September 2007

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Networking Central

Save A Child's Heart
Improving pediatric cardiac care in Israel and around the world.

-- David Litwack 

Faki Khamis from Zanzibar could barely stand or walk when he arrived.

Mamush, an orphan from Ethiopia with a serious heart defect, could not speak and seemed developmentally delayed when he arrived.

Janan, from Iraq, was born with a large hole between the two chambers of her heart, making her appear blue around the lips and nails.

More than one thousand children from around the world – children who speak Chinese, Swahili, Russian, Arabic, French and Spanish have learned to say todah rabah ("thank you" in Hebrew). Like Faki, Mamush and Janan, they are children fortunate enough to have had their hearts repaired by Save a Child's Heart (SACH) since 1995, when the organization was started. The children come from China, Ethiopia, Ecuador, Eritrea, Ghana, Nigeria, Vietnam, Congo, Zanzibar, Zimbabwe, Moldova, Ukraine, Russia, Jordan, Gaza, Judea-Samaria, Iraq and elsewhere around the world.

Chinese child in post-op after cardiac surgery provided by Save A Child's Heart.

Each was brought to the pediatric cardiac ward of Wolfson Medical Center (WMC) in Holon, Israel. Some were newborns; others old enough to have suffered from the terrible symptoms of juvenile cardiac disease -- a blue tint in their faces and finger tips, shortness of breath, terrible weakness and stunted growth. Lifesaving surgery performed by the dedicated SACH team of Israeli volunteer doctors and nurses gave them a chance to lead normal and healthy lives.

Three weeks after surgery, Faki was able to run and even play soccer. After two operations, Mamush spoke fluent Amharic and even spouted off a little Hebrew. Janan returned home to Baghdad completely cured after catheterization and surgery by the SACH team.

In addition to these children, a special volunteer cardiology clinic run by SACH has treated hundreds of Palestinian children, often performing minute surgical procedures on babies a day or two old. These children and their families, whose experience in Israel has been warm and caring, become important ambassadors for peace when they return home.

As dramatic as these recoveries are, they seem even more so because they take place far away from home, and usually without the company of parents and family. Usually, children are screened by SACH medical staff in their home countries. Then, they are brought as a small group to Holon for surgery. Children above the age of three are accompanied by a nurse or escort from their home country, while a parent accompanies the youngest children. A group’s average stay in Israel is three months, during which time the children undergo medical tests, surgery and recovery. Many of the children have no communication at all with their families, who live in isolated areas with no telephone access.

Vasily Pahomi

To some people, the word "no" is just not an option. Because his mother refused to accept "no" as an answer, a little boy in Moldova is alive today. Vasily Pahomi was examined for the first time in 1996 when the SACH team held its first preoperative clinic in Moldova, examining children with heart defects. Although he was only a few months old, his condition was quite advanced and SACH could not take the risk of flying such a young, sick child so long a distance. As difficult as it was, we informed Vasily’s mother that we would be unable to care for him.

Fortunately for Vasily, his mother did not accept that. She returned home and sold her farm in order to pay for the airfare to go to Israel. To this day we do not know how she did it. One afternoon she turned up at our door with her five-month-old baby in her arms and made it clear to us in a language none of us understood that we were going to make her baby well again! And that is exactly what we did.

Initially we conducted a palliative procedure. A shunt to facilitate the flow of blood was placed between Vasily’s heart and lungs. The results were positive and immediate. Vasily’s skin turned to a normal pink instead of the light blue his mother thought was normal. We stayed in touch with the local doctor handling these cases and at the age of two, Vasily arrived in Israel for a definitive operation. He returned to Kishniev, his hometown, a healthy child. It is ironic that Vasily’s mother, who did not know the difference between an auricle and a ventricle was a primary figure in keeping her son alive.

