Changing the World One Smile at a Time Transcript

More Elephant Intro

[00:00:38] Jason Rudman: Welcome to the latest conversation in the More Elephant podcast series. Once in a while, usually every quarter or so, we go off of our journey a little, and we invite a nonprofit organization and a nonprofit leader to come talk to us about the work that they're doing, how they got into the work, the impact that it's having on lives, both here in the U.S. and around the globe.

And so, I'm delighted today to welcome Troy Reinhart, who is the SVP of Community Ambassador Development for Smile Train. Their tagline is ‘Changing the World One Smile at a Time,’ and so I'm already smiling. You won't be able to see me, but you can hear me. But if you can ‘hear’ my smile, I'm really excited about this conversation. So Troy, welcome to the podcast.

[00:01:24] Troy Reinhart: Hey, how are you doing, Jason? Great to be here and great to see you too.

[00:01:28] Jason Rudman: Fantastic. Fantastic. So, what I'd love to do in the time that we have here is for you to take us on a journey, both your journey and the journey of Smile Train, and the great work it has done and will continue to do around the world.

I think I'm right in saying this is the 25th anniversary year of Smile Train, which is an amazing milestone. I'd like to go back though, and just start with how you got involved. I think your story is amazing because your first job at Smile Train was reception, I believe, you were the receptionist, and so 22 or so years later, you've got this amazing role doing great things around the world. So would you take folks through how you found Smile Train and how that's connected to your origin story?

[00:02:19] Troy Reinhart: Yeah. So, Smile Train – 25 years this year, which is amazing. So, in 1999, our founders came together and had this dream of creating this cleft organization, a sustainable model of helping patients all around the world.

And in 2001, I was living in New York City, and like most of us, I was looking for that career and that job and I knew somebody at this nonprofit, a very grassroots organization at the beginning. I think we had maybe 50 employees globally. We didn't even start fundraising yet because our founders believed that they wanted to really create the model and the programs and show the work we're doing.

So, in 2001, I came in and started answering phones and that same month, they started to fundraise. We started to place some ads in the newspaper, and guess what was happening? Donations were coming in, but there was no one to key in the donations, to do anything with the donations. We were really grassroots!

So, I really moved myself into a database position at that time too. And then, 22 years later, here I am. But, I've always had a dream to work for the nonprofit world. So, it's not odd that I ended up in that world, but it's hard probably that I've stayed so long because you know, today, most people don't stay that long at an organization.

[00:03:32] Jason Rudman: Right. What fuels the dream of a nonprofit? And so just again, if you connect that to your origin story because you and I met in New York. Not the cheapest place in the world to live. And yet, you had identified early that a nonprofit was your root. So, connect that to the essence of why that was important to you.

[00:03:50] Troy Reinhart: Well, there were a couple of things. I mean, I think growing up in the church and in Catholic schools, you've always done philanthropic work. So, it was always kind of ingrained in everything we've done. I really didn't realize until I was at a receptionist position that, Oh, wait, I can actually make a career out of this.

One good thing about Smile Train, our founder, Charles Wong, came from the corporate world, so he did run us like a corporation. He was like, ‘Hey, if we're going to succeed and thrive, we can't run like a grassroots organization. Let's run with ROI, investments and really looking at this. So with that said you know, New York. Yes, it's very expensive to live, but I knew I wasn't going to become a millionaire working at a nonprofit, but I was going to become happy because I was going to be happy with what I was doing.

And so, at the end of the day, yes, there are your typical, you know, it's a job; you have your challenges, your issues, your problems, but knowing that you are doing something for somebody else out there at the end of the day, that is kind of the return on investment. I think that's what really fuels, not just me…there's a lot of us at the organization who have been here for over 15 years.

[00:04:53] Jason Rudman: Yeah. I love that - it's there's joy. right? Even as you describe it, hey, I wasn't going to be a millionaire, but I'm happy. Right? And what I do every day, I see the power of what this organization does every day and the lives that it changes.

Would you describe cleft for the audience? You had shared with me, we typically think of it as cleft palate, but there's two or three modalities of it. And then what actually causes it? How does a baby get born with the cleft palate experience?

