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Jonathan M. Chen, MD, has led teams of doctors and nurses—most from NewYork-Presbyterian Hospital/Columbia—on yearly missions to perform heart surgery on children with congenital heart disease. For the first and second missions, in March of 2005 and of 2006, the teams traveled to Cambodia. This year, they set their sights on the African continent, traveling to the Fann Cardiovascular Hospital in Dakar, Senegal. There they operated on seven children between March 12 and 16, 2007. The children in Dakar were much smaller and had slightly more complex problems than in Cambodia, where most were teenagers, says Dr. Chen. In Dakar, most were toddlers; the tiniest patient was an eight-pound, two-year-old girl, the largest a 22-pound teenager. The missions are sponsored by Surgeons of Hope Foundation, Inc., a not-for-profit organization whose goal is to bring lifesaving surgeries to children in developing nations while helping build surgical expertise in these countries. Surgeons of Hope estimates that 100,000 children in Senegal suffer from heart disease, and one-fifth are in urgent need of surgical treatment. In all of Africa south of Morocco, says Dr. Chen, there are just 10 cardiac surgeons, five of them in South Africa.
As grim as the statistics are, the benefit a pediatric cardiac surgery mission offers is potentially exponential, explains Dr. Chen. "If even one of the operations we conducted enabled one of the surgeons to secure his skills in pediatric cardiac surgery," he says, "that surgeon could go on to operate on 100 sick children over the course of his career." This year, the New York team worked alongside two Senegalese surgeons, including cardiac surgeon Dr. Mouhamadou N'Diaye, Fann Cardiovascular Hospital’s director. Dr. Chen reports that both surgeons caught on quickly to the pediatric cardiac surgery techniques their New York colleagues taught them. As in the previous trips, the team faced major shortcomings in the hospital facility. "We had some huge obstacles on this trip," says Dr. Chen. Before the first operation could even take place, the team had to spend the better part of two days repairing broken equipment, using a hefty dose of ingenuity In repairing the anesthesiology equipment, they found themselves using duct tape and wine cork. Determining that the catheterization lab was too small to carry out the necessary procedures, the team constructed a new one in an operating room with the diagnostic equipment they brought from New York, including arterial blood gas analysis machines, a portable echocardiogram machine, and an echocardiography probe. As the surgeries commenced, the team was compelled to scrub with IV fluid from saline bags, having discovered the sinks were clogged by calcium deposits.
A highlight of the trip was a dinner with the President of Senegal and his wife at their official residence, where the team urged investment in medical supplies. Despite his limited knowledge of French, their language, Dr. Chen walked away convinced in the couple's sincerity. "They were very grateful, we're the first American group to go and do congenital heart surgery there," he says. While the children recovered from surgery, emotions of parents ran high as they expressed their gratitude. Many had been told their children were inoperable. "The greatest gifts we get," says Dr. Chen, "are the photographs that the parents send us when their kids are back home." Click here to read about the 2006 trip to Cambodia.  |
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The doctors wanted to ensure the operations they conducted during their visit had maximum impact by operating only on the sickest.
While the rest of the surgical team spent the first 48 hours in Dakar preparing the ICU and operating rooms, Drs. Chen and Flynn examined the children and selected seven whose disease was so advanced that they would be inoperable within a year, when the next surgical team was expected to visit.
"Thankfully, we don't encounter patients in the U.S. who are this advanced in their congenital heart disease," says Dr. Chen. "The problem in Senegal is there are no doctors to operate on these children." 
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| ©1999-2007. Columbia University Medical Center, Department of Surgery, New York, NY. |
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