A Columbia doctor is making an effort to repair cleft lips around the world.

Although more children are born with cleft lips or cleft palates in the United States than in Africa, fewer African children undergo surgery to repair them. This is because many families have to choose between surgery or food.

The situation is enough to make anyone frown, not to mention being born unable to smile.

It's a piece of equipment essential to any basketball game, but it's not a hoop or a ball.

"Smiling is really important to me because it always makes me feel happy, " said third-grade student Arriana Fowler.

"When you're down in the dumps and feel all bad, if you smile you get your self esteem back up, " said third-grade student Kim Hildebrand.

In the physical education class at Rock Bridge elementary, kids exchange grins with each bounce pass. But for some children in Africa, smiling isn't in the playbook.

"Cleft lip and cleft palate is not a life threatening condition so when it comes to having surgery or putting food on the table, some of these things may get slighted a bit," said facial plastic surgeon Dr. David Chang.

"It's something you can't possibly hide because it's there on your face," said Dr. Chang.

Dr.Chang volunteers his time in Kenya each year to surgically repair cleft lips and cleft palates, a condition where the lip or roof of the mouth doesn't form properly in the womb. Those with the condition can't drink from a cup, and many can't even smile.

"These children are abandoned or sent to orphanages," said Chang.

Thanks to support from organizations like Samaritan's Purse and Smile Train, Dr. Chang's team transformed the lives of more 95 people.

Surgeries give patients the ability to communicate happiness, even in Swahili.

"Where you really see it is in the eyes of the parents," said Chang.

"A smile is like a long list of reasons to be happy in the world but even if you don't have one you can still feel happy on the inside," said Fowler.

"A smile is as wonderful as a butterfly flying through the air," said Hildebrand.

Smiles fellow grinners hope Dr. Chang can continue to pass on.