More than 10 years ago, The Smile Train started out as a special project of Operation Smile. But soon it became apparent that the two organizations had very different strategies and philosophies. Operation Smile is a traditional mission group that sends American doctors and nurses on 2 week missions. The Smile Train was the very first cleft charity to realize local surgeons in developing countries could be empowered to deliver much safer, less expensive and higher quality surgery year round - and not just two weeks a year. This "teach a man to fish" strategy explains the rapid growth and very low cost per surgery of The Smile Train. The Smile Train separated from Operation Smile in 1999 and today is completely independent and the world's largest cleft charity. Here is a side by side comparison between The Smile Train and Operation Smile.