This month we feature the work of the Caribbean Heart Menders Association (CHMA), which is a team of medical professionals and philanthropists who volunteer their time and talents to help children with congenital heart defects in third world Caribbean countries. In this interview we speak with CHMA President Barbara Davis-Sears, ARNP.
Tell us about the purpose of the Caribbean Heart Menders Association.
The primary purpose of the organization is to provide life-saving heart surgery and other non-surgical interventions to indigent children with the emphasis on establishing self-sustaining pediatric cardiac surgical programs in the communities in which we serve. This is accomplished by supporting the education and training of the local physicians and other medical professionals.
How did you get started? Describe Caribbean Heart Menders Association’s background.
Caribbean Heart Menders Association got its start in 1994 to address the needs of children dying from congenital heart disease in the Caribbean who would otherwise lead normal lives with early intervention. Bringing these children to the United States for surgery proved costly and did nothing to address the problem of treating congenital heart disease in the local community. Therefore, we re-focused our energies on developing self-sustaining local programs. I joined the organization about 12 years ago when I started working with children with congenital heart disease and learned about the program from the surgeon I worked with. I’ve been a member ever since and served in several capacities, with my most recent appointment as President.
How many medical mission trips has the Caribbean Heart Menders Association done thus far? What locations has the association traveled to?
The organization initially started by helping to sponsor children to the United States for heart surgery at an accepting hospital. We provided surgery for children from countries such as Jamaica, Guyana, Haiti, Trinidad and Tobago. However, over time this became cost prohibitive and did nothing to solve the ultimate problem of not having a local program to care for the needs of the children within each region. The organization then evolved to helping the local communities build a cardiac surgical program. The first medical mission was to Jamaica and has continued almost yearly since 2000. They are well on their way to becoming an independent Center for Pediatric Cardiac Surgery. Currently, they perform simple to moderately complex surgeries independent of medical missions. We’ve also traveled to Trinidad for several years in the past, but currently the program is not active. In conjunction with Project Haiti Heart, we assist with screening missions in Haiti, in which children with congenital heart conditions are identified and subsequently matched with a sponsoring institution. For the past seven years, we have traveled to the Dominican Republic where we have also helped to create an independent Center for Pediatric Cardiac Surgery. They also perform moderately complex surgeries independent of the medical missions. In addition, they perform non-surgical interventions in the cardiac catheterization laboratory independently. In 2010 we had our inaugural mission to Panama, on the invitation of the local cardiology group and local hospital.
Tell us about the recent trips in 2010 to Jamaica, the Dominican Republic, and Panama. How long was each trip? What types of procedures, including cardiac electrophysiology cases, were performed?
CHMA facilitated a medical mission to the Bustamante Hospital for Children in Jamaica from February 23, 2010 through March 5, 2010. During that mission, eighteen children underwent cardiovascular surgery of moderate to complex lesions. These included Tetralogy of Fallot repair, complete atrioventricular septal repair, mitral valve repair and a bidirectional Glenn operation. One child had a pacemaker implanted, 13 children underwent cardiac catheterization and/or electrophysiology study, and three children underwent radiofrequency ablation, for a total of 35 interventions. Our Second Annual Larry King-CHMA-CHIF-Bustamante Teaching Program in Pediatric Cardiac Disease course was also held, and we had over 125 attendees from across the island and neighboring island.
CHMA facilitated its seventh medical mission to CEDIMAT hospital in the Dominican Republic from June 26th to July 3rd, 2010. There were a total of eight surgeries of moderately complex cases, including Tetralogy of Fallot with absent pulmonary valve and aortic valve repair. In addition, a total of 17 additional patients were evaluated for future surgeries. During the mission all surgeries were done by the local surgeon, with the CHMA surgeon only serving as an assistant. All the nursing post-operative care was done by the local nurses. There were only a total of five medical volunteers for this mission, which highlights the progress of the medical training and the success of the program.
Caribbean Heart Menders Association also embarked on its inaugural medical mission to Panama on August 7–15, 2010. The mission consisted of cardiac surgeries, diagnostic and interventional cardiac catheterizations, EP studies and ablations. There were a total of 39 cases performed (11 cardiac surgeries including Tetralogy of Fallot repair, mitral valve replacement and closure of ventricular septal defects; 16 cardiac catheterization/interventions, which included valvuloplasty, device closure of patent ductus arteriosus and atrial septal defects; and 12 EP/ablation cases, which included patients with WPW, AV nodal re-entrant tachycardia and ventricular tachycardia) by 19 medical volunteers working along with the local medical professionals. An additional 13 patients underwent medical evaluation for future interventions. This mission was extremely successful in meeting its goals of providing congenital heart surgery and other non-surgical interventions by engaging and teaching the local physician, nurses and other medical professionals in performing and caring for children undergoing heart surgery.
