Along a dusty roadside in the state of Ceará in northern Brazil, Antonia sips a cold drink on a hot day at the local coconut stand with her father and sister.

The area has been stricken by a drought spanning more than five years and the scorching wind whips around the dust, which covers everything and everyone in a fine layer.

Life is hard for many in this desolate, arid region of a nation better known for lush rainforests, the mighty Amazon River and the sprawling cityscapes of Rio de Janeiro and São Paulo.

Like the other farmers in the area, Antonia’s father, Iranildo, has had to cope with the effects of the lengthy drought. In times like these, he can only grow enough food to feed his large family.

Even when more favorable conditions prevailed, Iranildo earned a low and inconsistent income selling surplus corn, beans and cassava.

Today, the family trio laugh and enjoy time with one another as they reminisce about the past.

Antonia’s husband, Alan, works at the coconut stand and beams with a wide, loving smile when their eyes meet. In precious moments like these, it’s nearly impossible to imagine a time when there wasn’t much that made Antonia smile.

That time was 11 years ago, before her cleft lip was repaired by Operation Smile Brazil.

Cleft conditions have long affected Antonia’s family. She represents the fifth straight generation afflicted with the condition.

Iranildo and Antonia’s mother, also named Antonia, were devastated to see their fifth daughter born with a cleft lip. But their sadness paled in comparison to the love they felt for their newborn baby.

Unlike many children born with cleft conditions, Antonia was fortunate to be able to breastfeed without difficulty.

However, with a family of nine to support, affording surgery for Antonia was beyond Iranildo's means.

Even after learning of Operation Smile Brazil’s inaugural program to Fortaleza shortly after Antonia was born, Iranildo couldn’t afford the bus fare nor the time away from the farm.

All he could do was offer Antonia a promise that he hoped he could one day fulfill: “I promise I will get it fixed.”

While Antonia was physically healthy as she grew older, the emotional distress she would experience was inevitable.

Once in school, Antonia was relentlessly bullied and tormented by her classmates because of her cleft lip. Often, Antonia would come home from school in tears, telling her mother that she no longer wanted to study. The terrible names she was called were too painful and persistent to endure.

It wasn't until Antonia was 8 years old that her aunt, Leidinha, intervened and finally persuaded Iranildo to take Antonia to Fortaleza for a chance to receive free, safe surgery from Operation Smile Brazil.

To this day, Antonia calls Leidinha “an angel.”

Although Antonia was frightened to travel without her mother, who had to stay behind to care for her younger siblings, she bravely made the more than 3-hour bus ride to the Fortaleza program site with her father and aunt.

At the hospital, Antonia remembers playing with the other waiting children. For many patients who arrive for screening, it's the first time in their lives seeing another person with their same condition. They realize that they aren't alone.

After Antonia's comprehensive health evaluation, Operation Smile Brazil medical volunteers determined that she was healthy enough to undergo anesthesia for her cleft surgery.

For Iranildo, the day he'd hoped for had finally arrived, and he felt immense relief to know that he'd kept the promise he'd made to Antonia many years before.

Still too young to understand the life-changing effects of the surgery she would soon receive, Antonia cried as the doctors took her into the operating room, as she didn’t understand why her father couldn’t come with her.

Iranildo soothed his daughter's fears by explaining that he and Leidinha would be there waiting for her.

Iranildo couldn’t believe his eyes when he saw his daughter for the first time after her successful surgery.

“Antonia was the most beautiful child in the world,” Iranildo said. “The other children (who had surgery) were pretty, but she was the most beautiful.”

Antonia remembers waking up from anesthesia and noticing that her face felt different and her lip was sore.

In that moment, all Antonia wanted most was to return home to the loving embrace of her mother. Once reunited, Antonia’s mother cried tears of joy when she saw her daughter’s new smile. 

Antonia's parents decided it was best to wait for her to return to school until her lip had healed fully.

The day finally came for Antonia to face the children who had once tormented her.

Her teacher gathered her classmates together and asked them: “Have you seen Antonia? Look at her now – she has had surgery and see how beautiful she is.”

The teacher went on to explain to the class that Antonia had always been beautiful and that she had always been just like them – that any of them could have been born with a cleft lip and that Antonia never chose to be born with her condition.

From that moment on, the bullying ceased and Antonia made many new friends and enjoyed social life as she continued her studies. 

Meanwhile, her surgical result and photogenic nature grabbed the attention of a well-known toothpaste brand.

Antonia – the girl who was once relentlessly tormented – became the face of a nationwide advertising campaign in Brazil.

Years after receiving her new smile, Antonia visited an Operation Smile Brazil program to Fortaleza.

It was there that she helped nurture children and their parents by talking to them about her cleft care journey, hoping to ease their fears about surgery.

She showed them a photo of her smile before her operation as Antonia stood before them, serving as living proof of Operation Smile’s life-changing work.

Antonia said the experience brought back powerful memories and that helping the parents and children brought her immense joy.

“If it was not for Operation Smile, I wouldn't be here telling my story,” said Antonia, who hopes to one day become a doctor or nurse to help children like herself. “Thank you for bringing back my happiness.”

Our promise of improving health and dignity during the COVID-19 pandemic endures. Once again, we’re providing surgery and in-person care while taking stringent measures to keep families safe. Hope is on the horizon. And we remain focused on what cleft care makes possible for children, helping them to better breathe, eat, speak and live with confidence.