Humanitarian Missions: a Call for Action and Impact from Cardiovascular Surgeons

Nina, Vinicius José da Silva; Farkas, Emily A.; Nina, Rachel V. A. H.; Marath, Aubyn

doi:10.21470/1678-9741-2017-0197

Cited by 5 publications

(5 citation statements)

References 9 publications

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“…Thus, as pointed out by Dearani et al [ 24 ] , humanitarian outreach activities should focus on education and sustainability and surgical tourism should be limited to those centers that will never have the capacity to have a free-standing cardiothoracic program [ 22 ] . Evidently, it was documented that success of cardiac mission should not be measured by the number of successful operations of any given mission, but by the successful operations the local team were able to perform after the departure of the visitors [ 24 , 25 ] . In our own situation, we had 33 mission trips and carried out about 266 cardiac procedures in 242 patients over a seven-year period, yet the locals had not transited to independence even for minor cases like atrial septal defect, VSD, and minor forms of TOF, as well as valves in adults ( Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Surgical ‘Safari’ vs. Educational Program: Experience with International Cardiac Surgery Missions in Nigeria

Nwafor¹,

Vickram²,

Osenmobor³

2020

Braz J Cardiovasc Surg

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Introduction In any country, the development and growth of open-heart surgery parallel stable political climate, economic growth, good leadership, and prudent fiscal management. These were lacking in Nigeria, which was under a military rule. The enthronement of democratic rule, in 1999, has caused desirable changes. The objective of this study is to report our experience with foreign cardiac teams that visited the National Cardiothoracic Center of Excellence, University of Nigeria Teaching Hospital, for seven years, in order to restart its open-heart surgery program. Methods To achieve the desired open-heart surgery training, our center received regular and frequent visits from foreign cardiac teams who would perform open-heart surgery with the local team. Results During the period of seven years, a total of 266 open-heart operations involving both adults and children were performed, with a mean of 38 cases per year; 150 (54.4%) males and 116 (43.6%) females were treated, with a ratio of 1.0:0.8. Six different teams visited the center at different periods. Conclusion After these years of cardiac missions to our center, the experience of the local team, especially the surgeons, is far from desirable because each team visit usually lasted about a week or two and each team, with exception of the CardioStart International/William Novick Global Cardiac Alliance, adopted the surgical ‘safari’ method.

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Section: Discussionmentioning

confidence: 99%

Surgical ‘Safari’ vs. Educational Program: Experience with International Cardiac Surgery Missions in Nigeria

Nwafor¹,

Vickram²,

Osenmobor³

2020

Braz J Cardiovasc Surg

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“…Only a century ago, Theodore Billroth publicly condemned the dream of cardiac surgical interventions by stating that "any surgeon who wishes to preserve the respect of his colleagues would never attempt to operate on the heart" [13]. Over the last 6 decades, the specialty of pediatric cardiac surgery has evolved from a heroic effort with occasional success into a consolidated, sophisticated specialty with excellent outcome [12]. The large strides made in the developed to Ghana, Sudan, Egypt and India [18].…”

Section: Discussionmentioning

confidence: 99%

“…Their aim actually was to do humanitarian services especially to the indigent patients who cannot afford medical tourisms to India, Ghana, Sudan, Egypt, South Africa, UK and USA. Their contributions were like a drop of salt in an ocean, because nongovernmental organizations formed by them concentrated more on Safari or Blitzer types of cardiac surgery missions without inculcating structured educational program for the local staff [12]. Thus after 5.5 years, the local staff who ought to have expanded the man-World Journal of Cardiovascular Surgery agement of cardiovascular services to patients with CHD, failed because of the inadequate educational program for them.…”

Section: Introductionmentioning

confidence: 99%

Status of Congenital Heart Defects in Nigeria: The Role of Cardiac Surgery

Nwafor¹,

Eze²

2019

WJCS

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Background: Unlike in developed countries, the delivery of cardiovascular services to children born with congenital heart defects in Nigeria is inadequate. There are problems at both pediatric and adult ages with high morbidity and mortality on account of inadequate surgical care. Objective: To determine the status of congenital defects and assess the impact of foreign cardiac missionary missions vis-à-vis the effects on the magnitude as well as on the educational program for the local cardiac team. Materials and Method: In the last 5.5 years, Foreign Cardiac Surgery missions were reinstituted at National Cardiothoracic Center of Excellence, Enugu, Nigeria. The participants performed cardiac interventions on a variety of patients with CHD. We performed a retrospective review of this endeavor. Patients' demographics, number of patients, age ranges, types of CHD and clinical evaluation methodology were obtained from our hospital's record department. We also assessed types of cardiac interventions, outcome and challenges and the impacts of the foreign cardiac surgery missions. Results: During the study period, a total of 72 children with CHD were evaluated. They were 39 males and 33 females. The age ranged between 0-10 years in children and 41-50 years in the adult. We studied both simple and complex anomalies. A VSD was the commonest (n = 22, 27.16%). Conclusion: Foreign congenital cardiac surgery missions were not able to provide adequate services for the care of CHD that require cardiac surgery both in terms of reduction in magnitude as well as adequate educational program for the local cardiac team. Thus infants, in particular, suffer an early death. The need for governmental support to develop a comprehensive program to care for these patients is essential in Nigeria and other developing countries.

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“…27.2 and 27.3). Thoughtful judgment in patient selection, pre-operative optimization, surgical technique, and postoperative care including recognition & management of complications is vital to ensure the success of the mission and to establish a foundation for future program development [5].…”

Section: Team Composition and Logisticsmentioning

confidence: 99%

Nuts and Bolts of Establishing a Contemporary Global Cardiac Surgery Program

Farkas

Nina

Henson

et al. 2021

Sustainable Development Goals Series

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The unmet burden of cardiac surgical disease worldwide is disproportionately shouldered by low & middle income countries. Strategies to address this disparity have relied predominantly on short term medical service trips from those in higher resource regions, but variability surrounding singular missions has historically jeopardized long-term effectiveness. We propose a framework for development of global cardiac surgical programs that endorses a methodical & structured approach in low resource countries, positioning programs and struggling centers to advance systematically toward sustainability and success through collaboration.

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Humanitarian Missions: a Call for Action and Impact from Cardiovascular Surgeons

Cited by 5 publications

References 9 publications

Surgical ‘Safari’ vs. Educational Program: Experience with International Cardiac Surgery Missions in Nigeria

Surgical ‘Safari’ vs. Educational Program: Experience with International Cardiac Surgery Missions in Nigeria

Status of Congenital Heart Defects in Nigeria: The Role of Cardiac Surgery

Nuts and Bolts of Establishing a Contemporary Global Cardiac Surgery Program

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