Thursday, February 24, 2011

Leslie O'Meara posting!

Hi Ceeya,

I just wanted to say thank you again for including me in such a wonderful medical mission. I finally arrived in Minneapolis 24 hours after I was supposed to due to stormy weather! I am still adjusting getting back to daily life in the US and have had a few days to reflect on my experience in
Rwanda. I am so grateful for having the opportunity to participate with such a great organization as team heart.

Being a new participant within the group I was welcomed with opened arms by
every member of the team which really helped me to feel at ease in unfamiliar territory. I especially want to recognize my step-down team members for functioning so well without the luxuries we have in the US. Also I would like to recognize Suellen for being a phenomenal charge nurse of the unit. I was very impressed by the teamwork that was exhibited among the physicians nurses and other members of the mission in collaboration with the Rwandan medical staff which reiterated to me how well this program can progress in years to come. I have made many strong friendships over the course of two weeks and am already excited to reunite with my fellow team members in different areas along the East coast!

I returned back to the Midwest as public protests against oppressive government continue in the Middle East and Africa as well as my home state of Wisconsin. With all of the turmoil and negative press about corruption and unmitigated greed, it is gratifying to know that there are people who are making sacrifices to help others. Groups like Team Heart make the world a better place.

Thank you again for Team Heart!


Leslie O'Meara

Monday, February 21, 2011

A note from Erneste Simpunga!

Dearest friends of Rwanda, Team Heart

Now that I hope everybody is back to the United States, Once again,I would like to take this opportunity to thank you so very much foryour continued support.

I want to extend my deepest appreciation to everyone for his/her help.
On behalf of 15 patients saved this year and also the ones that havebeen saved during the past 4 years, including myself since you startedyour mission to Rwanda, I wish to say that " Your help is highlyappreciated"
Thanks to Ceeya, Dr.Bolman and David for a wonderful visitation hereat Riviera High School.
David, thanks for visiting my village. My family was so happy to meet you.
Finally, To all Team Heart members whether you were present or not, Iwant to appreciate the party that you have organised for all thepatients. It was so wonderful.
We love you so much,
May the best of your past be the worst of your future.
Youngman from Rwanda,

Saturday, February 19, 2011

Last Day!! Part 1

Everyone is sad to be leaving and the patients are sad to see us go. A transfer at noon yesterday went very smooth and we love this group of surgical ward nurses. Some we have seen before but their skill level and assessment skills have really shone on this trip. They have played a more visible role--not just there to do the personal care. The have also seemed to understand the wonder of such a complex surgical procedures in this setting. We know the patients will need continued good care, no infections, and follow-up which works, to continue on their path to healing and just some good luck.

Transportation is an issue. There are very few patients from Kigali proper where buses are many....most need a combination of travel involving buses, and the dreaded moto-taxi and then some walking in the full day sun. Not exactly what I would want after being ill for so long , followed by cardiac surgery. But they are so excited to reach their home and their families.

After we left the hospital yesterday, we had a wonderful afternoon in many direction. Some sleeping, some shopping and some of us completing the valve forms to mail in...but at 5 we gathered at the studio for Emmanuel (not our patient Emmanuel) and his brothers near the guest house at their studio/gallery for an art show. Wonderful colors and wonderful young men...

We held out traditional departure dinner at Heaven with the most beautiful moon we have EVER seen. First bright orange, and over the night as it rose, the moon paled and you could see Orion and other constellations in the night sky. Somehow very fitting....

Thursday, February 17, 2011

Article from the Rwandan Newspaper on Saturday

14 undergo cardiac surgery at KFH-K
By Frank Kanyesigye

Fourteen adult patients with rheumatic heart disease are undergoing cardiac surgery at King Faisal Hospital-Kigali (KFH).

KFH-K started its 2011 heart surgery programme for adult patients on Saturday last week and at least 12 patients have been operated on and the remaining two are going under surgery today.

The exercise is carried out by the team of volunteers composed of 42 doctors and Allied Health Professionals from Boston, USA (Team Heart Inc.) and local Rwandans, including surgeons, anaesthetists, cardiologists, physiotherapists, pharmacists and nurses.

Dr. Joseph Mucumbitsi, the Paediatric Cardiologist and Coordinator of the programme at KFH-K, said that about 221 Rwandans have so far benefited from the cardiac surgery and catheterization programme.

“We have had three challenging cases so far, but we are happy to have handled them successfully,” said Mucumbitsi.

He added that they expect to discharge the patients after seven days on average but some could stay longer depending on their adaption to post surgery situation.

“We are committed to do a follow up on our patients so that they continue receiving medication,” he added.
Speaking to some of the cardiac surgery patients who were operated on some time back, they said that they are doing well after the operation.

Jean Paul Iyamuremye, 34, from Kigali City, underwent operation in April 2008 and now he says he is in a good condition. Before surgery, he used to spend sleepless nights because of the pain.

“I am now operating my businesses without feeling any pain. I thank the doctors for having restored back my life.”
According to Josephine Uwera 31 from Nyagatare District, she underwent operation in April last year and she is feeling much better although she still feels a little pain because of the scar.

Uwera hopes with time she will be fine because now she can eat well, do other activities which she had failed to do when she was sick.

The National Cardiac Surgery Program started in April 2006 in partnership with the Ministry of Health and four visiting surgical teams that include; “Team Heart Inc.” from Boston USA, “Healing Hearts Northwest” from Washington, USA, “Operation Open Heart” from Sydney, Australia and “Chain of Hope”, from Brussels, Belgium.

