“When I was a girl, the oath we took said – in part – ‘May fire rain down on America’. I didn’t want to say it. I’d lived in America and had friends there. I was nine, so the teachers let it slide. They didn’t believe it either. Had I been in high school I would have been punished.” Madia, an anesthesiologist resident told me. She continued to talk about the revolution, her eyes coming alive, “It was the best time of our lives! There was such solidarity. We all came together.”
Now the US – along with France, Turkey, Qatar, and the UK – are considered friends of the revolution. The flags of the countries can be seen in the graffiti that covers nearly every vertical surface in the city. A careful student of 21st century American foreign policy might note that this in not always the case with the nations we try the ‘help’.
A hated tyrant was ousted, without invasion or intrusive nation building, and a loose group of put-upon citizens were able to take their country back. Libyans are grateful for the help, as well as, in the end, being allowed to drive their own revolution. And why not? People and societies must own their victories, or they aren’t really victories.
To that end, taking care of your own children is written into the operational model of the ICHF. Certainly the care for the children is a part of the mission, but the true endgame is creating a sustainable model for a pediatric cardiac unit that works: Writing protocols and technical training to international standards as well as working within the cultural framework of the host country. It is crucial distinction that separates the ICHF mission from the medical safaris. They no doubt to good work and save lives, but when they head back to their comfortable lives, no much more gets done. When ICHF volunteers head back to their comfortable lives, they know that they have left not only a mark, but that mark is part of building a sustainable solution.
The importance of this cannot be overstated – people must own their victories to get anything out of them: the systems must make sense the to the doctors and nurses and all the others who use them. They must take pride in it for it to work. Without pride and a sense of ownership of the many volunteers and supporters of the International Children’s Heart Foundation, it wouldn’t work either.
FREEDOM is spray painted, in English, on nearly every wall in Benghazi. It’s all over the walls in the countryside as well. The Arad world is very fond of walls, so that is a lot of spray paint. Arabic graffiti abounds, but some 40% of the slogans denouncing Gaddafi, screaming freedom and the hope that is the new Libya, are in English. On a drive out to the Biblical city of Cyrene, I asked a young man I’ll call Ahmed why the graffiti was in English.
“We want the broadcast our message, the new Libya, to the world – not just to the Arabs, but to the whole world.”
“I thought Gaddafi struck English from the school curriculum. Who can read it?”
He thought about this, “We learned.”
Ahmed is a pilot in training in Tripoli. He has an idea for an invention in the aerospace field and is learning English himself, not to spray paint on walls, but to go to the US or Canada to produce his invention. Libya is moving ahead, but not fast enough for him. “Do you plan to stay in the West?”
“No, I’ll bring it back to Libya.”
He is a young man and this entrepreneurial attitude is new among Libyans who left their country or dismissed it as hopeless during the Gaddafi regime. Since the revolution of 2011, hope and pride abounds. Pay for doctors has increased literally tenfold, to bring it to a level that is still not quite competitive, but the gap has narrowed. If the Libyan citizenry is still relatively poor, the country is rich. They can afford the new pay-grade and are investing in themselves. There is more to a first rate medical center than simply buying it. It is a matter of training, procedure and practice. For the ICHF, missions to places like Libya filled with the hope and desire to make the most of their resources are heartening. For Libyans, their world changed on February 17th, it opened up and a great many things suddenly became possible.
Hope may spring eternal, it may overcome all, but the fact of the matter is that it is very, very fragile. Freedom is not easy. Its most glorious aspect is also its most dangerous: it is exactly what you make of it. Libyan driving – bad by the lively standards of the Arab street – is a little too free, making it largely an exercise in faith and tightly calculated physics. In downtown Benghazi, shell blasted buildings still stand amid an alarming amount of the rubble. Libyans talk about a blooming tourism industry but to that they are going to need a broom. Still, the war damage is being repaired at an impressive rate for a nation that doesn’t have a permanent government.
There are those, few but out there, who are nostalgic for the old regime. They say that it was, if nothing else, stable. Which was true if you didn’t have political opinions or ambition. It is true that freedom is a messy affair. Churchill was right when he said that democracy was the worst form of government other than every thing else that’s been tried.
Self-determination is hard work when it’s old hat, when it’s is new it can be brutally traumatic. It leaves scars. It requires people to believe that a risky common goal can be achieved, and for everyone to do their part to make it happen.