How many patients are treated each year? How many trips are made each year, on average?
Typically we do about three missions per year. Last year, we treated 110 children affected by congenital heart disease from Jamaica, Dominican Republic and Panama. In addition, we worked with Project Haiti Heart and also cared for children with non-cardiac disease who were affected by the recent earthquake. Although the exact number is unknown, there were several hundred children treated.
Who are the doctors and nurses that treat the patients? How many take part? What kind of equipment is available?
All of our medical professionals are volunteers from various well-known medical centers, including the University of Miami Jackson Memorial Hospital, Joe DiMaggio Children’s Hospital, Cincinnati Children’s Hospital Medical Center, All Children’s Hospital in St. Petersburg, and others. A typical team is comprised of approximately 14–16 team members for new missions; however, as the local team becomes more independent, the size of our team decreases. For instance, last year’s mission to the Dominican Republic was comprised of only five team members. The local institution must have equipment necessary to run an intensive care unit such as ventilators, oxygen, and piped air, in addition to equipment necessary for cardiac surgery, such as a Heart-Lung Machine and a functioning operating room.
Tell us about some of the more memorable patients.
Of course all the patients we care for are special and memorable. However, at times there are those that touch the heart in a very special way. One such patient is Jhon from the Dominican Republic. He’s a bubbly and talkative young man. His only wish was to be able to play with his friends without getting tired. He suffered from a congenital heart defect called Tetralogy of Fallot, in which there is obstruction of blood to the lungs. Therefore, he was quite blue and frequently tired after minimal activity, as there was a limited amount of blood getting to his lungs for oxygenation. After surgery he couldn’t stop looking at his fingernails and lips as they were now pink. It was truly amazing to watch the thrill and joy on his face. He has continued to do well and plays incessantly with his friends.
Another patient that comes to mind is Rayon from Jamaica. We met him on a mission to Jamaica. Although he was a year old, he was the size of a newborn. He didn’t even have enough energy to be fed from a bottle. He was too sick to have surgery in Jamaica, so he was brought to the United States by a sponsoring hospital. Well, as the saying goes, a picture is worth a thousand words, so I’ll let the pictures here tell the story. Words cannot express the joy of seeing that child who was at the brink of death become a healthy, thriving toddler enjoying life as he should!
What have you learned about the people and culture?
I’ve learned that despite the barriers in language and some cultural differences, basically as human beings we are all the same. We have the same hopes and dreams for our children. We desire to be free from pain and illnesses. The breaking heart of a mother whose child is suffering from heart disease in Jamaica, Panama, the Dominican Republic, Trinidad, Haiti and the United States is the same. I’ve been honored to share in the culture and language of the countries to which we travel, and I’m enriched because of those experiences.
What are some of the challenges that have been faced during these missions?
The greatest challenge we deal with is learning to give excellent care with limited supplies. We are blessed here in the United States to have so much, but at the same time, we waste quite a bit. We learn very quickly to be frugal and waste nothing. We also rely very strongly on our clinical skills and expertise, as we don’t always have the luxury of the latest generation medical equipment to rely on, and we do an amazing job.
Tell us about the costs associated with these trips. How are the missions funded?
The cost of each mission is approximately $30,000–$40,000, which accounts for hotel, airline, meals for the team, medications, and disposable medical supplies. The missions are funded by grants, donations of medical supplies, donations of equipment, monetary donations and fundraising activities by our organization. We have an upcoming fundraiser on June 25, 2011 at the Signature Grand in Davie, Florida, at 7pm. For more information, please visit our website at www.caribbeanheartmenders.org or call 786-250-2462.
Our next medical mission will be July 9–16, 2011 to the Dominican Republic. We will also be coordinating a nursing training mission to Jamaica in August 2011.
Is there anything else you’d like to add?
Through our experience we have found that working in conjunction with other non-profit organizations that have the same goals as our organization emboldens the program’s chances of success. We have seen this in the Dominican Republic and Jamaica, and we will continue this model in Panama.
For more information, please visit: www.caribbeanheartmenders.org