[00:05:26] Troy Reinhart: So basically, a mother will know within the first trimester, as long as she's having her proper scans, and the scans are working okay. That is when the baby's head is forming, it's coming together. And what happens, there's a blocker that blocks it and that's where you will develop potentially.

It's a facial difference, one in 700 births. That's the global number. So, it happens everywhere around the world and in some countries, it's even a higher incidence based off of other factors. And you will either be born with a unilateral, which is the single kind of opening of the lip; a bilateral, which is two – so picture where the nostril holes are and straight down. And then cleft palate. So, if you were to push your tongue to the roof of your mouth, that is wide open.

Most of the time a palate is present, you just don't always see it. It's the lips that you would notice first. But the challenges aren't just looking at the child and saying, ‘Oh God, something's wrong with this child.’ It does affect eating, breathing. You could just imagine; breast milk will come out of the nose and everything. So, they have trouble feeding.

So it starts there but really the journey of cleft, it's not only one surgery. They may need speech therapy. Dental will be very important because of the structure and the way the mouth is being formed, the teeth will come in, most likely, they'll come in crooked and you'll have to have that corrected later on in life. And then of course the psychosocial – just because you fix the cleft doesn't mean you're really fixing the child completely because they still do have this scar that is evident to people. And, most overcome it but there's still people that have challenges with that.

[00:06:53] Jason Rudman: Right. I think that's really important. It's not just the visual impairment that you see, but also the other challenges that bring and I think if I'm right, you had shared with me that is part of the difference in the way that Smile Train approaches it because it's a real wraparound delivery model, right? It's not just going in and figuring and fixing the visual impairment that you see.

[00:07:17] Troy Reinhart: Right. And when we were founded in 1999, what we did different was, there were other organizations out there that were doing this. So, we weren't the first in that sense. But where we were the first was creating a model that was a little different. We did not believe in sending over foreign doctors into foreign lands and coming in and doing a mission, fixing it for two weeks, maybe not getting to all the children, you know, a child may be sick, can't have the surgery, and then they may not be back there for another year.

So, we knew that there are already surgeons that were doing this type of treatment all around the globe. Of course, they were providing it to their patients that could afford the surgery because healthcare, insurance plans, didn't exist. Smile Train came in and said, well, why don't we come in and provide that funding for those families and that training, additional training for those doctors?

So, we only use local surgeons. We're in 90-plus countries that we've done work. We just hit 1.9 million cleft surgeries. And like I said, it's a journey.  So, they'll have that initial surgery – that patient will be at our hospital from birth, from really diagnosis if the mother knows it at that time, to any type of nutritional care, all the way until their adulthood, until 18, 19, 20. If you met a patient here in the U.S., the U.K., they would tell you the many different surgeries and how long they spent on their cleft journey. So that's what Smile Train wanted, that same exact care everywhere.

[00:08:39] Jason Rudman: That's brilliant. We talked a little bit. You mentioned one in 700 births globally. In the U S., it's handled immediately. And so, I think that that's the difference for people that are also listening, right? What happens in the U.S. or the U.K., as two examples, is very different than what might happen on the continent of Africa or in Brazil or India. And so, you also mentioned the stigma that's attached to it.

So, not only, as you mentioned, that the child is still dealing with a reconstructed part of their face visibly, but, as you go further afield, around the globe, there is tremendous stigma attached to the birth of a child that has cleft. Would you talk a little bit about how that shows up? And again, the connection to the way that Smile Train thinks about its delivery model and how it is slightly different than what had preceded it.

[00:09:37] Troy Reinhart: Yeah. So, a really good example is most of these families that we're working with, for the most part, aren't having really the proper prenatal care. So, they're not going to hospitals. They're having these children in their own villages and in their homes.

So, you can imagine this baby is born by a midwife with, by the family and they see the child. In some of these regions, especially Ghana as a really good example, just because we've had so many stories come out of there, they will think this is a demon child because nobody knows exactly what is going on. They think it's a curse from God. The mother looked at another man while she was pregnant. There was an eclipse in the sky, which explains why this baby looks this way. And the community will actually turn on this family and the husband will leave it a lot of time.

