Monday, April 7, 2014

What is your Mission?

Mission Statement:

Working in partnership with the Rwandan Ministry of Health, and the Rwanda Heart Foundation, and global partners, TeamHeart will address the burden of cardiac disease:

To address the suffering of adolescents and young adults afflicted with advanced rheumatic  and congenital heart disease in Rwanda with surgical intervention to return to a productive and fulfilling life.

To work with the medical and nursing staff in Rwanda to establish a sustainable regional center of excellence in cardiac care for children and adults.

To prevent advanced rheumatic heart disease through a combined effort of surveillance, prevention, education and early intervention as an example of effective countrywide intervention against rheumatic heart disease that can inspire a scalable  model in sub-Saharan Africa.

Program Components:

1. Cardiac Surgery: Now in our eighth year, the Brigham and Women’s Hospital and Massachusetts General Hospital (BWH/MGH) based TeamHeart (TH) will continue to work with the Ministry of Health, and local medical personnel to establish a sustainable independent cardiac surgery center in Rwanda to address the surgical burden of all types cardiac disease requiring surgical intervention.

2. Rheumatic and Congenital Heart Disease Registries: Working together with the Ministry of Health, the Rwandan Heart Foundation, TH will identify register and implement a care-delivery system for those patients requiring surgical care. Those with milder forms of rheumatic heart disease who need secondary prophylaxis,  will be followed with a goal to prevent the progression of disease. Patients with CHD and RHD awaiting surgical intervention will be placed on national waiting list to facilitate referral for care.

3. Management of Cardiac Disease: To prevent rheumatic fever (RF), and thereby progression to rheumatic heart disease (RHD), a collaborative project will improve management of all aspects of streptococcal infections in a region that has been identified with a presumed high rate of disease. Identification, early intervention, prevention and post operative follow up will be the focus of the first outreach clinics in the country devoted to cardiac disease. 

Wednesday, March 12, 2014

Dear Members of Team Heart 2014:
I have been back in Boston for the last couple of days, and have had some time to reflect on the visit of Team Heart to Kigali this year. In many ways, this trip proved to be the most satisfying of all our trips to date. It was also, without a doubt, the most intense and exhausting, partly because of the extracurricular activities which accompanied the usual surgical challenges. The main thing, indeed, the thing that keeps all of us coming back, year after year, is the unbelievable patients. This year, as always, the challenges were many, and also, as always, they were outstripped by the rewards. Beginning with the amazing work of the screening team, and the humbling responsibility of choosing only the 16 most 'deserving' to have the opportunity to undergo surgery, the patients quickly winnowed their way into our collective consciousness and affection. Seeing the effect this has on the various team members is always remarkable to behold. One of the challenges many of us face is learning to maintain sufficient emotional distance to be able to continue to function when the inevitable disappointments happen, and at the same time, not compromise our compassion for these very sick and vulnerable people. We operated on sixteen high-risk patients, by any measure which can be applied. Thanks to the selfless, tireless efforts from all involved, from the theatre team to the ICU and the step-down unit, and including Sluice Team 6, all the volunteers, our biomedical experts, these patients were all given at the very least a chance at a longer and healthier life, and the opportunity to pursue their dreams. I know I say this every year, but it is so rare as to warrant comment yet again. One of the most consistently moving aspects of this entire experience year to year is the way each and every team member checks their egos at Customs, and does absolutely whatever is necessary to ensure that the patients do well. That everyone helps everyone else, without being asked, and that the laser focus is always, always on the patients and on each other, speaks volumes about the quality of individual that this effort has attracted. This is the best work that we do in our careers, and I am truly humbled and proud to work with each and every one of you. 
I would like to also recognize our Rwandese colleagues, who, this year, stepped up to perform at a higher level than ever before. In theatre, perfusion and anesthesia was more Rwanda-centered than ever. In ICU and Step-down, the same was true. This is very rewarding to behold, and bespeaks the need for a more sustainable effort in cardiac surgery in Rwanda, such that this momentum in education and information transfer can be maintained and enhanced. 

In this, our seventh year of performing surgical missions, I feel that we have finally reached a threshold of credibility regarding both our commitment to Rwanda, as well as our ability to consistently perform cardiac surgery at a very high level. This cachet was evident in many of our discussions with various stakeholders, including the leadership of KFH, Dr. Gasakura, the physician to the President, the Ministers of Education and State, representatives of the Ministry of Health, the President and Vice-President of the Senate of Rwanda, among others. The visit of Sir Magdi Yacoub and his daughter, Lisa, also enhanced our credibility, and allowed us to begin to leverage our work to help reach the next level, namely to develop a sorely-needed dedicated cardiac center for Rwanda and the surrounding region. 

I will stop there, as I have already rambled on too long. Thank you, one and all, for your dedication and for your love of your fellow man, so evident in all your efforts for Team Heart on behalf of our mutual patients. Til next year. 
Chip Bolman