For the children and their parents the "journey" to a new life can be long and fraught with worry. That is why SACH makes such a great effort to provide as warm and supportive an environment as possible. The three-story SACH residence, in a neighborhood near the hospital, is run by a housemother and staffed by dozens of volunteers from around the world. The home is outfitted with colorful, child-friendly furniture, a computer, a television and lots of toys to keep the children busy while they await surgery and then recuperate. The nurturing offered at the SACH home is an important element of recovery.

One obstacle toward reaching the goal of saving more lives is limited space in the hospital. The current Pediatric Intensive Care Unit at the WMC offers just six beds, one isolation unit and four intermediate beds. Built and equipped in 1994, the unit does not meet the growing need. The unit was designed to handle open-heart surgery for 150 children annually. Lately the unit has been overloaded, and occasionally patients must be transferred to the adult intensive care unit to make room for new patients. Next to the Pediatric Intensive Care Unit, the hospital has a room designated for the parents of the children admitted to the unit. However, the room lacks the basics that SACH believes should be available to parents who come with their children.

A major part of SACH’s mission is its comprehensive outreach program to train medical personnel from partner sites in developing countries. SACH brings doctors and nurses to Israel to study for periods of three months to three years, and has also arranged post-graduate training fellowships for doctors with partner hospitals overseas. In conjunction with the Sackler School of Medicine and often under the sponsorship of the Israel Ministry of Foreign Affairs, SACH’s in-hospital teaching program has trained dozens of physicians and nurses from China, Ethiopia, Eritrea, Moldova, Nigeria, Gaza, Judea-Samaria, and Zanzibar. Fellowships have been offered in anesthesiology, pediatric cardiac surgery, pediatric cardiology and pediatric intensive care.

SACH training is not only carried out in Israel. Its outreach program sends SACH teams of pediatric cardiologists, ICU specialists and surgeons to developing countries, where they conduct screening and surgical missions and also provide on-site training. SACH staff conducts annual missions to partner communities in China, Ethiopia, Eritrea, Mauritania, Nigeria, Zanzibar and Russia. Local medical personnel work with the SACH staff as they examine children -- screening them for candidacy for operations in Israel -- or conduct surgery on-site.

An average screening mission sees 200 children in five days. Since its inception, SACH has evaluated more than 4,000 children throughout the world. During their stay, the SACH team members lecture on advancements in pediatric cardiology, give courses in Pediatric Advanced Life Support, and raise awareness in order to prevent congenital and acquired pediatric heart disease.

SACH’s ultimate goal is to create high quality independent medical centers in developing countries. By working with local physicians and health officials in partner countries during annual screening and surgical missions, SACH seeks to ensure a higher level of medical care for children in developing countries throughout the world.

In fact, SACH has made significant progress in helping its partner sites achieve improved levels of pediatric medicine. One partner, Hebei Children's Hospital in China, stands out as having made enormous strides, and SACH personnel see progress on every consecutive visit. Chinese medical personnel trained by SACH on-site and in Israel, working together with SACH personnel, have conducted surgeries and catheterizations on 80 children in Hebei and Lanzhou over the course of six successful surgical missions, and have significantly increased their surgical skills. Moreover, since working with SACH, the Chinese partner hospitals have significantly upgraded their medical facilities.

SACH is making a significant impact at other partner sites as well. For instance, when SACH began working in Ethiopia, there was only one pediatric cardiologist for a population of 55 million people. SACH has trained a second pediatric cardiologist there. In addition, SACH activity has significantly improved the level of pediatric care in Zanzibar and Nigeria, raising their level of awareness and leading them to invest in their medical infrastructure. SACH facilitated the eventual purchase of echocardiography machines in both locations. SACH has helped several of its partners establish clinics to follow-up postoperative children and dispense medicine.

For more information about SACH or to support their lifesaving mission, visit their website, or contact David Litwack, Executive Director, 301-785-0720, or davelitwack@cs.com.

Past Networking Central Groups of the Month

In this section, we highlight a new local group each month in order to encourage networking.

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