This is where Smile Train is like, ‘Oh, the surgery is not even part of it yet.’ We have to actually now work with our social workers and our communities and educate them on cleft. So, over the years, the one good thing that has happened is a lot of these babies in these villages have been corrected. And now, when a new baby is born, they've become their own poster child. A family will know actually that nothing is wrong with that baby, it could be fixed. It's free and they can live, a full productive life, hopefully.

But, that was our biggest challenge at the beginning, because just because you're offering a free surgery doesn't mean a family wants to take a free surgery. They don't think anything is free, of course – give me your baby, I'm going to put them on this bed and they're going to come looking out like this? We have a picture and they're like, well, this doesn't make sense. So, it's taken a while to get to that point, but working with governments and local midwives and educating is still key in a lot of these regions.

Another, China, was an important one. Imagine having your first child being born and it was a girl and had cleft. That was just uncalled for, so you'll see a lot of the orphanage is filled with a lot of babies. And so, how do we go in and say, you know, don't worry, everything's going to be okay. So, it's taken time. It's still a battle, but we have to address each region different because it's not a one-size-fits-all model.

[00:11:42] Jason Rudman: Let's take both of those if we can, and just go a little deeper, right? So let's talk Ghana. It's not lost on me that I'm thinking about going into Africa with a team that may not look like most of Africa, right?

And then coming in and saying, ‘Oh, but we can fix it.’ I'm thinking about the  the history of colonialism in Africa and the advent, of missionary Christianity and all of that coming in and how Ghanaians view not only cleft but also “Oh, we've got these folks coming in and they're telling us that they know what to do.’ Would you walk through a little bit more of the journey that said, Hey, before we fix a cleft, we've got to get the community engaged and, as well, the connection to the availability of skilled surgeons in Africa to be able to do the work?

[00:12:34] Troy Reinhart: And that was another challenging thing with Africa. As you can imagine, it's a huge continent, many different countries. And if you became a skilled plastic surgeon there and you did your studies, a lot of times, you went off to the U.K. or you went off somewhere else, because you were like, well, I can make money. So, we were like, how do we give them a sense of ownership to help their own communities and show what they're doing? So, once you do find those key plastic surgeons and those nurses and anesthesiologists, all of them that really want to do the work, we really, pride them.

We invest, not just in that child, we're investing a lot in this doctor. We're sending them to conferences all around the world, giving them opportunity, helping them craft their work. You know, a lot of times this is what they want to do. They want to help – you know, the last thing they wanted to do was turn away a patient and said, I can't help you. So, we developed fellowship programs and education and training has been very, very key, especially somewhere like Africa.

And we want to show that, ‘Hey, look what you could do for your own communities, and you don't need these Westerners to come in and save the day. At the end of the day, you should be saving the day! And you can do that.’ I think we've always put so many band-aids on Africa and didn't rely so much on actually how many skills and resources and things exist there that you don't need to come in and, and like I said, save the day.

And that's what we've seen. So now that you have these amazing doctors that have been almost 25 years because Africa, we were there pretty much from the beginning when we were founded. Not all the countries. You look at them now and they have thousands and thousands and thousands of surgeries and they've perfected their craft too.

We use what's called a local kind of sustainable training model. We may use doctors in Africa, that go train other doctors in Africa. So, it's still kind of like to like, and we'll do like these in-country missions because you can imagine some of the countries we work with in Africa, the nearest hospital is still four or five hours away. We will send our surgeons out there into the field and, you know, kind of know their own community. So, it's been amazing what we've been able to do there over the years. When we first started at the beginning, 25 years ago, their biggest worry was HIV and AIDS; we come in and we're going to help with cleft. They're like, we can't even think about that right now. Now that, you know, still there's HIV and it's not as prevalent and as high on the list anymore as, as it was before, but at least now they're focusing on other medical treatments, which is great.

[00:14:58] Jason Rudman: That's remarkable as well, right? If you think about the journey in 25 years, to your point, Charles Wong, the founder, identifies a need, wants a different delivery model, and inserts that model into an environment where the most prevalent and pressing thing that we're trying to solve for is HIV and AIDS. And somehow, this finds a way to break through.