This international partnership was built with the aim of developing an autonomous Cardiac Centre of Excellence for children and adults, and offering new opportunities and access to highly specialised cardiac care to Rwandans every year. It will also respond to the local and regional heart surgery needs.

Reflections from the Ward

It's hard to believe that today is the day before our last day of this year's successful 4th mission. As I write this, I am wondering where the time has gone. At the end of today we will have discharged a total of 6 patients. We will have all the rest (another 9) on the ward ready to be cared for by our KFH nursing and physician colleagues. All in all, another amazing experience. Words really can't describe the transformation we see in patients and their families from the time we meet preoperatively until the time we say goodbye at the end of the trip. At first, they appear curious about all these 'muzungus' who come from far away to care for them. While they may be slightly fearful of us and their impending surgery (and full of questions just like westerners), they are always hopeful and thankful for providing them with another chance at life. They want what we want--to kick a soccer ball, to play with friends, to return to school or work, to enjoy their loved ones. By the end of our time together, we learn to communicate not only with our broken kinyarwandan but also in ways that words can't describe Claudine's eyes, Sifa's smile, Laurent's quiet presence, Smart's gentle soul and the list goes on. It is almost as if we become a family for a brief time.

Our KFH colleagues have been great. They are patient with our sometimes demanding ways. We have learned from each other. Working together, rounding together and caring for the patients together has been one of the great rewards of this trip (I write this with Dr. Gloria at my side!)
So now, I must return to work. There is a lot to do to get ready for the trip home including celebrating our successes tomorrow night. Good bye for now. I pray the snow is gone when I get home.
Leslie O'Meara, RN is our Minnesota connection this year. Originally from Wisconsin, she heard about Team Heart though other previous University of Minnesota Team Heart members. Very willing to work long hours and with resource challenges, she is a great addition to the team. The patients here are delighted to be in the sun and out for a cardiac rehab walk around the exterior corridor. Rumor has it, they were led on an unplanned independent walk while Suellen was at lunch by Claudine's grandmother! All discharge teaching has been completed as we have less than 30 hours left in hospital. Emmanuel has left the KFH ICU and joins his group for today and tomorrow fine tune-up--as much as we can do. He will be in the hospital for some time and require close follow-up.

Leslie Sabatino, with tears, but very proud, dropped by to say good-bye. Each team member has put their heart and soul into this project. As we say goodbye one by one you can see the joy and concern on each face.

Those leaving earlier have arrived home safely....we have one group heading to Tanzania to climb Kilimanjaro and the step-down unit and physicians will leave on Saturday.

The challenges remain today of finding safe clean dry storage, for about 1 ton of supplies, regulating INR of a couple of patients and have the follow-up system work--each one making the remaining team very anxious. It is not that we have left it to the end--we have been working on this since the arrival.

Wednesday, February 16, 2011

Last night Shift

Hi everyone back at home and patients that might be reading this! My time in Rwanda is almost finished. I leave Saturday afternoon. It is my last night shift here. I cannot believe how fast the time goes buy here. The patients are sleeping and so I have some time to write.

It has been great taking care of the patients on the step-down. Working on the step-down I have the privilege of seeing most patients before surgery, in the ICU, and then I get to care for them on the step-down up until they are ready to go home. I think when they first come out of surgery they do not know what hit them. They look scared and worried, but then after a day or two after transferring to the step-down they start smiling, talking, and laughing. It is an amazing thing to see. Many of my patients are already asking when they can return to work, school, and having more children. It was also great to see my patients from last year. They have returned to there work and school and seemed very happy. I was surprise that despite the language barrier many of them called me by name.

After a long stretch of work, I had a day off and I feel refreshed coming back to the hospital tonight. I spent my time off relaxing, dancing, and I made my visit to the genocide museum. It was just what I needed to not only give me much needed rest and a mental break, but also time to remember why I am here. Rwanda is a beautiful country, but the people here are even more beautiful. They are so grateful for so little and they do not take much for granted. They teach me to be more patient (even though my patience is stretch very thin here at times), to not stress the small stuff, and that less is often times more.

The staff at King Faisal has been so helpful and supportive. It has been a privilege to work with all of you. It was great working with familiar faces as well as many new ones. I have some great pictures of many of the patients and at their request and permission I hope to be able to share them on the site so that everyone can see them (and hopefully some of them will be able to see them too!) I do not have a way to upload my pictures, but I hope to do so before I leave.

Alright, time to get back to work!

Stepdown Happiness-Part 2

1. Khana Khanzana-The best Indian food!
Stepdown nurses and ICU nurses--ICU leaves today....

2. Gentile, standing visits from 2009 double and TV ring, from near Congo, 25 years, returns to visit. Sharing patient education and support with Jean Paul, 2008, Yvonne a valve done in India -- heard we were here and stopped to visit-- and Emmanuelline and Claudine.

3. Gentile, 2009 patient.

4. Jean Damascene and his wife before discharge.

5. Claudine without being asked, gets up for a walk. Still with some right heart failure, and still very weak, since she was hospitalized for 6 months before we arrived--seeing her begin to take interest in life has been such a reward. Her she poses with Emmanuelline dressed in the skirt Suellen and her sister made for the female patients--easy on and off, they give ease for ambulation and they look lovely.....the sashes are used for wraps for the head, sashes or ties!

