Saturday, December 22, 2012

December Planning Trip to Rwanda.

In mid-December BWH Team Heart volunteers Steve Senat and Leslie Sabatino traveled to Kigali with one mission in mind; Determining the barriers to order supplies direct and ship direct. A first time visitor to the country, it was clear Steve immediately loved the countryside and the people he met. He approached the task at hand systematically and immediately understood the challenges the local team faced.  Together he and Leslie identified where they could work together to meet those challenges and look for a positive resolution. It was amazing to see their heads bent close together hour after hour over a computer, as Leslie, A BWH CISU Nurse,  who knows inventory needed inside and out, and Steve, BWH operating room procurement team,  who knows where to find inventory,  excitedly met with outside vendors and hospital staff alike. This is the unseen side of a trip and one of the largest efforts to build a sustainable program. If you do not have supplies consistently managed, you will never have a cardiac surgical program….

Day 2 brought a trip to Butare. A beautiful drive down with Jean Paul, our favorite transportation expert....and a patient from 2008, we made a stop in Gitarama to meet the nurse who forms the backbone of Coumadin delivery and INR testing for about 7 of our post-operative cardiac surgical patients. It is wonderful to finally place the name and face and see the area where  she works.  Her photo is here with the Team Heart visiting group, Libertha does not get nearly the recognition she deserves for this critical need!

Gitarama Visit 12/11/12-Nurse Libertha from Coumadin and testing clinic with BWH Nurse Leslie Sabatino, BWH Operating Room Procurement Team, Steven Senat Team Heart Volunteer and Coordinator, Ceeya Patton Bolman, and BWH resident in Global Surgery and Health Equity Jabaris Swain, MD

Butare visit to CHUB brought the introduction to the visiting team members to Dr. Ganza, recently returning from training in Brussels following a cardiology fellowship.  First hand, we were able to see the challenges Dr. Ganza and his local team face, as they do not even have the basic echo machine for diagnosis available.  However, with little resources Dr. Ganza was able to present an amazing group of patients, all requiring urgent cardiac surgery. Two  beautiful and frightened  young ladies in early 20's were pregnant and with severe mitral stenosis. They will undergo elective C-sections by a competent OB team in the next few weeks before labor can begin.  They then will recover, nurse their infants and wait for our team to arrive to undergo cardiac surgery when babies are just a bare month old.  They were frightened and overwhelmed by the attention and crowds we attract, but we had two successful patients with us who could speak with them to reassure them there was a future ahead and they might live to take care of their children.  One young lady's eyes opened wider as she looked at the healthy individual showing her a well headed chest incision. She seemed to calm in front of us she talked with the volunteer about how she too became ill when pregnant and found her cardiac disease was rheumatic heart disease. Often rheumatic heart disease is silent until pregnancy increases the demands of the workload of the heart. Until then she had no ideal how ill she was!

Following the pre-op evaluation where each patient was presented efficiently with appropriate  lab results reported.   The  attempt to accurately diagnose using an abdominal echo probe for cardiac diagnosis was a challenge. It is apparent how much this wonderful physician can do with so little resources.  We also watched as he worked closely with the local team with  much respect for the work nurse Marie Claire,  who runs CHUB Coumadin and testing center provides for post operative patients.  Ww watched in amazement as they worked with a machine using the most basic of echo machine with a probe not designed for cardiac echo.  We hope to meet this need in January with a generous donation from Philips of a CX-50 machine to share between two wonderful cardiologists. 

The local team hosted tea for several post operative patients and our visiting Team Heart members and it was only after Dr. Ganza began speaking that we realized the patients had been carefully selected to illustrate the profound change in their life following  critical cardiac surgery. Each postoperative patient in the room would have died without surgery… many within 30 days of the time we initially saw them. It was a profound moment to look around the room and see the healthy individuals.  Choking back emotions, those of us visiting,  were moved to be able to se the result of our work. Several, from the more recent surgical visit still struggle to return to the work force, but others from earlier surgery could relate what had worked well for them,  providing both hope and encouragement. The other amazing moment was to realize that each was part of the intricate post operative care system! works!

Putting clearly into perspective, this is what we do...every aspect. Supply and demand of inventory, surgical expertise, postoperative follow-up, screening and prevention and economic stimulation to return patients to education or the work force.   It distills down to people--People here on US ground and people there on Rwanda soil.