The same can be said for open-heart surgery. You should see these once hopeless children immediately post-op. It is raw and aggravated and heart wrenching and just plain gruesome. Then consider the alternative.
It is always interesting to reckon what a child is thinking, but when the child has been born into a world utterly incomprehensible to the American child, the exercise gets really interesting.
As he is being transferred from the bed to the operating table, Mohammed is looking stoic and brave and very much a child who wants to make his father proud. I can only imagine that he does. But Mohammed, at eight years old, lived through a brutal civil war at about the same age that I was contemplating a career as Spiderman.
Libya is a country where hope is still so fragile that isn’t really given to flights of fancy. The parents know it, and as is always the case, the children know it too even if they can’t say why. But there is hope: the war is over now. For Mohammed, however, a danger lurks that is not from above but from inside. The boy has a hole in his heart.
His hopes, and those of his parents, are pinned on an Iranian-born Swiss surgeon, Dr. Ali Dodge-Khatami. He is performing the ASD closure in an operating theater that is better equipped than I was expecting. The issue in Benghazi is not one of equipment but of education and training, and that is why the ICHF has come. The Libyans know this and have sent staff from Tripoli to take part in the training.
In situations like these, there is always a mild dose of culture shock: in the scrub room the Libyan anesthesiologist kneels on a small rug, making his 5:00 prayers. The bypass machine to be used for the procedure is maneuvered quietly around him and into the theater. Mohammed’s chart has his nutritional status listed as “Normal” but from across the room nearly every rib in his chest can be counted. And he is. An American who could once believe that he’d have spidey-senses can afford to get fat, but this is a different world.
What he thought, as he woke in the long quiet of the night shift, was “Is the surgery over yet?” Those were the first words he uttered to his mother and veteran ICHF volunteer Andrea Hiebert. It was over, and it was a success. He’d be sore, but was well. He went back to sleep.
What then, did the boy think when he awoke to the handover from night shift to day, drifting out of a groggy sleep to find a dozen doctors and nurses from around looking, smiling and chatting away in a incomprehensible babble? Were they discussing him? They are friendly faces, ones that – so his mother says – are telling him that he is well now, he will live and play soccer and, if the mood hits, can consider a career as a superhero as long as he has a sensible backup plan.
I took his picture, and with now prompting gave me a thumbs up. I think we understood each other. He walked out of the ICU a few hours later on his own. He has hope and a realistic one at that.
ICHF was in Sulimaniyah, Iraq in August performing heart surgeries on children — part of the Remedy Mission in conjunction with the Preemptive Love Coalition. While Dr William Novick was operating, photographer Jon Vidar captured this image of surgery as reflected in a heart monitor machine. The photo received the People’s Choice Award at FotoWeekDC 2010!
Congratulations to Jon Vidar (http://www.jonvidarphotography.com) for capturing some of what our medical teams do in the field!
ICHF will be traveling back to Iraq December 4-18 to operate on more children. It is estimated that there are more than 4,000 children in Iraq waiting for life-saving surgery. Worldwide, more than 1,000,000 children are born each year with a heart defect — making this the number one birth defect globally.
ICHF strives to go to poor countries to operate on children suffering from the world’s #1 birth defect – Congenital Heart Defects. But, ICHF is also committed to helping each country build its own self-sustaining pediatric cardiac care/surgery program over time. The words below are from medical volunteer, Barry Markovitz, MD.
As a pediatric intensivist, I wanted to do volunteer medical work for a long time, but never came across an opportunity to practice my skills, the only thing I know – pediatric critical care – until I learned about ICHF. My true passion is pediatric cardiac critical care, and when I found ICHF, I jumped. Big time. This organization has accomplished so much, in so many disparate places, it boggles the mind.
The sights, smells, and sounds of a medical mission trip are like no other. And, it only takes experiencing one of these medical trips to scratch the surface of understanding the dedication that the medical volunteers have for this cause.
June 29th in Maceio, Brazil was a typical day. The “day shift” left the hotel by 7am for a full day of surgery and recovery. This particular trip is comprised of 15 medical staff plus several interns and guests. This list includes people from all over the USA (NE, TN, IN, LA, GA, CA, MI, etc), United Kingdom, and Venezuela. Only 2 of those on the medical staff are full-time employees of the International Children’s Heart Foundation – the rest are taking vacation time to volunteer to operate on the children in this poorest region of Northeast Brazil.