Stepdown Happiness and Concerns-Part 1

1. Leslie Sabatino doing more inventory of our mountain of supplies, while waiting on rounds and procurement meetings as begin our planning for next year even as we are still working. We took a break to visit the national center for procurement, greeting a friend Juliet Mbabazi, the new CEO. Beginning to purchase in Rwanda and have delivered direct is a goal for 2012.

2. Drs. Igor Gosev and a sleepy John Connell wait for rounds with Dr. Nathan which are delayed by lab data missing. Adapting to a system which can work to provide both care in follow up and with in the system is a struggle. Many times I think that the local team just figures out a way to make it work for them and in small numbers of INR 1-2 a day, it is OK.--But after 4 years; how can we still be waiting on 8 INR's at 2 pm?

3. A happy Shabani, the patient who returned to theater for oozing is also going home today. A handsome man, he is anxious to return to work. He already looks so much better you have to caution against doing too much too early, along with the discharge teaching they are each receiving. Jean Damascene has been giving speeches of thanks to each person walking though the door. Both are anxious for the final rounds saying they can leave yet today.

4. Pat Caruso, RN, St. Vincents, a veteran cardiac surgical misson nurse from Worcester brings calmness and expertise to her group of "young men"--here with Shabani. You can just tell they all adore her as she moves competently between them, keeping it all straight and providing compassionate and tough love care.

Tuesday, February 15, 2011

I've had the time of my life...

Wow I can't believe it's time to leave Kigali. Maddie, Chris, Jabaris & I are sitting in the Kigali International airport waiting for our long flights home. We leave Jabaris in Brussels and he gets to boston via Frankfurt while Chris & Maddie continue with me to DC and then we part ways with them going to Boston and me going to Raleigh-Durham. But at least I have someone with me on my long flight this time! Chris, Maddie and Gio have now started referring to me as the "mystical unicorn" because everyone in Kigali stares at me with my blonde hair.
After packing the OR, 9 of us from the OR had the opportunity to go to Lake Kivu in Gyseni on the border of the Congo. It was absolutely AMAZING and we all enjoyed the chance to relax and enjoyed the scenery on the way to the Lake. Our driver took us to the border of the Congo and I have to say, those were not the friendliest faces.
While some of us were in Gyseni at the lake, Chris, Maddie, Jabaris and Igor went to Akagera National Park on safari where they saw tons of animals including the elusive elephant! I believe they're the first ones to see one! I would post pictures of both of our adventures but the internet in the airport is too slow and I'm out of patience! But I will post them when we get back!
Thanks for all of your support and prayers! It means a lot to all of us. Our trip means so much to the people of Rwanda. This was latest evidenced by the customs guy who saw my Team Heart shirt and thanked us for being for here and said we were doing great work here. And then asked when we were coming back and said he would be waiting on us! So wonderful to hear!


ACLS and storage

Today Leslie taught ACLS and emergency cardiac surgical post op care to a very interested group of King Faisal ICU and theater nurses. Unfortunately, I missed the photo opportunity......but it was wonderful to sit near and listen to the exchange and enthusiasm......

Also, our life of storage continues....this is only one of three stacks that must find a spot to stay in locally. Thursday is the day for relocating all boxes. If some of you recognize the boxes--yes we have moved them 3 times. Each year we vow to be better at estimating supplies --a bar scanning system has got to be the next step. Clearly we need a volunteer to head this up!

Today 2/15

ICU last day with BWH Surgery Resident Jabaris Swain watching patients so nurses could eat lunch. (OK-- this year HE wins the award of our most incredible resident) Everyone has been wonderful, but Jabaris has been amazing. He stepped in and immediately went to work. Not at all intense, his personality is perfect for this type of trip--always willing to do just whatever it takes. He definitely earned a short break after ICU closed and did a day safari with Perfusion Chris Swanton and Theater Nurse Maddie Mars--they even saw an elephant rare in Akagera National Park.

2. KFH House Officer Gloria, hard at work in step-down unit. What can we say? She has a wonderful smile, is incredibly kind to the patients and has worked right beside us every step. First she and Taufiek became a team doing pre-op evaluations. Then Jabaris and Gloria a team to reckon with, now with BWH John Connell and Igor Gosev. She is our consistent link and we have grown to adore her.

3. Erneste stopped by to do translation with pre-discharge teaching. Hearing patients can live successfully with Coumadin/Warfarin and follow-up and return to productive life made each patient he spoke with feel so much better. It did not hurt he looks incredible and very handsome in his Senior 6 uniform....

4. KFH ICU nurse Hannah has worked with us at least 3 years. She is dear and here she and KFH head nurse Connie work to transfer our last patients to step-down.

We have had so much emotional support from both Connie and Judith. In times of stress they are right there to help and if we need to vent our upset feelings --they are there to lend a compassionate ear.

Monday, February 14, 2011

Emmanuel Transfer to KFH ICU

Our ICU transitions today; our pride, Emmanuel, triple valve, walked to the KFH ICU. He will need a few more days of intensive observation, only one more drip to wean by tomorrow. Getting solid food now, he seems bewildered by all the attention by this incredibly compassionate team. Somehow, it is appropriate to have E.D. , KFH ICU RN, transfer and accept him-- he has been a wonderful addition to the ICU working with us. ( sigh .........we are delighted but getting a little sad......ICU closing is a BIG step)

Sunday, February 13, 2011

Cardiology team

TeamHeart visiting Cardiology team, Marilyn Riley and Dr. Pat Come have not stopped evaluating patients just because our patient selection and surgery is complete. In addition to scanning each patient both pre-op and several times during recovery, they also continue to scan patients for the next team. Communicating information to both the local team and the HHNW is important if patient is to make the consideration for surgery in April. Some individuals have heard we are here and just show up asking for screening...we do our best to work with in their system.

