Thursday, August 31, 2006

Twenty-Eight and Counting

Twenty-Eight and Counting

I counted the number of kids and young adults on the Haitian Hearts list today that need heart surgery. There are 28. The cases are evenly divided between congenital heart disease and rheumatic heart disease. They all need heart surgery.

Some of the 28 patients are OSF-SFMC patients that have been operated in Peoria. OSF refuses to care for these children now. They will die without surgery and other medical centers don’t really jump at the chance to operate international children that have been operated somewhere else. So these Haitian Hearts patients are really in trouble. I examine them here and Haitian Hearts pays for their medication from Peoria, but they need the surgical cure.

Pictured above are four patients that are representative of the 28 on the list that need heart surgery.

The girl at the top is Mirlande. She has the beret with USA printed on it. She is 14 years old and has been short of breath for two years. She can’t walk up a hill very well at all and Port-au-Prince is built on the side of a mountain. Mirlande has a leaky mitral valve that was caused by rheumatic fever that has put her in chronic congestive heart failure. She needs a new mitral valve.

The baby boy below Mirlande, being held by his father, is Ocean. He is 14 months old. If you look closely, you can see that his left chest is larger than his right chest. The reason for this is that his heart is large and pushing the left side of his chest outward. He has a very ominous sounding murmur due to a hole between the lower chambers of his heart called a ventricular septal defect. Each time his heart beats, it sends too much blood to his lungs and too much blood back to his heart. He needs the hole patched in surgery. A good pediatric heart surgeon and team can do this very easily. Before the heart lung bypass machine was available, cardiologists around the world knew their patients had ventricular septal defects, but could do nothing about it except treat them medically. At autopsy, the hole could be seen quite easily. If Ocean does not have surgery, it will not be due to lack of heart lung bypass machines. The technology is in the developed world to help the pediatric heart surgeon perform successful surgery. The problem is the will is not there to help kids like Ocean.

The third photo down is Joseph. He is 16 years old and has rheumatic heart disease that has destroyed his mitral valve. He needs surgery very soon or he will die. He is an excellent student, has a passport, and is ready to travel.

The last child on the list is Jhiny. She is 14 years old. I examined her for the first time and she has a hole between the upper chambers of her heart. This is called an atrial septal defect. She is chronically short of breath. You can see that the left side of her chest is larger than the right side because her heart is sick and enlarged. She needs surgery too. Interestingly, a medical center in the United States evaluated her echocardiogram four years ago and sent her mother a letter stating that Jhiny was "invited" to their medical center for repair for a mere $27,500 dollars but if she stayed longer than seven days, she would be charged $1,500 dollars per day. This seems kind like a cruel letter to send. Her Haitian mother could not afford this since her income is less than $100 dollars per year. So Jhiny is four years sicker.

If anyone out there in cyberspace has any ability to help these kids, please do so soon. If you have a good contact with an administrator or someone who sits on the board of a medical center, please contact them. As a rule, physicians love to take care of international patients, especially kids with heart problems, and will waive their fees.

Thank you.

John Carroll, MD

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