The day included two surgeries and the surgical team didn’t return to the hotel until almost 9pm. These 14 hour day are not uncommon at all on ICHF trips. In the ICU there are about 6 kids at any given time. The good news is that the Operating Room and the ICU are air-conditioned. The children are taken to the OR by their parents just as in the USA. The medical team gets ready in a space about as big as a closet. One of the ORs is very tiny and some of the local equipment leaves a lot to be desired. Unfortunately our entire shipment of equipment and supplies is still being held up at customs in Sao Paulo.
The dedication factor hits me in many areas of the hospital but particularly in the Operating Room. The various physicians, nurses, perfusionist, etc. are on their feet the entire day with very little rest in between cases. The concentration to perform heart surgery on tiny babies is intense. Every once in a while the mood is light, but for the most part things are very serious in the room.
Then it hit me….most of these medical experts are donating their vacation time to travel across the globe to share their expertise to save children who might otherwise die. D E D I C A T I O N. And, the medical staff that are employees of ICHF are also sacrificing incredibly to dedicate their lives to ICHF and saving children. Their sacrifice is beyond comprehension. They could be making much more money in the USA. And when they are back in the USA between trips they are still working long days to organize the next trips, raise funds, write medical papers, etc. It is truly incredible to realize what all of these people are sacrificing to provide this humanitarian service worldwide. These are Moms and Dads, uncles and aunts, brothers and sisters travelling to strange lands, leaving their families to work in less than desirable conditions – all for the greater good of the world.
Outside the Operating Room there are physicians and nurses working in the ICU with the children who have completed surgery. Every team member is a critical link in the chain to make sure the children are able to return home healthy. There are tense moments in the ICU as some children hit bumps in the road as they recover. Some of these medical volunteers work 12 hour shifts and others work 24 hour shifts. It seems like someone is always coming and going from the hotel.
One of the most interesting areas of this hospital is the pediatric ward where the patients go after surgery. One large room with old metal beds and cribs where the patients recover. Windows are open because there is no air-conditioning in this part of the hospital. The hot, sticky air causes everyone to sweat as they sit there. This area is on the top floor of the hospital where the heat rises and makes the muggy room practically unbearable. Children cry and parents linger by the bedsides of their children. At night many of the parents have nowhere else to go so they sleep on the hard floor. Thankfully, one of the guests on this trip has purchased three air-conditioning units and we have arranged to have them installed before we leave.
DEDICATION – there is no other word to describe the sacrifices given by our medical staff and volunteers!
WATCH VIDEO FROM THE OPERATING ROOM VID00039
Pictures from Brazil:
From May 8th through May 22nd, ICHF has a medical team in Kharkiv (or Kharkov), Ukraine. Kharkiv is the 2nd largest city in Ukraine. The city is located in the northeast of the country. As of 2006, its population is 1,461,300. Every year, 6000 children are born in Ukraine with genetic heart diseases. Only will half will receive the surgeries that they need to survive, and will die. (Info from our partner, Chernobyl Children’s Project).
Some pictures and stories (Thanks to Frank Molloy of ICHF and Caroline Lonsdale, Volunteer)….
This is Natalie – age 24 – she was operated on Thursday 13th of May – the fourth day – of the 8th Mission of ICHF to Kharkiv. Interviewed Friday 14th May
When I met her on friday morning she slightly surprised me by speaking reasonably fluent English – she called me over in english – at this time she still had most of her tubes and wires in place – “Is my operation over, was I good?” – she was at this time less than 24 hours after her surgery “you have golden hands” she told me – a message I think to the whole team – she was hot and uncomfortable and I helped her sit up and sponged her back with a cold flannel -
She asked and I told her that today we would be taking out all her tubes – not to worry – and that she would have some medicine to make her a little sleepy and pain free while we did that , we did that – and she slept off the medication for a few hours – and then I took this photo..
Natalie is 24 – pictured with her sister Dina – 26 – Natalie was born with an abnormal Aortic Valve which had become leaky and was in need of replacing. The defect had been diagnosed 2 weeks after birth – so Natalie knew she had a heart problem all her life – with this type of defect the usual plan is to wait as long as possible before any surgery – as the natural valve can still function well for many years. Natalie told me how in recent years she had become increasingly tired and sweaty and get a headache with any exertion- she also described how her hands and feet would swell up and she described them as “ugly” – she likes to swim, and do disco dancing but could not do this as much as she wanted to in recent years. When asked what she was most looking forward to in life now – she said (through her sister Dina whose English was better than Natalies’ ) she wants to satisfy her soul, be pretty – get a husband and have children . Natalie and her sister both work as sales managers – which they described as “not hard work’ meaning physically she could manage that type of work with her heart problem.