2008 MVR,TVR Erneste Simpunga received a 2 1/2 year follow up echo scan today and received an wonderful off all Lasix, we were able to see him briefly as he took Team Heart President, David Wilson to his village to meet his parents. In his last year at Riveira High School in Senior 6, he prepares for national exam in November 2011. He is all muscle and grades were much improved after the change in grading and administrative structure....and a gentle reminder. Erneste shown here with step-down coordinator Suellen Breakey, is always willing to do translation and visit with the post ops and provide encouragement as few have been as sick as he. Erneste thoroughly enjoyed connecting with TeamHeart friends from his BWH surgery as he visited with the nurses who provided care post-operatively.

Patient Reunion 2/12/2011

The patients from previous years always visit if possible. This year Team Heart hosted a lunch to welcome the patients back. They were greeted by Dr. Alex Butera, CEO-KFH, Dr. Mucumbitisi and Chip. Following lunch they were invited by Team Heart to an open discussion of life following valve surgery, the challenges and issues and how they might support each other. The patients broke into small group discussions and addressed the challenges and the solutions needed--an empowering moment.

A exhilarating moment when all patients together first agreed to form an organization as part of the Rwanda Heart Foundation, electing Jean Paul Iyameuremye, Team Heart AVR 2008 as first President. It was a moving moment for Team Heart members present as we observed the support these wonderful people share with each other.

A Message from Chip Bolman

Saturday afternoon, Team Heart completed our 15th and final surgery, a mitral valve replacement in a 19 year-old girl with severe mitral regurgitation. All the cases went well, were technically successful, and, as of rounds on Sunday morning, are doing well. We had one emergent take back for bleeding, one patient who tried very hard, and unsuccessfully, to die the first night after surgery- a triple valve patient, and the other usual issues, shown here 24 hours later. All this notwithstanding, everyone survived, and the smiles we received on rounds today more than compensate for all the hard work. The team has performed superbly. We have many new and many return members, and each and every one has done a wonderful job of caring for the patients and of supporting one another.
Ceeya and I are so very proud of the team this year, as we have been each prior year. The experience quite simply could not have been better. Our Rwanda friends and colleagues, especially Joseph Mucumbitsi, but also Nathan, Mugisa, Gloria- the House Doctor, Maurice- the aspiring cardiac surgeon, and all the nurses and staff who have done such a good job for our patients, truly are part of our team, and we of theirs. The work is hard and challenging, but we see progress each year, even if it is slower than we might like.
As we pack up, and some, including me, leave today for home, we reflect again on the incredible privilege we have been granted to be able to do this work. These are wonderful people, and the opportunity to perform such a service for them, and to be able to help save and change their lives is reward enough for each of us. It truly is the best thing we do, both personally and professionally.

Saturday, February 12, 2011

Last Case into the ICU !!!!

The last case just came to our wonderful ICU here at King Faisal Hospital.

She was admitted by Judith and Idi. They did an amazing job rapidly stabilizing the patient and she will soon be off her breathing machine.

This is the future for Rwanda!!!!


Last day of surgery

Well today is our last day. It's kind of bittersweet. We've helped so many people this week but we know there are more that need our help. We have all been working with the local staff helping them learn how to do Cardiac surgery. I have been very fortunate to have a wonderful Perfusion assistant this week, Theoneste. He is so eager to learn Perfusion and is grasping the concepts wonderfully! So well in fact that he has now pumped his first cases! (under our close supervision and support!) We went on bypass and then let Theo take over until the cross clamp came off and then we took back over. He is going to India in May to learn Perfusion and he is going to be far ahead of his other classmates. Rwanda is going to have an excellent Perfusionist in two years! Too bad that Perfusionist doesn't translate to Kinyarwandan! But I did learn how to say what I do "Njyewe Samantha nkoresha imashini y'umutima n'ibihaha."
One more case to go then time to pack up the OR.


Trip to Gisimba Orphange

Friday was a big day for the Team Heart-Gisimba joint project. Volunteer Andy Willett has helped us nurture this relationship for 3 years and it has been wonderful to see his leadership guide appropriate donations. The septic again needed to be pumped and this was done during the early visit. Food supply was in acute shortage. Andy found a food supply warehouse -50 pound bags of rice, etc. and loaded up a truck. Next came the mattress project as 20 new mattresses was purchased and delivered. The art project for development as method for expression of healing and recovery with local artist is planned for later in the week with donations from Team Heart donors.

Trendy and much need underwear, for both boys and girls, along with the mattresses was supplied by donations from Nashua, NH through Michelle LaChance and from Boston residents and TeamHeart members past and present.

First time team member , Boston-Caritas anesthesiologist, Robert Hunsaker, resupplied the first aid room and worked with Gisimba nurse to make certain she has all needed.

Learn-to-read , chapter books in English and school supplies finished our donation. We have grown to love these children and enjoy watching them thrive in a loving and secure environment and so honored to play a small role.

Friday, February 11, 2011

A mother-nurse reflection

My assignment last night was taking care of 2 boys both 25 years of age.
They were doing wonderful and was enjoying taking care of "my boys".
My oldest daughter called me from the US and she was on her way home from work. In our conversation I mentioned that both patients I was taking care were born the same year as her!
This made me realize how different life should be for them. I hope with getting their health back they get to do what 25 year olds should be doing. Enjoying life and planning their FUTURE!