This holiday season, we appreciate your donations and gifts which continue to make this program possible.  Warm season greetings and Happy New Year to you and yours.

Butare Visit 12/11. Team Heart members with patients from previous surgical development trips with Cardiologist, Dr. Jean M.V. Ganza. Leslie and Steven in back with joyeuse and Jean H. Sammy, Marcelline with Deborah, our local administrator for Team Heart in front !

Wednesday, October 10, 2012

Update 10.10.2012

v  Approval to work in Rwanda is now required for all NGO's. In response, the application for official INGO status in Rwanda has been prepared and submitted.  A comprehensive 104-page document prepared under the leadership of Team Heart project manager, Noella Bigirimana details the work we do, the partners in country we work with and the source  and amount of our funding. We anxiously await approval, indicating the country values the contributions TH makes to both education and care delivery in cardiac disease and acknowledges TH's careful attention to following  guidelines for providing care. An advantage of the process includes the opportunity to align Team Heart and Rwanda's goals and to determine the best measurement of outcomes. 

 Noella, a pre-med graduate of Cornell University in Ithaca,NY, is a  native of Rwanda and taking a gap year while working with Team Heart. Noella will travel with the surgical team to Rwanda in February and currently is coordinating a meeting of international surgical partners working in Rwanda, scheduled June 2013 in Geneva, among other strategic planning.

v  A successful Team Heart Golf Tournament raised funds for team travel for the 2013 surgical trip to deliver life-saving surgery for young adults and adolescents. Held October 1 on a gorgeous day in Nashua, NH, the tournament was chaired by three-time traveler and step down-ICU nurse, Michelle LaChance. The course at Sky Meadow Country Club is already booked for the third annual tournament in September, 2013, as planning began as soon as we wrapped up play. Thanks to an amazing organizing committee who, incidentally, all work full time at leading hospitals!

v  A comprehensive curriculum has been developed and copyrighted under the leadership of Dr. Patricia C. Come, a 5-year traveler for Team Heart pre-op evaluation team. Submitted for approval to the Senate of the Medical School of the National University of Rwanda, we anticipate and hope applications will be entertained for January admission. The curriculum is a diploma program designed to increase the cardiology knowledge of selected internal medicine physicians working in regional centers to improve post-operative care and increase the identification and early intervention of those with rheumatic heart disease and other heart disease. The selected physicians, after completing the program, will work closely in regional clinics with nurses to provide care. The regional  Rwandan nurse led clinics, forms the backbone of the health care system.  

v        JaBaris Swain, MD, 3-year traveler with Team Heart begins his two-year Cabot Fellowship in Global Health Equity Residency in General Surgery, designed to train academic surgeons in the science and practice of surgical care delivery in austere settings, as well as develop research and policy leaders in this nascent field. Housed in the BWH Center for Surgery and Public Health, the program is one of the few global surgery residencies in the U.S. His work will be designing a proposal to investigate the cost benefit analysis of cardiac surgery in resource poor settings to submit to the Ministry of Health for consideration to work with local caregivers and investigators. Team Heart is proud to support a portion of this fellowship.

In October, under Team Heart sponsorship, JaBaris will travel as an invited guest to the NIH as an observer in global health. In December he will travel to COSECA, (College of Surgeons, East Central and South Africa) in Addis Abba, Ethiopia and will return with the team in February to provide direct care.

Team Heart and Dr. Swain was featured in the recent RHD News Newsletter for the World Heart Federation! Thank you JaBaris for your acknowledgement of Team Heart and the work we do in Rwanda!

v  December travel to Rwanda will include BWH procurement expert Steve Senat and Leslie Sabatino.  Steve and Leslie identified a short list of critical items to order and procure with direct delivery to Kigali working with local team leaders, led by Vedaste Ndayisaba, King Faisal hospital and the newly restructured CAMERWA. Team Heart is the first expatriate cardiac team to take this critical step to sustainability.  This step to transfer expertise for cardiac surgical procurement must happen if surgery is possible independently.

v  Rwanda welcomes back home Dr. Jean Marie Vianney Gapira Ganza from completing his interventional cardiology fellowship, Universit√© Catholique de Louvain Brussels. Originally located in Butare where his family lives he had previously worked in the NUR Medical School UTHB. Team Heart has worked with him since our first year in Rwanda, and he is both loved by his patients and respected by his colleagues. His graduate thesis was regarding rheumatic heart disease, the leading cause of heart disease in Rwanda at this time.  We look forward to working closely with him in the future.

