Dr. Hirji Adenwalla: Adding Smiles To Lives


May 19, 2016

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Smile Train partner surgeon Dr. Hirji S. Adenwalla is, quite possibly, the only surgeon in the world who has been exclusively performing cleft surgeries for the last 15 years.

He is the head of The Charles Pinto Cleft Centre at Thrissur’s Jubilee Mission Hospital in south India, the very first hospital to apply for Smile Train’s partnership in the country back in 2000. Under Dr. Adenwalla’s direction, the centre has become one of India’s leading comprehensive cleft training centers and attracts young medical students from all over India.

He sets a strict pace for his team to follow. He has seen more than 16,000 cleft lip and palate surgeries performed at his centre. He performs cleft surgery three times a week.

And, he’s 86-years-old.


Treating children with clefts has become his obsession. An obsession that caused him to pull the emergency stop on a moving train when he saw a child with an unrepaired cleft outside on the platform.

His consultation room has of a portrait of René Laennec, the inventor of the stethoscope, and is covered with signed black-and-white photos of surgical pioneers from around the world.

In our opinion, Dr. Adenwalla is the ultimate smile maker as he changes the faces of India’s cleft children one little smile at a time.

About Hirji Sorab Adenwalla

After his medical education and specialization in surgery at Jerbai Wadia Hospital in Bombay (where his father incidentally was the Dean) he shifted along with my newlywed bride Gulnar in 1958 to a small Mission Hospital in a sleepy town called Trichur in Kerala. As was to be expected, the 20 bed hospital was very basic and offered most rudimentary treatments; and not surprisingly he was  called upon to carry out almost everything…from delivering babies to fixing hernias to mending broken bones, from removing appendices to tackling snakebites. Gulnar was occasionally called in to administer anaesthesia since there was no one else. (She actually managed quite well!).

Dr Adenwalla and Dr Farokh E. Udwadia grew up together and continue to be best of friends. According to Dr Adenwalla “…as kindergartners we used to sit on the steps of our school and cry together when our mommies were late”!

As the hospital grew and acquired more doctors he started focusing on his chosen specialty – surgery, and came across a large number of cleft patients. Amazed by the quick, dramatic and permanent improvement that resulted not just for the patient – but for the whole family traumatized by the birth of a horrible looking child – he started devoting more attention to those!

So large was the number of patients coming in, and so fascinated was he with this one life changing procedure he gradually gave up everything else and became a full time cleft surgeon. The problem however was money; there was never enough to treat all who came in. A Dutch charity called Simavi learnt about his work and chipped in with some support. It helped, but not enough. The more cases he operated, the more new patients came in…and he just didn’t have the funds to treat them all.

Meantime remains unstoppable! At 86 he still operates three times a week and basks in the world-wide recognition that has since come his way. A few years ago CNN produced a documentary on his work and life, he received the Joseph G. McCarthy Award for Cleft Surgery – regarded as the Nobel of cleft surgery, sits on Smile Train’s Global Medical Advisory Board. At the recent Annual Conference of Association of Plastic Surgeons of India in Mumbai last December he received a Lifetime Achievement Award for his work. “The best is still to come…..” says Hirji with a twinkle in his eyes and a glass of single malt in his hand!


About Smile Train & Clefts


Have you ever seen someone like this? Even if you have, chances are you’ve probably forgotten. There are so many people with all kinds of birth defects that more often than not we just look away!

This boy has what’s called a cleft lip.

What’s that?

Not many know that a cleft – or a gap – in the upper lip (often accompanied by a hole in the roof of the mouth, called a cleft palate) is one of the commonest birth defects among humans. While the exact causes are a medical mystery, it’s estimated that one child in every 700 is born with this. For India, this translates into over 35,000 babies born each year with this defect. And there’s an estimated backlog of over 10 lakh people with untreated clefts! But…

Is it really a ‘problem’?

Because of the grotesque facial deformity and speech impairment, children born with clefts are condemned to grow up as virtual social outcasts. That is, if they are allowed to grow up at all. Many such kids – especially girls – are killed at birth or abandoned. But even when they are allowed to live, their families are ashamed of them, other children taunt them and most schools won’t accept them. Actually it’s a life-sentence of shame and isolation.

Can…It be corrected?

The ‘cure’ for clefts has been around for decades; they can easily be fixed by a well-trained plastic surgeon. There are however two problems; first, such surgery can be very expensive and second, there are just not enough doctors and treatment resources to take care of all such patients.

Isn’t this just one more problem of poor countries?

Yes, and no. Strange as it may sound the incidence of cleft births in say California is the same as in Bihar. But whereas a child born in California receives the right treatment at the right time the one in Bihar is unlikely to. Clefts are actually more an economic rather than a medical problem.

What happens if the cleft is corrected?

A child who gets his or her cleft repaired goes to school, learns a trade, gets a job, raises a family and becomes an active participant in the economy instead of being a burden on Society.

Genesis of Smile Train

In late 1999 three individuals with long stints in the Corporate world decided to do something to give back to the Society from which they had received so much. And decided to start a charity that would be like no other!

It was predicated on two premises: first, there are far too many problems facing mankind; we cannot solve them all – so we’ll focus on one, and make a difference. Second, we wanted to demonstrate that good management is more important than good intentions and decided we’d leverage our accumulated knowledge and experience – this time to impact children’s lives instead of bottom lines!

The one ‘problem’ chosen: cleft lips and palates. A US registered not-for-profit Company (www.smiletrain.org) headquartered in New York City was set up that would be nothing like traditional charities or NGO’s.

In sixteen years Smile Train has become the world’s largest cleft charity having sponsored well over one million safe, quality and totally free reconstructive surgeries in 80+ countries and is on track to sponsor 125,000 this year.

Smile Train is also one of the leanest charities; it has a worldwide staff of just 80, that made The New York Times call it, “…..one of the most productive charities – dollar for deed – in the world.”

How is Smile Train different?

Unlike other medical charities, instead of bringing in surgeons and other medical staff from the West, Smile Train works only with local doctors empowering them via training, equipment and financial support to provide excellent cleft treatment in their own country. Working towards eventual self-sufficiency rather than perpetuating dependence. This also provides treatment 365 days a year, not just when the medical Missions come visiting. And costs a lot less!

This also fosters a sense of ownership and pride among local medical professionals and communities. Bringing in global medical protocols, practices and standards for Safety and Quality not only ensures children in poor countries get world-class treatment for clefts but also raises overall levels of medical care benefiting the Society at large.

And Smile Train doesn’t accept any funding from any national government or religious or political body and has absolutely no ‘hidden agenda’. Its only constituency: the cleft child.

Smile Train in India

The India program – the second country to start in 2000, just months after China – is by far the largest and most cost-efficient; with almost 45% of global surgeries it takes accounts for less than 25% of the global budget. Through 170 carefully selected and rigorously screened ‘partner hospitals’ it has provided close to 475,000 surgeries since inception. This year it is on target to sponsor over 50,000. Managed by a total staff of six, and it is….

The only charity that’s won an Oscar!

In 2008 Smile Train produced a 39’ documentary called ‘Smile Pinki’ (www.smilepinki.com) chronicling the life of 5 year old Pinki Sonkar born with a cleft lip in a dirt poor landless labourer’s family in a small village in Mirzapur District and how it changed after she received reconstructive surgery. In 2009 this documentary won an Oscar!


More about Smile Train: https://www.smiletrain.org/