This March, a team of doctors, nurses, and biomedical engineers from the University of Vermont Medical Center joined Team Heart, a medical mission in Rwanda to care for young people with rheumatic heart disease.
Team Heart was founded eight years ago by a cardiac surgeon and nurse in Boston who recognized the plight of young people with rheumatic heart disease. Rwanda is a country of more than 11 million people, but there are only five cardiologists and five ultrasound machines. Basically, there is no cardiac surgery available despite an extremely high incidence of valvular heart disease in the country.
Untreated, these patients face a very grim prognosis and very short lives.
I was there to act as one of the general cardiology and cardiac ultrasound specialists. When we arrived, we screened more than 100 eligible patients at clinics, hospitals, and even churches across the country. The patients ranged in age from 12 to 45 and many of them were profoundly malnourished. To put things in perspective, the smallest patient we operating on weighed a mere 57 pounds. All of our patients had a will to survive and a magnificent spirit, which was readily apparent in their smiles.
In the end, we could only operate on sixteen people, each of whom we thought was unlikely to survive another six months without surgery. Of these patients, several had three heart valves replaced, others had two and only a few patients had a single heart valve replaced. The surgeries were long and challenging, but everyone survived.
The teamwork demonstrated by the doctors, nurses, and support staff, was unbelievable. Everyone worked selflessly and late into the night and complaints were nowhere to be heard. The patients and families, in turn, were brave and so unbelievably appreciative that it broke our hearts. Some of the parents slept outside on the hospital balcony in order to be close to their children. Some children were orphans and dependent on the support of friends from the orphanage and there are new friends that they made through the shared experience.
When we left the country all but one patient had been discharged and that patient, who was incredibly ill before surgery, was clearly on the mend. It was unequivocally the most satisfying medical experience of my entire career and one I hope to do again every year for the rest of my life.
Marc Tischler, MD, is a cardiologist at The University of Vermont Medical Center where he is also director of the Cardiac Ultrasound Laboratory. He is an associate professor of medicine and radiology at the Larner College of Medicine at UVM.