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Paediatric cardiac assistance in developing and transitional countries: the impact of a fourteen year effort*

Published online by Cambridge University Press:  01 June 2008

William M. Novick*
Affiliation:
Department of Surgery and, University of Tennessee Health Sciences Centre, Memphis, Tennessee, United States of America Department of Pediatrics, University of Tennessee Health Sciences Centre, Memphis, Tennessee, United States of America International Children’s Heart Foundation, Memphis, Tennessee, United States of America
Gregory L. Stidham
Affiliation:
Department of Pediatrics, University of Tennessee Health Sciences Centre, Memphis, Tennessee, United States of America International Children’s Heart Foundation, Memphis, Tennessee, United States of America
Tom R. Karl
Affiliation:
Division of Pediatric Cardiothoracic Surgery, University of California-San Francisco, United States of America International Children’s Heart Foundation, Memphis, Tennessee, United States of America
Robert Arnold
Affiliation:
Division of Pediatric Cardiology, Alder Hey Children’s Hospital, Liverpool, United Kingdom International Children’s Heart Foundation, Memphis, Tennessee, United States of America
Darko Anić
Affiliation:
Department of Cardiac Surgery, KBC-Rijeka, Croatia International Children’s Heart Foundation, Memphis, Tennessee, United States of America
Sri O. Rao
Affiliation:
International Children’s Heart Foundation, Memphis, Tennessee, United States of America
Victor C. Baum
Affiliation:
Departments of Anesthesia, Pediatrics and the Cardiovascular Research Centre, University of Virginia, Charlottesville, Virginia, United States of America International Children’s Heart Foundation, Memphis, Tennessee, United States of America
Kathleen E. Fenton
Affiliation:
International Children’s Heart Foundation, Memphis, Tennessee, United States of America
Thomas G. Di Sessa
Affiliation:
Department of Pediatrics, University of Kentucky, Lexington, Kentucky, United States of America International Children’s Heart Foundation, Memphis, Tennessee, United States of America
*
Correspondence to: William M. Novick, University of Tennessee Health Sciences Centre, 1750 Madison Avenue, Suite 100, Memphis, TN 38104, USA. Tel: (1)-901 869 4243; Fax: (1) 901 432 4243; E-mail: ichfno@aol.com

Abstract

Background

Paediatric cardiac services are poorly developed or totally absent in underdeveloped countries. Institutions, foundations and interested individuals in those nations in which sophisticated paediatric cardiac surgery is practised have the ability to alleviate this problem by sponsoring paediatric cardio-surgical missions to provide care, and train local caregivers in developing, transitional, and third world countries. The ultimate benefit of such a programme is to improve the surgical abilities of the host institution. The purpose of this report is to present the impact of our programme over a period of 14 years.

Methods

We specifically reviewed our database of patients from our missions, our team lists, surgical results, and the number and type of personnel trained in the institutions that we have assisted. In order for the institution to be entered into the study, the foundation had to provide at least 2 months of training. In addition, the institution had to respond to a simple questionnaire concerning the number and types of surgery performed at their facility before and after intervention by the foundation.

Results

We made 140 trips to 27 institutions in 19 countries, with 12 of the visited institutions qualifying for inclusion. Of these, 9 institutions reported an increase in the number and complexity of cases currently being performed in their facility since the team intervened. This goal had not been accomplished in 3 institutions. The reasons for failure included the economic situation of the country, hospital and national politics, personality conflicts, and continued lack of hardware and disposables.

Conclusions

Paediatric cardiac service assistance can improve local services. A significant commitment is required by all parties involved.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2008

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Footnotes

*

The presentation on which this work is based was given at the Inaugural Meeting of the World Society for Pediatric and Congenital Heart Surgery, held in Washington, District of Columbia, May 3 and 4, 2007

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