She has a yellow and red cat – likes reading, swimming in the Black sea – likes driving a car and wishes someday to drive a motor boat, a popular pastime on the black sea by Odesa.
Natalie was very tired at the time of this picture – she wanted to leave the ICU and go back to her room – because she could not sleep here – her oxygen tube had been recently taken off her and if her oxygen levels stayed OK I told her she would for sure be able to leave in the next hours or two – I also told her that – subject to her surgeon Olga ( the local chief cardiac surgeon) she would probably be able to go home on Monday. Natalie was very surprised at this – and I followed up by asking what she was most looking forward to when she got home – “Drinking lots of cold water-” she said (fluid restriction after cardiac surgery makes many patients feel very thirsty) – she then looked away from me – grimaced – I thought she was going to laugh but she started crying , wiped her eyes – and said that the other thing she was most looking forward to was holding her mother, and her brother.
Some of the other patients include:
Kamila Cherkasova – 25 days old. Double outlet right ventricle. Right BT shunt performed. Kamila has been sick, but is getting slowly better. Remains in ICU, but is not on a ventilator.
Elina Lemoschenco – 1 year old. Patent ductus arteriosus. Elina had a PDA ligation, did very well. Discharged from ICU the following day.
Tatyana Golubkova – 17 years old. Aorto-atrial fistula and PFO. Tatyana had this repaired, extubated quickly and discharged from ICU the following day.
Achkason Bogdam – 16 months old. VSD closure. Extubated quickly and doing well.
Tatyana Lazazova – 3 years old. PDA ligation. Extubated quickly, and doing well.
Angelica Kurligina. 17 years old. Atrial septal defect repair, also found to have total venous anomalous drainage in OR (suspected by our cardiologist) which was also repaired. Angelina was extubated within 20 minutes of arrival in ICU. Discharged to the ward the next day.
Julia Kostomarova: 4months old. Tetralogy of Fallot with patent foreman ovale. Complete repair done. Extubated the following day. Remains in ICU at present with heart rhythm issues, but doing well.
Kristina Terehova: 4 years old. Tetalogy of Fallot with right pulmonary artery stenosis, who had had a previous BT shunt (not sure where) – Repaired. Extubated an hour after arrival in ICU. Should go to ward later this afternoon.
Dima Grudina: 2.5 years old. Atrial septal defect. Repaired. Extubated a couple of hours after arrival in ICU. Walked to the ward the next day.
Here is a great example of a recap of one of our 33 annual trips. These are real kids…just like your kids or kids you know! These are real parents who are worried sick about the future for their children suffering from life-threatening heart defects. Please take a moment to check this out by clicking below here: Honduras Trip Recap
The International Children’s Heart Foundation (ICHF) is pleased that you are visiting our Blog! This will be a great way for you to keep up-to-date with all the exciting developments occurring around the world with and through ICHF.
ICHF is a 501(c)(3) headquartered in Memphis, TN. The mission of ICHF is to bring the skills, technology and knowledge to cure and care for children with congenital heart disease to developing countries. ICHF does this regardless of country of origin, race, religion or gender. We travel to these countries with a complete medical team and provide surgeries to the children for free. We also train the local medical professionals to perform these surgeries on their own eventually.
This fiscal year we have 33 two-week trips planned around the globe in countries including: Honduras, Dominican Republic, Nicaragua, Colombia, Ecuador, Brazil, Ukraine, Belarus, Russia, Egypt, India, China, and the Philippines. We are on pace to provide life-saving heart surgeries to more than 800 children around the globe! On each trip we take a complete medical team of surgeon(s), anesthesiologists, perfusionists, intensivists, cardiologists, OR nurses, PICU nurses, etc.
We will be Blogging about: the trips we take and the lives we save; interesting stories about the children we serve around the world; stories about our various volunteers and staff; links to helpful information about Congenital Heart Defects; Links to other organizations around the globe helping children with heart defects; interesting statistics about congenital heart defects, etc.
We will include pictures and video. We will have Guest Bloggers. And….of course, we welcome your comments on ways to enhance this Blog!
This week we have full medical teams in Colombia and India. In the 1st Quarter of 2010 we operated on 172 children and expect to reach 180 children in the 2nd quarter!
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