In 1987, a young cardiothoracic surgeon in London got a lesson about the entrepreneurial state of his profession. He discovered that certain London clinics were charging exorbitant fees to perform heart surgery on desperately ill children from the Middle East. The families of these youngsters had sold everything they owned and borrowed from friends and neighbors in order to bring their sons and daughters to London where they could have lifesaving operations. What disappointed the young physician was that many of the surgeries were fairly simple procedures, which could be performed by senior surgical residents in many hospitals. Instead, the families were paying upward of 35,000 pounds for these three-hour procedures.
In an interview last week, that surgeon said, “It was sickening. As physicians we are charged with a responsibility to do no harm. But how much harm was being done to those families? The practice of medicine is not supposed to be run as some sort of normal trading business. A clinic is not a retail shop where the standard profit/loss model applies.”
Determined to do something to help needy children worldwide, in 1994 an organization called CardioStart International was born. CardioStart is an international, charitable, non-profit, humanitarian medical organization dedicated to providing free heart surgery and other medical support to children and adults living in underserved areas of the world. It comprises volunteer medical and non-medical staff located throughout the UK, the USA, Canada, Central America and Asia.
CardioStart provides free open-heart surgery to children and adults, irrespective of their financial means. It coordinates surgeons, anesthesiologists, cardiologists, nursing professionals, nutrition experts and technical personnel for each mission. Importantly, CardioStart makes its missions more than one-off exercises. In addition to performing immediate lifesaving procedures, the organization establishes new cardiac surgery units where none exist and assists established centers lacking adequate facilities or experienced staff. The group donates equipment and medical supplies to keep cardiac centers running and offers continuing education and support to units being deployed.
Since its inception in 1994, CardioStart has conducted over 326 successful open-heart operations and helped establish seven new heart surgery and intensive care units. They have assisted in the initiation or development of 16 medical programs in nations such as Albania, Bolivia, Egypt, Haiti, Iraq, Jordan, Nicaragua, Pakistan, Peru and Ukraine.
“We have done open-heart surgery under some of the most challenging conditions, turning places that seem little better than huts into operating theaters,” explained Dr. Aubyn Marath, CardioStart president and founder. “We make up for the lack of facilities by having the procedures performed by skilled, dedicated staff, monitoring patients closely and using modern antibiotics to control infection. Since the majority of our patients have never been exposed to antibiotics before, the drugs work surprisingly well, without infection being very evident. In 328 surgeries we have had only two deaths, neither one as a direct result of the patient’s surgery. The first death was caused by the negative affect of a medication on a patient and in the second case a power failure caused an equipment failure. Although the numbers of surgeries are small, our surgical success rate has approached that of major world cardiac centers.”
CardioStart plans four medical missions yearly. Its most recent mission was in March 2001. At that time 18 CardioStart volunteers used their skills to help children in the town of Vinnitsa, which is located in Ukraine, 400 miles south of Chernobyl. In addition to performing surgery and setting up a heart surgery unit at the children’s hospital there, CardioStart volunteers also worked to improve the lives of the youngsters in the town’s orphanage.
“While the primary purpose of CardioStart is to improve health care, there are underprivileged children in every city we visit who are in need of other forms of assistance,” CardioStart’s president said. “So on every trip we help a local orphanage improve the quality of life for the children in its care. On our trip to Ukraine, four British plumbers came with us and installed running water and sanitary facilities in the local orphanage. The facility had been operational for 150 years and had been modernized only in very limited ways. The 80 orphans living there had never seen flush toilets before. In the winter they had to go outside in the snow to a hut located about 100 meters from the main building and relieve themselves in a hole in the ground.”
How does CardioStart know what to bring on its missions? An advance team visits the proposed city months before the medical team is scheduled to arrive. They liaise with government officials, hospitals, medical practitioners and community leaders to learn how they can best be of assistance. Upon its return, the advance team makes a detailed report and then the required supplies and equipment are gathered and shipped in a massive freight container. The container usually arrives slightly before the full medical team flies in. Most of the supplies and equipment in the container are donated by private companies and hospitals in the United States.
“The contents of the containers are often a very odd assortment of things and that surprises people,” said Dr. Marath with a laugh. “People expect to see us unloading transfusion equipment and bandages but then they find that perhaps we’re pulling out filing cabinets and boxes of pens and they get confused. People forget that nurses need to record notes on charts. That’s not possible if there’s nothing to write with. And how can a hospital keep its records straight if there are no filing cabinets? All these items are necessary. The countries we visit have very low national health care budgets. If they spend money on equipment then perhaps they can’t afford medication. It’s terrible for a hospital to have to choose between an X-ray machine and antibiotics. Every piece of equipment we bring gives a boost to the health care resources of a cash-strapped Third World country.”
Dr. Marath is currently the acting chief of surgery and the director of Cardiothoracic Surgery at Saad Specialist Hospital in Alkhobar. Based as he is in Saudi Arabia, the president of CardioStart has been exposed in detail, through media and first-hand reports, to the true horror of the violence in the Occupied Territories. In light of this, he has worked to send CardioStart volunteers on a mission to Palestine. They will be reaching there on Aug. 31. The medical mission will be composed of five doctors, six nurses, two respiratory therapists and two perfusionists. The volunteers are from the UK, USA and New Zealand. They will be dividing their time between the Shifa and Ramallah hospitals. The team hopes to perform 20 open-heart surgeries during the two weeks of their stay. The medical mission has been arranged in cooperation with the Palestinian Authority’s Ministry of Health.
Due to the high level of violence in the Occupied Territories, an advance team has been unable to put together the usual site survey before the group’s arrival. Consequently, in addition to performing surgery, the medical team will be collecting data and conducting interviews to determine the area’s most pressing needs. After the medical mission’s conclusion, their report will be forwarded to the CardioStart warehouse facilities in Tampa, Florida, and several other warehouses throughout the United States. Then equipment and supplies will be gathered and shipped to the Palestinian Ministry of Health for distribution.
“It is true that volunteers who choose to go to regions of conflict are at risk, and do require substantial courage to confront the true nature and extent of the problems faced by the poor,” said Dr. Marath. “But who are the recipients of our aid and services? They are people, like us. They have been marginalized, dispossessed and their family structure is becoming chronically traumatized and dismembered. Year after year these ordinary people have had to endure the violence, disruption and deprivation of some of the simplest amenities — entirely without choice. In choosing to visit Palestine we are offering support to hospital colleagues and patients at a time when they are most vulnerable and in need of assistance. Rejecting this mission would mean turning our backs on the life the Palestinians have to face and endure each day and committing them to a deteriorating and uncertain fate. That we will not do.”
Learn more about CardioStart at their website, cardiostart.com, and follow the activities of the group’s trip to Palestine through reports carried in Arab News.