v        Dr. Maurice Musoni has begun his first year of general surgery and cardiac surgery in Johannesburg, South Africa. We have very little information about how his work is going, he is on trauma service now and is working very hard. He traveled with the support of the Ministry of Health.Team Heart is very proud to have arranged the position and to ensure he is able to take advantage of the comprehensive learning experiences.

v  Strategic planning for Team Heart. Do we expand, do we focus, do we build? Do we answer the multiple requests to fill urgent needs in other countries?  If you would like to join a meeting or sit on a committee, or receive minutes contact:

v  Screening-What happened to the screening program of school-age children from September 2010? Data analysis is in process at this moment. Thanks to Boston cardiologist, Bernard Bulwer, and Studycast, all echocardiograms have been read. Echo findings must be graded for input into computer and Dr. Mucumbitisi is compiling  gradings in Rwanda. Early indications could predict a large number of unknown individuals with RHD in the country who will one day need surgery if not identified and placed on prophylaxis. Even then, some will progress to require cardiac surgical intervention. Thank you to The Medtronic Foundation, the J. Warren Harthorne, MD Fund for Screening, Studycast, and Cathy and Mannie Jackson Gift for funding this project and making it possible.

v  Support Team Heart! Consider a Capital ONE Credit Card! A percentage of your charges will be donated back to Team Heart each month to support these projects. To apply for the card, visit:,Inc.

Friday, June 8, 2012

Father's Day Tribute Card....

This father's day, show your support of Team Heart by purchasing one of our Fathers Day Tribute Cards. All proceeds will go to improving our post-operative patient care in Rwanda. With the new Rwanda requirement of  10% co-pay for all patients, accessing the health care system is a challenge for some. Many of our patients have been ill for years, on the brink of death,  waiting for the chance to have life-saving surgical intervention. Most are young and may never have entered the work force without our help. Though survival rates and post-operative health are improving, our patients still need jobs to pay for medical care. Though Rwanda offers universal coverage, or "mutuelle," the care providers  who are knowledgeable about rheumatic heart disease and post-operative care are located in just a few hospitals throughout the country--and because many people do not have access to public transportation, they do not know about the options available to them.

It's hard to believe that $15 tax deductible donation of the $20 sales price could have much of an effect on our patients. But it could save a life.  
For more information?

Thursday, May 10, 2012

The second annual Team Heart Golf Tournament will be October 1, 2012 at Sky Meadow Country Club in Nashua, NH.  The tournament is a scramble start with teams of four.  There are many prize opportunities including airfare and two nights accommodations for two to Las Vegas.  This prize includes a round of golf at the exclusive Spanish Trail Country Club.  There will be a dinner and awards ceremony to follow.  Fundraising is crucial to completing Team Heart's overall goals and mission and is the main funding source for all of our traveling volunteers.  Please join us for a great day of golf and support a good cause to eradicate Rheumatic Heart Disease in Africa. 

For more information on both participation and sponsorship of this event please contact...  Michelle at, or

Saturday, March 24, 2012

Strengthening Rwandan Surgery: Surgical Residents’ Perspective

Guest bloggers Gita Mody (Team Heart 2012), Robin Petroze & Edmond Ntaganda discuss efforts to strengthen surgical care in Rwanda.

In March 2011, the Rwanda Surgical Society hosted a workshop in Kigali on the theme “Strengthening Rwanda Surgery.” Rwanda has been extremely successful in combating morbidity and mortality due to communicable diseases and is now actively tackling treatment of non-communicable diseases, many of which require surgery. However, there are very few surgeons in Rwanda, and over the past several years, there has been growing interest amongst local, regional and international partners to promote Emergency and Essential Surgical Care as well as specialty surgical care in Rwanda. Therefore, the purpose of the workshop was for stakeholders in Rwandan surgery to meet one another, form the basis of lasting partnerships, and strategize on cooperatively expanding surgical services. The attendees were forty-five surgeons, anesthesiologists, industry representatives, residents, students, and others from five countries. There were some long-term and some brand new participants in Rwanda surgery, but all were eager to form a collaborative with a shared vision of a Rwandan-owned, sustainable surgical training and delivery program.

For the full article: speakingofmedicine/2012/03/20/strengthening-rwanda-surgery-surgical-residents’-perspective/