You had mentioned, again, for those of us who have been to Africa, have an appreciation for Africa, not lost on us that the nearest hospital could be four, five, six hours away. Does that mean that part of the evolution of the model has been taking the service, the experience - has that localized it such that there's less of a reliance then on the hospital that's four or five hours away that requires the entire family to go and they've got to figure out how to stay? Does it bring the fix to the community just so we understand it a little bit more in terms of how it's evolved?

[00:16:03] Troy Reinhart: Yeah. And I mean, some things that have evolved and let's just look at technology over the past 25 years – we now have speech apps that you can put on your phone. You don't need that patient to go and drive five, six hours and go to a speech camp for a few weeks. What we could do is actually bring the speech therapy to him. Or send these local speech therapists into these communities for a little more time because it's easier to bring one person and 30 patients in, but technology has been huge for us in that sense.

Even technology for a sense of allowing them to know about our programs. I mean, love or hate social media. I think I've mentioned this before, it still is able to reach these places that we would never be able to reach and bring news and say, ‘Hey, do you have a child like this? If so, here's how you can get the help.’

So, I would say each patient that comes in, how did you hear about us? You'd be very surprised the amount that say through social media and, interestingly enough, radio is still a very, very popular in some communities and that’s odd because we're such a visual thing, but they're able to describe it enough on a radio advertisement that explains what cleft is.

[00:17:09] Jason Rudman: So, awareness and how people understand, because it sounds as though it's gone from very much a pull model, which is we're going to go into a country, we're going to find the opportunities, to very much using technology, social, and other means to now say, hey, our doors are open. You had mentioned if you have a child that looks like or is, shows up in this way, we're here to help.

Could you talk a little bit about how that works? I think we had talked when we were gearing up for this conversation, we talked a little bit about the Philippines, which is a series of islands across many bodies of water, and the ability to use technology to get the word out. And then also, I think, a rather unique partnership that you have with the Miss Universe organization to drive the message even further.

[00:18:09] Troy Reinhart: Well, one thing that's great, like I said about Smile Train, is we have, right now, 1100 partner hospitals all around the globe, and they're strategically placed. So, obviously placed in areas where there's a higher population but then that doesn't always take care of where there's less population. And the Philippines is a really good example, 10,000, 11,000 islands out there, if it's still 1 in 700 births, and I will say it's actually higher in Asians, so it's closer to a one in 500, definitely even more children are being born in a place that's super populated, like the Philippines.

So, when we have the partnership with the Miss Universe organization, a good example is Catriona Gray, she was Miss Universe four or five years ago. She has 14 million followers, she will go on Facebook, hold up her Instagram, and hold up a photo and say, do you know a child like this? And we will get thousands of calls because, you know, there's new families being born or there's a lot of children that just didn't know that the surgery existed.

And so, that's where Smile Train really comes in and says, okay, we've identified these patients, but in places like that, it's still a challenge. So, it'll be a different model where we may have to bring some of the children in. We'll have kind of what's called ‘cleft camps’, where we'll just dedicate weeks specifically, to helping those children that are in really remote areas because the idea is you don't want to keep on doing one-offs.

You want to be very strategic and cost-effective about how you're doing everything. And we have amazing partners in these countries that are so dedicated. It's not just the surgeon. It's the social workers. It's the woman at the front desk that's checking in everybody. It's, it's a team. It takes a full team to do all this.

[00:19:48] Jason Rudman: So, a cleft camp? That is your ability to take an entire wraparound delivery service and then, to your point, from a cost-effective perspective, immerse yourself in the community for a period of time. And so how frequently do those show up in somewhere like the Philippines and that enables you to positively impact the lives of how many kids annually?

[00:20:14] Troy Reinhart: Well, one thing to keep in mind too, it's important that surgery is done in a timely manner and fashion. So that lip surgery should be done within three to six months. Most likely, we're going to be doing quarterly camps, separate from a hospital that's in a main city in Manila where we could go every day and have the surgery.

Somewhere far away, we may group them together and there'll be on a quarterly basis because we still want that first surgery done within those three to six months because that's the critical time. And the pallet is done between nine and 12 months, that's the roof of the mouth. Then the other care just really depends on the growth of the child. Sometimes, you know, these children won't need additional surgeries just because of the way that their cleft was formed and a really great outcome of the surgery too.

