Tuesday, February 23, 2016

NP Julie in action...

I traveled to visit Redempta's family in her village near Kamonyi, located to the south of Kigali.  Our Team Heart patient and registered nurse Theo and his Uncle  accompanied me.  It was an incredibly beautiful drive.  The mountains and valleys so green.  We arrived and were immediately greeted by Demi's youngest brother Cosi and her Mama.  Her Mama looked wonderful, she was dressed in a traditional Rwandan dress with a matching head scarf.  

We  entered Demi's home and were met by her Papa, who was wearing a purple Braintree Youth soccer shirt (either my son Nolan's or Andrew's from a past year, sisters Laetitia, Rebecca and brother David.  All looked very well, smiling and happy!  We had a wonderful visit.  Papa asked to speak and with Theo as an interpreter, welcomed us to their home and went on to say how happy they were to see me and how appreciative that I was caring for Demi.  Papa continued by saying it was tradition to give me something to express their joy.  Pap went outside and came back into the room with a chicken!  The chicken was placed in my lap and my arms placed around him to hold him in my lap.  If only someone from Team Heart could have seen me!!  I was trying to hold on so tight, his legs were moving, his body was rested up against my left cheek.  I don't know how I managed to keep a hold of him...there are plenty of photos to share that I am certain will make you chuckle.  However it was not a laughing matter for Papa.  This was serious, almost ceremonial feel.  I explained that I was unable to keep the chicken, despite my pure happiness and gratitude, as I was staying in the hotel and working long hours at the hospitals.  I asked that he keep and take care of for me.  He was happy to do so.   Certainly a first for me!  Julie Carragher

Sunday, February 21, 2016

You cannot help but be amazed by these volunteers…their expertise, love of teaching and true compassion brings one to quick tears. It is always so emotional when you arrive, have jet lag and are reminded why you are here. The screening teams advocacy for the vulnerable population, those patients so ill they would not survive a trip to India if they could pay for it, propels the team into action…it is this point they can advocate for the majority and not the reality of having to select a number to fit into 16 slots for the operating room. Come a week from Sunday,  in a classroom with Bobby, Chip, Danny and Martin and Rwanda colleagues joining them to select—reality sets in…16 slots.

I joined the screening team at Rwanda Military Hospital for a few hours to watch them in action. We were  pleased to have our advocate Dr. Evariste Nganda, from RBC there, because it helps the RBC to see the faces we see, the disease that is there. Dr. Evariste is a quick study and spritely moves through the room to sidestep being roped into a cardiology tutorial 101 as teaching is everywhere.  If he is not careful Dr. Come will be including him in her teaching session  all about venous filling and how to interpret in the face of RHD

Being in the same room with her energy is infectious, as everyone loves cardiology in her hands. Rwanda Military Hospital is one of the the best-organized hospitals we screen in  which  cares for public sector in the country.  Although it is designated a military hospital, it is viewed as a key public hospital for the civilian population.  It seem like a good place to work for civilians as well and I am sure having more of what you need when you need it is a big part of that, and there is job security for good performance.  We work with Dr. Jean Vianney Ganza, a cardiologist out of University of Rwanda Medical School who trained in Cardiology in Belgium.  His team is very welcoming and provides great space for our screening. Dr. Ganza has been our closest ally here and we see how the referral population is changing for him. There are few patients referred by him that do not meet the strict screening criteria that Julie C., NP and her screening team set forth. 

We enjoy and admire all the cardiologist. There are 4!! Yes 4 for this country of 12.5 million and maybe 2-3 in training in South Africa or Brussels. They each bring their expertise and are fierce advocates for their patients…

Just today we saw the impact of this advocacy. Dr. Emmanuel our Pediatric Public sector cardiologist,  who is much loved and admired by all of our Team brought a scrawny young man for consideration in Screening 2014. The young 14 year-old lived with his two older brothers who took wonderful care of him, but felt hopeless for his future. He had been turned down by other teams and Dr. Emmanuel felt if he just had a chance…one chance, he might have a future. He was the last patient selected at the selection meeting and for those of us there,  the discussions were intense.  He was sick very sick, malnourished due to the heart disease beyond imagination and he had this wonderful smile and was so trusting.

His rheumatic heart disease had ravaged his body and the best efforts to provide nutrition by his bothers was not evident as his body wasted.  I am sure the call to the brothers was a happy  one for Dr. Emmanuel to say he had been selected for a chance to have surgery. Dr. Emmanuel stopped by every few days to check on him..a second visit to the OR for tamponade gave the ICU team and surgeon Chip a scare but was handled so competently we could have been in any major cardiac center—we did have the best nurses, surgical, anesthesia and ICU teams.  

Young Mr. Gratien visited us today and just could not understand the tears as cardiologist, sonographers looked at him with so much pride. He looks so normal! Now in primary 4 he is making up for lost time. His brother was pleased at his school performance and his attention to his health maintenance.  I predict good things for this bright young man…..

He is photographed here he is with Dr. Jeanne who screened him in 2014.  We normally get Cardiologist Jeanie Decara for 2 weeks, but this year she must leave before surgery begins.  Full of compassion and expertise, she certainly can feel good about giving back when she sees the outcome of this young man. He would have not survived 6 more months.