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During the trip to the Crudem Medical Center in Milot, Haiti in November 1996, A discussion was held regarding open-heart surgery. Crudem is a regional health facility serving a local population of 20,000. Patients also come from nearby areas of northern Haiti, including Cape Haitian, the second largest city in Haiti. Over 70% of health care delivery in Haiti is through International non-government organizations (NGO's). Haiti is the poorest country in the Western Hemisphere. With a population greater than 7 million people the economic and political climate is very unsettled and insecure.
The true incidence of heart disease is unknown, yet rheumatic and congenital heart disease are common disease in young children. There are only three echocardiography (ECHO) machines in the entire country making an accurate incidence or definitive diagnosis difficult to document.
After considerable discussion and debate, the open-heart project at Crudem was formulated. The ultimate goal was to establish a continuum of care ranging from prevention to diagnosis and ultimately curative strategies. It was hoped this would serve as the model for future endeavors in other areas, particularly Port-au-Prince, the capital.
From November 1996 to August 1997, equipment and supplies were gathered and sent to Haiti to bring the operating room and intensive care unit up to standard for open-heart surgery. A team of three went to Crudem in August 1997 to set up the equipment and supply the hospital.
In November 1997, a team of six from the University of Massachusetts Medical Center and St. Vincent's Hospital both in Worcester, Massachusetts spent a week at Crudem. The first two successful open-heart operations in Haiti were performed (VSD repair in a 7-year-old girl; MVR in a 18-year-old male).
In November 1998, a second trip was undertaken. Prior to the trip an ECHO machine was sent. This enabled more precise identification of patients. The team was increased to eight. Four successful operations were performed.
In November 1999, a team of 12 went to Crudem. Two mechanical ventilators were added thus enabling postoperative respiratory care. Three operations were successfully performed (two mitral valve replacements and one pulmonary valvotomy).
In November 2001 a team of 10 went to Crudem. An additional heart/lung machine was sent. Three operations were successfully performed (ASD; MVR x 2).
During all four trips, evaluation of patients was performed. Several screened patients, all children, were sent to the United States for free open-heart surgery. Local medical and non-medical staffs were involved in all of our endeavors, thus assuring continuity of care and allowing for further development and transition to local control.
Since this report another team from the Mayo Clinic, headed by Dr. Tom Orszulak, a CT Surgeon, have made 3 trips to Milot. In November 2001, another team from Israel, headed by Dr. A. Cohen was to extend open- heart surgery to younger children with congenital heart defects. Unfortunately, Ami's tragic death cancelled that endeavor. The ICHF team performed 3 open-heart operations during that trip and dedicated the trip to Ami's memory.
Mayo Clinic Team, February 2003
The 5th trip in November, 2003 involved two teams over a two week period. Over 40 patients were evaluated utilizing the Acuson Cypress Echo machine. Nine patients underwent corrective cardiac surgery. A broad based strategy was proposed to increase the number of teams, and pursue further training of native Haitian health care personnel. The Mayo Clinic team returned in February, 2005. They successfully performed 5 open heart operations.
(A testimonial from the Team Testimonial page can be viewed here, 3.6M MS Powerpoint)
Haiti 2003 Team I
Haiti 2003 Team II
The first open heart operation done in Haiti at three year follow-up
In January 2009, a pilot mission was undertaken regarding
future feasibility. A reassessment was undertaken regarding resuming open
heart surgery at Milot. The consensus was not to restart the program at
Future initiatives include development of a Rheumatic fever/ Rheumatic heart disease study in children from the Milot, Haiti area. In addition, referral of selected surgical patients will be made to USA, Dominica Republic, Martinique, and Paris France. Cooperation with La Chaine de L'Espoir, is in progress.
Because of the earthquake, Cholera epidemic, political unrest, and security issues, further trips to Haiti have been delayed. In November 2010 a feasibility study was performed at CRUDEM. The initial impression was that cardiac surgery could be resumed in 12-18 months. In the interim, efforts will be made to have some patients referred and operated on in the Dominican Republic.
Following the last visit the consensus was to initiate the
open heart surgery program in January 20012.
Please access the feasibility study below by clicking on the link.
Haiti dedicationIn January, 2012 the cardiac surgery program at Sacre Coure Hosital, CRUDEM Foundation in Milot, Haiti was re-started after one year of active planning and preparation. Two successful open heart operations were performed. The cardiac surgery team under the auspices of the International Children’s Heart Fund dedicated the team trip to the memory of Britney Gengel and her Lynn University team that died in the Haiti earthquake of January, 2010. http://belikebrit.org/
Please click on the link below to view the report.
Haiti Report 2012 (6 M)