Nicaragua: Operation Baby Hearts

Monday November 05, 2007 02:46:20 PM


 An ICHF country program of the kind in operation in Nicaragua requires significant funding.  The two year (2006-2007 and Nicaragua Country Program Logo2008-2009) funding for the Nicaragua country program is a collaboration among US and Nicaragua organization and individual sponsors who include:

  • Rotary District 7500 Gift of Life Program
  • Rotary District 7470 Gift of Life Program
  • Rotary Club of Managua
  • Hospital Infantil Manuel de Jesus Rivera
  • Ministry of Health of the Republic of Nicaragua
  • Coranzon Abierto Foundation

The International Children's Heart Foundation has been working in Nicaragua, a poor and densely populated Central American country, since 1994 when it was invited in by the doctors at Hospital Infantil de Jesus Rivera (La Mascota) Managua, Nicaragua.  At that time, open heart surgery was not performed on either adults or children and, although it was possible for some children to receive surgery in other countries, it was available to only 6-10 children a year. With one percent (1,568) of the annual live births each year born having heart defects and 35% of the children (547) needing operations in the first year of their lives, the doctors were extremely frustrated as they watched their country's children die.

ICHF OR teamICHF's short term goal has always been to provide surgical care to those children who would die without immediate help. As of July1, 2007, ICHF completed 17 medical mission trips and operated on 331 children.  During each of the medical trips, our colleagues in Managua learned diagnostic procedures such as echocardiograms and have worked alongside their counterparts on our teams, learning surgical techniques and peri-operative care in the Intensive Care Unit (ICU).  Additionally, ICHF has provided over one million dollars in medical supplies and equipment to the hospital.

Despite all this work, a fully independent pediatric cardiac care service, has never taken hold. The inadequate organization and personnel, and the absence of support from the government's Ministry of Health along with consistent external funding have been serious barriers.

Dr. FentonBut, this is changing. With renewed determination from the local Corazon Abierto Foundation, the Minister of Health and the Director of Hospital Infantil, ICHF has placed a full time pediatric surgeon, Dr. Kathleen Fenton, in Managua a the hospital for two years. Dr. Fenton will lead the education of the local team and serve as a clinical surgeon. For forty -our weeks a year, Dr. Fenton will live and work in Managua. She will be supported with ICHF teams twice a year to operate on children with the most complex heart defects. Dr. Fenton is working with the recently established La Mascota pediatric cardiac surgical teamDr. Hernandez

The goals of this expanded Country Program are simple, but not necessarily easy to achieve:

  1. Perform 100 surgeries during the first year -- half of them open heart and the remaining half closed heart operations.
  2. Improve the diagnostic capacity of cardiac congenital and acquired diseases.
  3. Decrease the number of waiting surgical patients suffering from cardiac defects and the amount of time they must wait.
  4. Equip an operating room with appropriate surgical instruments and supplies along with a recovery room, cardiology unit, intensive care unit and outpatient clinic.
  5. Decrease the mortality (death) and morbidity (diseased state) rate of children suffering from heart defects.
  6. Improve the technical-scientific capacity of the involved staff, including physicians, nurses, technical personnel and anesthesiologists.

Status Report: February 28, 2007

Dr. Fenton with patient & familyDr. Fenton moved to Managua in December, 2006. On February 13th, 2007, Dr. Fenton received approval to operate from the Ministry of Health so surgeries and team training is now operational. By the end of February 2007, nine children had received surgeries and are thriving. Each quarter thereafter, 27 children should receive surgeries.

News of the new unit has spread and three private physicians are now referring children. In addition, the unit can't do open heart surgeries along with the closed heart surgeries as the 12 bed ICU unit often has only one night nurse. ICHF is working with two Nicaraguan organizations that support the ICU to resolve the situation by hiring four additional nurses.

To supplement Dr. Fenton's teaching, the Nicaraguan medical team members providing anesthesia and intensive care also need off-site education aboard. training session

The future plan is to add facilities to the hospital for the pediatric cardiac unit. This includes its own operating room, additional ICU bed, a cardiac catheterization laboratory and cardiology ward.