One thing we did notice over the years what we called mission models those would be places that come in for two weeks and leave. We noticed that because of the mission repairs that weren't done as effectively because they were trying to get through things very, very quick. So that's another thing Smile Train is, safety is our number one priority. So, if a baby comes in and they're sick or not feeling well, we're going to delay them until the next surgery date. We're not going to allow them to go under those circumstances. It's not worth it.

[00:21:28] Jason Rudman: It's probably difficult in the 22 years or so that you've, you've been involved. The organization has changed the world one smile at a time. Where have you been most impacted in the work that you've done on a personal level? You might argue that's an unfair question but I'm going to go there anyway. A couple of examples that have personally hit home for you about the work that Smile Train does experiences that have been incredibly impactful in your journey at Smile Train.

[00:22:00] Troy Reinhart: Yeah, it's a loaded question because I've been very fortunate to travel and see the work we've done. I've met a lot of these families. I will probably say the first time is always kind of the most impactful. So, it was 2006. I went to Nigeria and that's where I met the first time actually seeing an untreated cleft in person and there were there were a couple patients. But I remember Funmi was one that I have this fantastic picture of, she's about six years old at that time, and she just sat against the wall, and you saw the sadness in her eyes. And she had this wide-open cleft.

We've stayed in touch and I still get photos of her and I have to share these photos with you because she is a diva now. Like you would not know this was that same person. She's sending that picture of her in her school uniform. And I'm like, ‘OK, we did it’ because her parents weren't sending her to school because it wasn't so much that they were ashamed of her in this case, they were just afraid of the bullying and everything that would happen because,  she just looked, unfortunately, not like other children and it would scare them in that sense. So, there's just patients like that.

I've been in Mexico recently where I had a father just pull me in the other room and he just started crying in front of me and tell me, I want to do everything for my family and be man enough to do all this – and this was all through translation in Spanish – and he's like, I just can't thank you enough because this was one thing I couldn't figure out. And it's not a big deal to us, you know, because this is what we do every day. But for him? He was probably losing sleep at night, trying to figure out how he was going to help his family because he just couldn't figure it out.

So you just have those moments where you're just with them and you connect immediately. And the biggest ones after the surgery, it's less of the, the baby you kind of see like the shoulders relax the happiness, you just see it in that, that mother's face, because a lot of times they're the ones that are really at the end of the day, you know, taking the burden. So that's where you kind of see it all. And there's tons of stories.

[00:23:58] Jason Rudman: Tons of story. Yeah, I did say it was a bit of an unfair question because I asked you to pick a few. I think it connects to where you started at the beginning. Some of the social stigma and the environmental stigma that you're dealing with, and you painted a real, really great picture there of the mother or the father where just the weight is lifted. I can't imagine the father in Mexico and that whole machismo context of – I’m supposed to solve for it and I can't. I hope you never get so immune to those stories because that is really changing the lives of people, one act of greatness at a time. It really is.

Where are the biggest challenges today? And the reason I ask that is because I think we're in a very, very fortunate position here in the U.S. I'd like to think that the stigma here, it would show up, but it would show up differently. We generally have the means to immediately handle it. So, if you would take us outside of the U.S., where are some of your biggest challenges in terms of where stigma still exists, where the operating model still requires a certain, you know, there's a shortage of doctors, etc? Where are you challenged?

[00:25:14] Troy Reinhart: Well, I would say the stigma is still, still, gradually decreasing, and you even hear about the power of Smile Train because we've been able to bring cleft that story over the past 25 years, so we've done a lot of education just in general about cleft, which has been fantastic, too.

Somewhere where I see a challenge with something we didn't expect is the aging out of surgeons. So, places like South America – you know, it's not difficult to find a plastic surgeon that will work with us, but now they're 25 years in, and they started when they were in their forties working with us, and now they're in their sixties, and they're ready to retire. And then we have these new surgeons coming up, that similar to just the new way of millennials and everyone's trying to make money and be successful.

So there's that less philanthropic interest where, I think a long time ago, that was more ingrained in older surgeons. So how do we teach the younger surgeons that this is something they need to carry on and move forward? We're utilizing those older surgeons to be those mentors and show what they're able to do.