Thursday, February 10, 2011

We have loved seeing our patients drop by and hope more will be able to return to the Patient lunch tomorrow. Why did I not think of this sooner? We love seeing them and they love seeing their favorite nurses and physicians.

1. ICU nurses minus Leslie (sleeping in after later night waiting for second patient). 2. Here we see Delphine, who immediately ask for Sofia with stepdown nurse Jacqueline and Samantha Kaiser Perfusion. ICU nurses Pam Sullivan and Diane Gay with stepdown Michelle and Leslie O'Meara....4. and Jean Habiyarimana, Year 1--he was one sick cookie, who was so excited to see Leslie, looking fantastic. 5. Madelon Roberts Capozziello and Ceeya bonding about the mountains looking just like the Blue Ridge Mountains of WNC.....

I cannot tell you how wonderful this staff is. Each person brings so much and gives so much. We are all getting tired.....but the adrenaline of seeing each patient do so well and their fast recovery is invigorating.

Families from the states are missed and hope you know that you are in our thoughts...

Black Tongue Disease

So I woke up yesterday morning with a black tongue, which I presumed was the beginning of some exotic African disease. Well, as it turns out, that is simply what happens when you pop a few peptol bismol before going to bed---something to remember for next Halloween.
The week is past the halfway mark now. It is amazing to see how quickly these young people are recovering from their extremely complex surgeries. They are such a quiet, dignified group of people. I love to see the women come in to visit with their beautiful long colorful dresses and the schoolchildren who yell our way, wave and stop to eagerly pose and have their picture taken.
Things in the ICU are moving along like a well oiled machine--it really is a great group of people that have joined this group. Two more days of surgery and then the ICU will begin to wrap up things with a possible closure next Monday. Then it will be back to the snow---I certainly hope it doesn't greet us at Logan!

Wednesday, February 9, 2011


Today is Operating Day #5 and finally had enough time to reflect...
After a couple of "eventful" nights (with positive outcomes thank God) all is moving along.
We are becoming quite a team and it's sad that it's only for a short while. What we are accomplishing in such a short time it's AMAZING!
Went to see the patients in Step-down last night and they looked great. They are all excited about getting their lives back.
The farmer can start providing for his family again, the young Mom can now take care of her baby,the 22yr old college student can now plan his future and the stories continue...
The feeling one gets from participating in this is life changing!
Unable to post yesterday because of internet outage. Day 4 of our theater. Prem did first case, a triple valve and we await arrival from theater. Our second case, a wonderful young lady, very sick will follow for a single valve. She is the size of a child much younger an will challenge us all to remain objective. We tease Jabaris our surgical resident who has worked non stop for the first 4 days, and Chip, her surgeon, this young girl batts her eyelashes and all melt along with them.

Shabani, photographed here at HIS request, with Katelyn, a MGH, ICU nurse sits up enjoying juice on his first post op day. Shabani had a "bit of oozing" during the night, and returned to theater briefly. A few stitches to reinforce and he was back in business. We have been delighted with our two intensivist. Naomi, from the Brigham and David from Gundersen Clinic in LaCrosse, WI have done a fantastic job. Both have been incredibly supportive of the nurses with Naomi knowing only about 1/2 ; and David knowing no one. It always amazes me at this moment after just 4 days; anesthesia from 2 institutions, nurses from 6, physicians from 3, perfusion from 3, that we are a cohesive supportive group all working toward the same goal-making life better for someone.

Tuesday, February 8, 2011

Hi Everyone,
We are coming up to the 1/2 way mark today and things have been so rewarding. We have quite a solid team. Everyone has been collaborating and doing such great across the board, both teaching and motivating each other.

This is what Team Hearts' goal was when we first envisioned it-, a solid group of individuals coming together in ways you can not imagine.

The patients are doing well, and believe it or not - I have been getting some sleep. (That's for 'the hubbs')

See you all soon

As we begin discharge planning with our first two patients, both from Partners In Health referrals, we coordinate with their KFH-PIH coordinator, Theoneste. Neither patients speak English, but the KFH nurses do a wonderful job of translating as Suellen and the step-down team begin to review discharge teaching. Our first patient does not feel as perky as the second today and not interested in a "kodak moment", but lovely young Berndadette, is photographed with her permission. Here, she is sitting up following surgery on Sunday, just on post op day 2, with the pillow case lovingly made by Wellesley Hills Congregational Church Button Box Quilt Shop and Sewing Center. Thank you to all sending good thoughts and prayers from WHCC.

Both patients will spend 1-2 more days in hospital fine tuning medication and getting stronger. Seeing patients drop by whom have had surgery a year ago has made them feel much better since the visiting patients look well and happy.

Monday, February 7, 2011

Day 3 in Rwanda

First day in the unit yesterday---now I know what the new grads must feel like!There are so many things done in a similar manner, but I think it may take a few days to feel comfortable
I can't believe it but I'm actually off today. I took an extremely long uphill walk back from town with Chris. I think we may have gotten it backwards and should have taken a cab back rather than to town. All I can say is that thank God my room air conditioner is now working. And yes, Rick, that was a walk from town where I did shop quite a bit.

