is calculated based on the following independent metrics:

[Charity Rating: 4/5]



Audited financial statements for current and previous years available on the charity’s website.



Grade based on the charity's public reporting of the work it does and the results it achieves.



The demonstrated impact per dollar Ci calculates from available program information.


Charity's cash and investments (funding reserves) relative to how much it spends on programs in most recent year.



For a dollar donated, after overhead costs of fundraising and admin/management (excluding surplus) 54 cents are available for programs.

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About Operation Smile:

Founded in 2011, Operation Smile Canada  (OSC) is a member of Operation Smile (OSI). Donations raised by OSC are used to support programs conducted by OSI, based in Virginia, US. Every three minutes, a child is born with a cleft lip or cleft palate. Annually, that is about 175,000 children worldwide. OSC says that without corrective surgery, as many as nine in ten children born with these conditions could die. In addition to fundraising, OSI recruits medically-trained Canadians to travel abroad on its missions to provide free cleft lip and palate surgeries for children and young adults in more than 60 countries. OSI conducts missions in low and middle-income countries, where it can take years for children to get treatment. It also establishes Care Centres that provide long-term support for patients in these countries. 

In F2019, Operation Smile Canada funded 55 Operation Smile missions in 14 countries, an increase from 35 missions in F2018. On these missions, volunteer surgeons performed 4,786 cleft lip and palate surgeries on 3,759 patients (3,253 procedures on 2,561 patients in F2018), and 722 patients received post-operative care. Doctors also performed over 7,000 dental procedures.

In F2019, 55 Canadian doctors and nurses were on 77 Operation Smile missions, 1% of the 7,096 volunteers for Operation Smile International. Four Canadian nurses were on missions in Morocco where 42 children and adults received specialized surgery for jaw and realignments after cleft palate surgery.

A key aspect of Operation Smile’s work is educating and training local doctors on best-practice cleft lip and palate surgery and care. In F2019, 15 of the 55 missions OSC funded were education and training missions. In these missions, Operation Smile plastic surgeons support national surgeons in the development of skills and confidence in doing cleft palate procedures. In F2019, 405 national doctors received this training on 78 patients in 125 surgical procedures. These local surgeons are now able to perform cleft lip and palate surgeries because of the training received from Operation Smile. This grows the national capacity for local doctors to do these procedures.

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Results and Impact

Operation Smile Canada reports that cleft lip and cleft palate surgery “changes a child’s life forever” and can take as little as 45 minutes. It claims to meet or exceed global medical standards and follow “top-notch safety procedures”. This follows concerns in late 1990's about "surgical safaris" where volunteering doctors left "a mess behind" including children who died in procedures. Large and complex cases should be left for national doctors who can provide the necessary follow-up care  OSC highlights multiple testimonials on its website and Smile report that highlight the lasting changes from the surgery in the lives of children. 

For Operation Smile Canada, the total cost per patient was $3,549 in F2019, compared with $4,554 total cost per patient in F2018. This does not include patients receiving dental procedures. This total cost contrasts with Smile Canada's statement that "a cheft lip can be repaired for as little as $240 in as few as 45 minutes". 

Cleft palate and cleft lip procedures done by local doctors cost between $120-$250 per patient. The concern is that patients will wait too long for a "free" Operation Smile procedure rather than pay $15 or free treatment at a government hospital. With long-standing cleft palates, speech outcomes diminish.

While Ci highlights these key results, they may not be a complete representation of Operation Smile Canada's results and impact.

Charity Intelligence has given Operation Smile an Average impact rating based on demonstrated impact per dollar spent.

Impact Rating: Average

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Operation Smile Canada is a Large charity, receiving total donations of $12.6m in F2019. This included $499k from the US Operation Smile ($900k in F2018) to grow the Canadian donor base and offset the high fundraising costs. Operation Smile's administrative costs are 11% of revenues and fundraising costs are 35% of donations. This means Operation Smile's overhead costs are 46%. For every dollar donated, 54 cents go to the cause. This is outside of Ci’s reasonable range for overhead spending and has been for the past three years. Operation Smile Canada's fundraising costs of 35% are significantly higher than shown to donors in television advertisements.

OSC’s funding reserves of $2.5m can cover four months of annual program costs. Operation Smile Canada owes Operation International $470k in F2019 and $78k in F2018 for programs.

In F2019, OSCF paid external fundraisers $103k to raise $130k. The cost to raise one dollar through external fundraisers is $0.79.

This charity report is an update that has been sent to Operation Smile Canada for review. Changes and edits may be forthcoming.

Updated on June 12, 2020 by Eric Jose.

Financial Review

Financial Ratios

Fiscal year ending June
Administrative costs as % of revenues 10.7%10.0%6.6%
Fundraising costs as % of donations 35.1%37.1%52.9%
Total overhead spending 45.8%47.0%59.5%
Program cost coverage (%) 33.4%32.7%990.1%

Summary Financial Statements

All figures in $000s
Donations 12,62411,1809,853
Other income 17208
Total revenues 12,64211,2009,860
Grants 7,5606,371430
Administrative costs 1,3521,118654
Fundraising costs 4,4314,1425,210
Other costs (1)32(3)
Total spending 13,34211,6646,291
Cash flow from operations (701)(464)3,570
Funding reserves 2,5252,0864,253

Note: F2017 expenses were restated in the F2018 financial statements. Ci has reported the restated expenses. Note from the F2017 financial statements: "During the year Operation Smile Canada (OSC) was in the process of formalizing an agreement to fund programs with Operation Smile Inc. (OSI - the International entity) that was in compliance with CRA regulations. That agreement was finalized in the last quarter of the fiscal year and as a result, fewer programs were funded during the fiscal year. In response, Operation Smile Canada created an internally restricted program reserve of $2,850,000 that will be used to fund OSI programs in future years. OSC has also established a stabilization fund of $500,000 to ensure the long term financial stability of the organization. OSI had provided OSC with an operating grant to cover a portion of the fundraising costs during the first few years of start-up that ended in FY17. As a result while fundraising revenue increased from the previous year, the total revenue decreased by nearly 4.3 million."

Salary Information

Full-time staff: 14

Avg. Compensation: $85,256

Top 10 staff salary range:

$350k +
$300k - $350k
$250k - $300k
$200k - $250k
$160k - $200k
$120k - $160k
$80k - $120k
$40k - $80k
< $40k

Information from most recent CRA Charities Directorate filings for F2019

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Comments & Contact

Comments added by the Charity:

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Charity Contact

Website: www.operationsmile.ca
This email address is being protected from spambots. You need JavaScript enabled to view it.

Toll free number: 1.844.376.4530

Local number Toronto 647.696.0600 



Dr. Michael Mars, Alex Habel, Debbie Sell Management of Cleft Lip and Palate in the Developing World. 2008

David Welling, James Ryan, David Burris, Norman Rich, "Seven Sins of Humanitarian Medicine", World Journal of Surgery, September 2010

Tel: 647-696-0600