Brian Mullaney has an unusual background for someone who is responsible for hundreds of thousands of life-changing surgeries. He's not a doctor - he was an advertising executive. But his 16 years of corporate experience served him well when he sold his advertising business and launched a second career calling attention to a problem that had become his passion.

A child with a cleft in Kabul, Afghanistan. More than 25,000 children in Afghanistan are living with unrepaired clefts

"A cleft lip or cleft palate's a hole in the lip and/or a hole in the roof of the mouth," he explains. "And in most developing countries, it's the No. 1 birth defect."

Many people in developing countries consider clefts to be a curse, Mullaney says. Babies who are born with clefts sometimes are abandoned or killed. Children with clefts lead lives of shame and isolation.

"So they can't go to school. They can't get a job. They can't speak properly. They can't eat properly," Mullaney says. "It's just really a horrible existence for these kids, and it's just so tragic because a simple, 45-minute surgery could change their entire life."

Finding a better way to treat clefts

Brian Mullaney, co-founder and president of The Smile Train, holds a cleft patient in Kabul, Afghanistan during a 2007 visit

In the 1990s, Mullaney volunteered for medical missions, traveling with American doctors to China, Vietnam and Gaza City.

Watching them transform lives with simple surgeries was a powerful experience, Mullaney says, but the one-to-two week trips were always bittersweet.

"…Inevitably, at every mission, three, four, 500 children would show up, and we only had room to save 100 or 150. So you have to turn away these mothers who had carried their baby on their back through the jungle for two weeks and say, 'I'm sorry, we don't have room on the schedule.' It was just horrible."

Mullaney with children in a village in rural Bangladesh in 2006

Mullaney felt that if he could train doctors in developing countries to do the surgeries themselves, many more children could be helped, at a fraction of the cost of sending medical missions from the United States. That was the genesis of The Smile Train.

"So we come in and we give some financial support and a little training and a little equipment, and we can help doctors who are very qualified and willing and able, who want to help their kids, and we can scale them up from doing 10 or 25 surgeries a year to doing 100 or 500 or even more."

Working with doctors in 76 countries, The Smile Train now oversees more than 100,000 surgeries each year.

Smile, Pinki

Three years ago, The Smile Train asked award-winning filmmaker Megan Mylan to make a documentary highlighting the organization's work.

Mullaney - posing with Pinki, a girl from rural India whose cleft surgery was the subject of Megan Mylan's documentary film - holds the Oscar for Best Documentary Short

"I come to filmmaking from a social-change background, and I like to tell stories that motivate an audience to feel that they can make a difference in the world…" she says.

The film follows Pinki, a girl from rural India with a cleft, who is discovered by a social worker and receives surgery to fix her lip, enabling her to attend school.

The film, called Smile Pinki, won an Oscar for Best Documentary Short at the 2009 Academy Awards. The effect of the win on The Smile Train was immediate, Mullaney says.

"We've seen a huge increase in the inquiries to our charity and to the donations and traffic to our Web site, and we're working hard trying to leverage this Oscar that we won into millions of smiles around the world."

Goal: Eliminate clefts

The extra attention comes as Mullaney's organization prepares to reach an historic milestone.

Mullaney with children in northern Uganda in 2005

"In China and India, they each have 35,000 new cleft babies born every year. And this year, for the first time, we will perform more surgeries on kids with clefts than new babies are being born. We'll do 40,000 surgeries in China, 50,000 in India. So in two of the world's largest countries, next year there'll be less clefts than there were the year before, which has never happened."

As The Smile Train celebrates its 10th anniversary, Mullaney says his goal is to eliminate clefts within five years by providing surgery to all children currently living with cleft lips or palates and setting up a network so babies can receive treatment soon after they are born.

Mullaney says someday he hopes to take the lessons he has learned with The Smile Train and use them to solve other medical conditions - such as club foot or some congenital heart defects. Those problems can be treated cheaply and effectively, thereby improving the lives of thousands more children around the world.

That, he says, would give him something to smile about.