. Diane

Good news

This morning we had the joyous privilege of seeing a patient from last year and she is doing very well. Susan is a beautiful young woman woman that underwent succesful mitral and aortic valve replacement during the Team Heart 2010 visit. She visited us today while getting her monthly blood test done for coumadin values. She just looks WONDERFUL. She has been able to return to the work she loves, teaching young Rwandese school age kids ( ages 10-13 ) . So, not only does she feel better, able to walk and climb the many hills of this country, but the future is also better for those kids that she teaches. This is why we do this.
We have also been incredibly lucky to work with an excellent medical resident from this hospital named Dr Gloria Mukeshimana. She has a strong interest in cardiology and we hope that she will be able to pursue that field. This morning we received word that she will have to leave us this week for a two month training posting in Uganda, effective immediately. This is sad news for the team because she's been a warm , caring and very competant physician that has helped us screen, translate and move patients through the hospital system. However, we are happy for her, because this acceptance letter was something she was hoping for , and is a very important step for her training and development. We send her off with grateful thanks, and wishes of success. We know we've made a friend for life, and have hopes that some of the Cardiology experiences we've shared with her will serve her training and her future patients well.

Year 1 Vedaste, Year 3 Susan

We had a wonderful surprise visit today, Susan our English teacher from last year had a routine appoint at King Faisal and stopped to see everyone. She looks wonderful and is teaching again.

Vedaste stopped by for a hug from Leslie and we hear he is doing very well. We hope to host a party for all the patients from the past 3 years and their families on Friday afternoon at King Faisal in the garden.

Sunday, February 6, 2011

I had to share this funny quote from dinner: "We need to toast two historical events from today. Number 1. Mubarak resigned and number 2. 12 doctors, nurses & perfusionists performed cardiac surgery in Rwanda....and let a lawyer watch!" -Dave Wilson, Esq. Team Heart President
After a 12hr NAP I think we are ready for our first shift! Wish us luck 3 pts in our unit tonight.
Heard good outcomes from our co-workers. Our MGH counterparts worked days today so we will be getting report from them tonight.

Turn blue to red...

The first case of 2011 went well! It was a mitral valve replacement on a 23 year old woman and she is doing great! She was extubated last night and is already up sitting in a chair and it's less than 24 hours since her surgery!

Day 2 case 1 is currently underway! First up is a double valve replacement followed by a single valve replacement this afternoon. The morning has had it's share of excitement for Chris & Gio (my fellow perfusionists in the picture with me). The oxygen pressure randomly drops making us unable to oxygenate the patient on bypass (or as we say in perfusion "turn blue to red"). But we were prepared and had an oxygen sitting right behind the pump and quickly switched over to that for the several minutes it took for the wall oxygen to return. Crisis averted!!! And at least the power didn't go off during this! So far we've been fortunate that it hasn't gone off while we're on bypass, but it's just a matter of time. But we're prepared for that too and have the pump plugged into an uninterrupted power supply and have a hand crank on the pump should that fail.

Hope everyone enjoys the superbowl tonight! We'll be missing it since it will be airing during the middle of the night here and we'll be fast asleep resting up for day 3. Have some chili and Dr. Pepper for me! Definitely can't get those in Rwanda!


News from the cardiology front

Marilyn, our incrdibly skilled echocardiographic technologist, and I, as the cardiologist on the trip, had the privilege of inaugurating the Team Heart Mission this yr, by arriving one week earlier than the rest of the team and screening many patients, trying to find those most in need of surgery, but who would also be able to survive the rigors of surgery and have long-term benefit. I see more critical disease here in 2 days than I see in one year at home. Our patients are generally teenagers or young adults who have likely had many bouts of rheumatic fever which have scarred at least one and, in many cases, 2 or 3 of their heart valves. The scarrring causes severe leakinss or narrowing of valves, producing symptoms of heart failure. Many of our patients have had to stop their work due to symptoms. Unlike in the United States, their disease is very advanced when they first come to medical attention. Heart valve infections, congenital heart disease, and primary disorders of the heart muscle are also causes of heart failure in this population. It is so wonderful when we can offer a patient an operation which may allow them to walk up hills (Rwanda is known as the land of a 1000 hills and feet are generally the only form of transportation for our pt) again and resume work and caring for their families. It is heartbreaking, however, to not be able to offer surgery to at least 40-50% of the patients we see-usually a result of chronic valve leakiness so weakening the right heart and/or the left heart pumping chambers that surgical risk would be too high. In addition, such pts, even if they survived surgery, would not generally have symptomatic benefit since advanced heart muscle function is not helped by valvular surgery. We have to catch those patients and operate prior to the advent of irreversible heart muscle deterioration. In many of these non-operable patients, however, we can often change their medical therapy (e.g. controlling heart rates if they are much too high) to significantly improve their symptoms. The patients are incredibly grateful for any help we can give them. The Rwandan population has suffered so much, from losing family and friends in the Genocide, from poverty, from lack of medical attention, etc.--to give them a chance for a better life is why we are all here. As was the case on prior missions, however, we get much more than we could ever give. This experience is truly a life-changing experience for all of us.
Our first patient had a mitral valve replacement yesterday. She is doing beautifully and will go from the intensive care unit to the step-down unit today. Our 2nd patient, who will receive 2 valves, is in the OR now. We have a busy schedule for the next week.

Pat come

Saturday, February 5, 2011

OR Day 1

The decision to start with one case was a wise one. The snowstorm forcing the ICU team reschedule was part of the decision to start Saturday later morning. Hopefully, the rest of the ICU will arrive by 12 noon in one hour....and we will be up to full speed by tomorrow. Many plans are part of the consideration of how many to do and how many cases per day. From the very beginning, we decided that our program would have a focus on development for a building a local program...not a race to show how many cases we cases we can do.