And it's not always about the dollar, you know, you could have your private practices. A lot of our surgeons will have their private practices, but they should still try working with their community and the public. That's why they became a doctor, to help everyone. So, working on that because the last thing we want to do is close down a program because we don't have the right doctors and nurses and anesthesiologists in place or speech therapy.

Speech pathology is important. It's not always easy to find them all around the world. So, that's why we really do depend on speech apps or teaching parents how to, for the most part, work with speech with their child. At the end of the day, no child does want to go to speech therapy, but it's important for them not only to look great but to speak confidently and become educated.

[00:27:06] Jason Rudman: So again, I, I think that's really important to reaffirm. That's not just about fixing the face, right? And the services that you provide will continue to need access to speech therapy, access to doctors.

I think you mentioned 1.9 million patients. You're probably getting close to the 2 millionth patient, and India, I believe, is the largest source of the work that you've done over the history of the organization. Is it simply because there's, you know, you're talking a billion plus people in India. Is that one of the places the organization started? And if so, how has India changed over the course of the 22 years that you've been working at Smile Train?

[00:27:51] Troy Reinhart: Yeah. So, India, once again, that is based on large population and other factors that also could cause cleft, which not only genetics, it's prenatal care for the mother, it's pollution. You can imagine all the environmental things that could also cause this.

So, in India, we're operating on about 35,000 patients a year, and that's just on that initial surgery. We're at about 750,000 surgeries, which is a huge number of that 1.9 million, but where I've seen it change there, and I've been to one of these hospitals in Varanasi, where Dr. Sibode, when he first started with us, he was only doing a few of these. Now the whole center is just a cleft center. The center has done over 25-30,000 surgeries. His surgeries are so perfected because you could just imagine if you're having to do these surgeries day after day; I mean a lot of times, you can't even see the scars on the face anymore…I mean, that's just how perfect it is.

So I would just say the technique and skills of these surgeons in India are just top-notch just because they've had so much, and I don't want to say practice, but they've just been able to do it day in and day out. The one good thing about India is they always will have that philanthropic kind of giving. If you've ever met an Indian doctor, there's a lot of great bedside manners and compassion. And it's great to see our programs over there. And, that's an area where we can pilot programs. So, because we were able to see if it could work in India, that's something we can maybe, you know, do elsewhere. So..

[00:29:25] Jason Rudman: Oh, that's really interesting. So, India has served as a bit of a petri dish for where how you can export it. That's excellent. Have you seen the connection then, because you mentioned it's not only genetic, but also environmental pollution, and exposure to the elements, has the work over 25 years or so in India, for example, also caused people to appreciate that connection, the environmental connection, and then attempt to reduce the incidence with you by trying to change the experience during pregnancy? Or is that kind of like a step that, you know, that would be great, but my goodness, we've just got to get this practice up and running…

[00:30:09] Troy Reinhart: Correct, correct. Well, and I would say at the beginning, our goal was really there was a backlog. That was another reason a lot of our hospitals were just working on children who were just within miles of the hospital because of the backlog. And then we were able to move out further and further.

We do invest in programs, in prenatal care as much as we can, but at the end of the day, if you look at the U.S. and the U.K., children are still being born every day with cleft. So, we do invest in, starting to invest in some research, but right now we're trying to put most of our focus on the surgical side of it, just because it becomes down to, a financial game.

You know, where do we want to put our money? Does it make sense to put it into research and then not be able to afford, you know, pay for surgeries? So, we know those are still existing, but there is still some research being done. So hopefully, one day, that would be an amazing if they could find out why.

[00:31:01] Jason Rudman: I'm thinking about the U.K., for example, and how you connect with the NHS… I'm just thinking through how that delivery model becomes even broader. But to your point, you went into India, you've dealt with the backlog, and you feel that you're actually on a proactive, ‘front footing’ now to start increasing the education and the awareness.

So, what would be the one ask of the More Elephant listeners that are listening to this, inspired by the work that you've done, the work that Smile Train does on a daily basis throughout the globe, what would be the one ask or the consideration that you'd have for the audience?

