Fourteen Years of Humanitarian Pediatric Cardiac Assistance: The International Children's Heart Foundation
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Medical and surgical services for children with congenital and acquired heart disease in most industrialized countries are easily available and all-inclusive, regardless of the cost. In many parts of the world, nevertheless, children with similar types of cardiac disease continue to be unable to achieve entrée to adequate diagnosis and care.1 Efforts to supply greater access to appropriate care for these children range from pro bono long-term commitments to entire institutional programs.2,3 In 1993, we established a program to make available pediatric cardiovascular services to children in developing countries. This report details our initial 14-year experience.
Methods
Acquisition of data and statistical methods. We reviewed all the records of the International Children s Heart Foundation database and patient databases at host sites for numbers of patients and their demographics, the types of operation, and the results. The combined data sets make up the substance of this report. All data are expressed as the mean plus or minus standard deviation. Comparisons of variables were made using the Chi-squared and Student s t tests. Differences were considered significant when P was less than 0.05.
Recruitment of the volunteer team. Team members were recruited by direct solicitation by one of the authors, prior team members, or via the volunteer page of the Foundation s Web site. All volunteers provided curriculums, appropriate licenses, diplomas, and references. Team acquisition and organization was regularly started three months prior to a planned mission.
Assessment and determination of sites. In order to evaluate the capabilities of institutions requesting assistance, a questionnaire was given asking information with regard to hospital infrastructure, hardware, disposables, personnel and the current condition of the pediatric cardiac service. The decision to arrange a mission was based upon information received in the questionnaire and our ability to acquire funds to cover the expenses of the team.
Determination of patients. After we received a requested list of surgical candidates, along with any pertinent cardiac studies, patients were prioritized based upon the data provided. The priority list was then returned to the site for consideration and confirmation.
Patient database. Data on each surgical patient was recorded in a central database. Surgical procedures were coded according to the European Congenital Heart Surgery Database, and all operations were assigned a categorization for risk using the classification system described by the Pediatric Cardiac Care Consortium.4
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