Today, our first case is a lovely young lady which we seen before on previous visits. She, like many of the patients, is here alone and will depend on the compassion of support of this incredible team to help her though the ICU and early post operative days. Stoically she listened intently to the list of tubes and support and the need for them. I can just tell she will be a cooperative patient and play a strong role in her recovery.

The list is as final as it can be here. The labs tests are not completed until they make the list, so there might be a few cancel if something should turn out abnormal. We have really been lucky to have the pre-op screening done with Pat and Marilyn and Taufiek --but Taufiek prepares to leave later tonight. He has been wonderful asset to have him with us and we will miss him as he returns to Boston.

The photo is KFH ICU nurse, George with Kumar the Bio-med, setting up the vent. The local staff has been wonderful and very willing to help. However there have been many changes in the hospital personnel and we miss those faces. Because of the turnover, some supplies had been moved and we spent many hours locating. We will certainly need to improve that part of the system or else return to the 3-4 day pre-op un-packing and set-up we used before.

So keep us in your thoughts as this lovely young woman gets her only chance at the opportunity to have surgical repair of her very destroyed valve to improve her health. We have an incredible talented team, surgeons, anesthesil, perfusion and nursing--we balance with the very real reality of the challenges of the system-- But doing so can make all of us better at what we do.

Is there a pharmacist in the house?

We've unpacked 6 suitcases and 2 trunks of medications - the pharmacy is now open for business!

Today we operate on our first patient. I'm excited to see her roll out of the Operating Room (or Theater as they call it here) with a new lease on life. I've spent the morning providing the anesthesiologists and pefusionists with medications that they will need during the operation. Once our patient arrives to the ICU, I'll set the nurses up with the medications they will need for the next 24 hours - mostly pain medications, postoperative antibiotics and blood pressure medications.

I have been working closely with George, the Australian pharmacist from the Open Heart team. George has had over 25 years of experience doing mission trips and is a valuable resource for the entire team. In his travels he's been to Papua New Guinuea, Nepal, Fiji, Tonga and Vanuatu. Maybe one day I'll be able to recite a list like that!

On Monday, George and I will meet with King Faisal's pharmacist to discuss the standard medications required for cardiac surgery. As part of our effort to create a sustainable program here at the hospital, we are working towards expanding the pharmacy's formulary.

It will definitely be busy, but I'm looking forward to an exciting two weeks!

Friday, February 4, 2011

Getting Started - Yay!!!!

Just got my groove on with some of the newest arrivals, Bonnie, George and Don at the Top Tower club.. Had a nice toast to cheer on the fab work they are going to do in the upcoming days.

So, Tomorrow is our first case and we are RTG (ready to go). I have 2 fabulous nurses here to start the ICU up and 2 of the wonderful King Faisal nurses, Clementine and Placide who are amazing, ready to work very hard. They are amazing. Please stay tuned as it is going to get better and better each day.

Team Heart Rocks!!!!

p.s. Please make sure to post a blog, so that your loved one gets motivation and we read them to the patients, if possible, so they know how many people are caring for them all over the world. They love it !!!!
:) Sabby

Everything ready to go!

Hi everyone!
We had a busy day at King Faisal today but everything is unpacked and ready for our first surgery in the morning! We still have some supplies arriving with other team members tonight and tomorrow but we're all excited & ready for the first case.
We're currently sitting at Heaven having a nice relaxing dinner outside while overlooking the city of Kigali. It is a beautiful night here! Chilly enough for a light jacket but not cold enough to keep us from enjoying the fresh air! Keep us all in your thoughs and prayers as we do our first case of 2011 tomorrow.

Thursday, February 3, 2011

second part of team arrived safely!

After long flight, but on time and uneventful the second section of team has arrived. Bonnie, George, Leslie, Jabaris, Bobby, Carmen, Samantha and Chris, Maddie and Dave and I . All trunks arrived and in good shape. We dropped them off and have not been reunited with supplies yet, so tomorrow will be one busy day!

Prem, Katie Andy and Luigi, Renata and Bob are delayed in Entebbe. I am not certain they knew they were going to land there en route, but expecting them to touch down very shortly. Prem and Pat can start working on final list. Chip and Susan, Gio, Mark and Naomi arrive tomorrow night......We are all very tired...more tomorrow.

Back to Rwanda; Team Heart mission # 4

As i sit with my morning coffee and watch the snow fall i get excited at the prospects of leaving it all behind and joining my friends in Rwanda. This is my forth trip with Team Heart and i am realizing I am a veteran of this mission, not only because i have been part of each trip but because i feel a calmness, certainty of our work. I was surprised how quickly i was ready and packed; a backpack of clothes for 18 days; a 50 lb trunk of " gifts" and medical "stuff" for the many i know and care for. Even though this seems like i am traveling " light" it is still more than the vast majority of this country; who many could carry their life's belonging on their backs.

I must say i am so proud of Ceeya and Leslie, our co leaders in this project. They have shown a rare calmness during all of the airline weather cancelations and have always felt we could start on time with our surgery. I feel we are becoming a well oiled machine and i expects the process to go smoothly. Our cardiologist, Pat Come and resident Tafeak ( sorry about the spelling Tafeak) are already in Rwanda doing workups on our pre screened canadates for valve replacement surgery. Our supplies have arrived and the team that left on wednesday will organize them so we can start surgery asap. We will operate for one week and we will keep you posted on our progress.