[00:31:39] Troy Reinhart: Yeah, I mean, well, at the end of the day, we can't run without fundraising and financial, but if that's somewhere where you can't help, just being that advocate in your own community. You know, really educating yourself on cleft to just kind of helps too, because I think a lot of people still don't understand what cleft fully is.

And then really just, you know, there's always ways to get involved at Smile Train that are from a non-fundraising way and if you go to our website and the Get Involved page, you can see different ways where you could actually visit our programs in the field and see it firsthand and get a better understanding of what it is. Or, if you happen to be traveling in areas or regions where we work, you can stop and see the programs.

But just really, being that advocate and understanding more about cleft and Smile Train, and it's a public health issue. These children shouldn't go untreated. And unfortunately, they still are in many, many countries. And we want to make sure that everyone has access to the free treatment that they should.

[00:32:26] Jason Rudman: So SmileTrain.org to figure out how to learn more, figure out how to donate. Would you just give a little bit color, because now I'm intrigued, right? Now I could join Smile Train in Ghana, right? So how does that work? What's that experience like at a very high level? And then obviously we'll engage the audience if they want to learn more.

[00:33:00] Troy Reinhart: Yeah. So, the one thing about Smile Train, since we weren't doing mission models, so we weren't sending over U.S. doctors, but we still wanted an opportunity for people to see the work firsthand. We have what's called “Journey of Smiles” and these are located on our website where we offer them.

So actually, in a month or so, we have a group of 11 supporters going to Guatemala and what they will do is they'll actually see the program. So, when that patient comes in from day one, they'll see all the workings, inside the hospital, everything that needs to be done. Then we actually bring them into the villages, and we bring them to the patient's homes, and they learn about their day-to-day life and everything.

And you'll see twofold: you'll see some that are still waiting for treatment and some that have been through our programs for, you know, 10 years ago. And,  they'll have their little ‘before’ photo with them and just show they're, they're thriving today, but that they're still going through maybe some other treatment. See them going through a speech session, but really just to kind of see the program.

And Guatemala is important for us, too, because most of the children, for whatever reason, are malnourished there. So, we support a huge nutrition program there where we got to get these babies up to the proper weight and I follow them on Instagram all the time. And we just had a camp this past weekend where there were a hundred patients that were in there, so you could just see the volumes that are coming through this hospital on a regular basis. And Guatemala is not a huge, huge place, but they’re in need.

[00:34:27] Jason Rudman: I just love, thank you for sharing that because again, I love the importance of the cure is the fix of what you see, but to your point in Guatemala, you've got work to do in a malnourished state to get kids up to the right weight in order to help them. And again, I think sometimes we so lose sight of the fact that it is this wrap-around model and all of the work that Smile Train does, both pre-, in the moment, and then post- in order to create smiles one surgery at a time, which I love.

[00:35:03] Troy Reinhart: One good thing about it is, it's a wheel of comprehensive cleft treatment. So, we have this wheel, and you could fit anywhere on that wheel at one time. Sometimes, we'll meet patients that we didn't operate on from the beginning, but they're having trouble with, you know, their palate reopening later in life. And, they'll just be inserted into our programs at that point in time. So, it's great that we have the services available that they need.

[00:35:27] Jason Rudman: All right. Well, we have work to do as a community to try to continue to build on all of the great work that you've done. Troy, first of all, from one human being to another, thank you for the work that you do. It's really, really inspiring. And again, I think it is inspirational in the world that we live in that people wake up every day and say, this is the path that I'm on. This is what I'm supposed to be doing. And I know for sure that the work that I do makes me happy. I think more people need that in the world.

[00:36:01] Troy Reinhart: And I appreciate you giving us this platform to talk about it. You know, I said, sometimes we're in our own bubble doing this day in and day out. So, it's great that we can share it with more people.

[00:36:13] Jason Rudman: Awesome. Troy, thanks for your time. Really, really appreciate it. And, we will make sure that everybody has access to all of the links, can understand how they can get involved beyond donation and we will hopefully as well, share some of the success stories to the degree that we're able to share pictures and stories of before, during and after.

[00:36:36] Troy Reinhart: Sounds great. All right. Thank you, Jason.

[00:36:39] Jason Rudman: Excellent. Thank you.

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