The Lifebox-Smile Train Safe Surgery and Anesthesia Initiative addresses critical gaps in pediatric surgical care across Sub-Saharan Africa, where a lack of trained personnel, inadequate infrastructure, and limited access to essential medical technologies put millions of children at risk. By equipping hospitals with vital tools such as pulse oximeters and capnographs and providing specialized training for surgical teams, the initiative enhances the safety and quality of pediatric cleft and general surgery. With a holistic approach that includes teamwork, communication, and infection prevention, the program strengthens surgical systems and builds local capacity, ensuring long-term improvements in healthcare. Through this effort, children across Africa gain access to safer, higher-quality surgical care, improving overall health outcomes.