A lot of colleagues and friends ask me " why do you keep doing this? Don't you have to pay for your flight and use vacation time?" Yes, this is true and sometimes i ask the same questions but something changed in me when i went over with Team Heart in 2008. I understood how blessed i am to have been born into a society of prosperity; poverty is cruel and unfair and i felt i have a moral obligation to give back; to the least of our brothers in Africa. Hope and gratitude are pure emotions in Rwanda; you can feel it in their handshakes, their eyes and their smiles. I am happy to go back and excited to see my friends and former patients well and thriving. I am ready to work but it never seems like work......keep us in your thoughts and prayers. Susan

Wednesday, February 2, 2011

Travel time!

Well I've made it to dc from durham, nc and am waiting on my flight to brussels where I will meet up with the rest of the team traveling today. I'm a little uncertain about flying 8 hours alone, I mean how am I supposed to go that long without talking to someone?! But I guess that's the price I pay for leaving mass general & going to duke! I have a fully charged ipad & kindle so I'm sure I'll be just fine on the plane! I'm excitrd to see my friends from boston again & to see what wonderful things are in store for us this year!
well as I'm writing this I learned the flight from boston has been delayed an hour but thepilot thinks they can make the time up in the air. I sure hope so! Good thing we have a couple of hour layover in brussels!

Team Heart on Channel 4 tonight

Please tune in to Channel 4 tonight to see a short story about our work and all the great things Team Heart can do.

Tell your friends and everyone.
Team Hearters ROCK and Flat Stanley too :)

Let's Do This!!!

Shoveled out (thanks to my wonderful husband - Vinny)- check,
Bags packed - check,
Tickets - check,
Flat Stanley - check,
Lab supplies and medications - check,
Feeling when you see the first patient walking the halls - PRICELESS !!!!!

This is why we do what we do - stay tuned to see all the beautiful faces of our patients and volunteers as we make miracles happen

The beginning of the journey

I'm starting today with positive energy and looking forward to what this trip holds for us. Medications and pharmacy textbooks are tucked away into 5 suitcases that each weigh just under 50 pounds according my new scale from Ocean State Job Lot! And my final suitcase of personal belongings has been dragged through the snow and is waiting at the Brigham ready for departure.
Whether we leave today or the next - it's just a good feeling knowing we're on our way back. To the rest of Team Heart...see you in Kigali!

Tuesday, February 1, 2011

German Detour

Greetings Team Heart and Team Heart Supporters. As many of you know, Kayla Q., Ashley J. and I were supposed to go to Eqypt for a few days pre Rwanda. Clearly that wasn't an option given the current political climate....sooo we are in Germany. While there are no pyramids or mummies, we have been exploring some of the small villages and castles that Germany has to offer. Today the three of us went to the German Apothecary Museum in the Heidelberg Castle and learned all about the pharmacological history of Germany (Bonnie-Team Heart Pharmacist Extraordinaire will be proud I'm sure). We are following everyone's updates about the snow storm at home...and hoping for for everyone's safe and timely arrival in Kigali. Kayla, Ashley and I will be arriving Friday night. See you all soon. ~Sara S.

Transportation to Logan

Boston Coach will be picking up at 12noon for the 4:15pm flight and 3:30pm for the 6:50pm flight at the 15 Francis Street entrance to BWH for those who are departing tomorrow afternoon and need to pick up a trunk.

Happy Travels!!!

It appears from talking to the travel agent, International flights are going out pretty much on-time. Domestic flights which several of you have, as connections are not.

As it stands now and from what is happening today, both the Luthansa 4:15 to Frankfurt and KLM 7'ish flights are expected to leave tomorrow and on-time. I expect Maddie and Chris to join our flight tomorrow, meeting Samantha in Brussels. So back to last minute packing!

Flights cancelled for the 6:50 am 2/2 departure on United/Ethiopian air affecting 5 ICU nurses and 2 step down nurses. Immediate rebooking efforts underway, but I am thinking we need to rebook for Friday to be safe. Nurses will be contacted individually for rebooking options.

Last day before The Storm!

Just finished my last shift at MGH and left with my heart full of wishes! I work with the best group of people. They stand 100% behind us and I couldn't be prouder to "represent" them.
Will get a short nap in before going to see Mom and Dad and last minute tying ends before heading out in AM hopefully to Rwanda where I hear is 60 degrees warmer than this!

Snow in Boston and

As we balance in our minds the concept of 20 more inches and real temperatures of 15 in the Boston area on the day of departure--while sunny and 83 in Kigali, we cannot stress enough the necessity of being in touch. As flights either take off vs get rebooked we need to make sure that I know if any of you get rescheduled and the route traveling.

We will make our way as we can and reconvene at the Top Tower! Donald, our bio-med has arrived and met Jean Paul. Donald will join Marilyn and Pat for dinner after a long long day of pre-op screening for them. Early night for Donald and tomorrow he will begin.

Egidia, BWH nurse, above called to wish us good luck--mainly on flights getting out of Boston, pictured here with Dorothee and Claudine, year 2. We look forward to seeing both young ladies at some point while we are there!

Team Hearters can handle ANYTHING !!!!

Hello All,
Here we go with our latest snow storm and it looks like its gonna be quite a doozie.

Please stay tuned very closely to the blog, and your Team Leader, for up to date info.

We are an extremely adaptable bunch and can handle anything together - this is just Mother Nature testing us, so let's show her we can cope with it. Keep your shovel close and be ready to go.

See you all in Kigali, if not in Brussels or Frankfurt before then.
Safe travels

:) Leslie aka Sabby :)