REPRODUCED FROM HERALD NEWS
by Laura Fraser
Dr. Debra Isaac monitors the steady thump, thump, thump of a Guyanese girl’s heart, healthy now thanks to surgery in April and equipment from Nova Scotia that kept the tiny organ alive throughout the operation.
The girl was one of a dozen children in Georgetown, Guyana who underwent heart surgery during a visit from a Canadian-led team and the International Children’s Heart Foundation.
The majority of the heart disease they found had been present since birth, Isaac said.
The Calgary cardiologist began training doctors in Guyana in how to read echocardiograms three years ago, building the local knowledge base to the point that it could support the surgical team that arrived in the South American country this spring.
Steve Taylor joined them, having already shipped a heart-lung machine once used on children at the IWK Health Centre in Halifax through the foundation known colloquially as Baby Heart.
Taylor works as a cardiac perfusionist in Halifax. In layman’s terms, he operates the piece of equipment that acts as the patient’s heart and lungs when their own organs stop during an operation.
He began volunteering with Baby Heart first in Honduras; when he returned, he decided to find out how to give this province’s used equipment a second life.
“Seeing what they’re working with — or not even having — I thought that we should be able to send this equipment that’s lived its expected life here at the hospitals in Nova Scotia, but it’s still in excellent working condition,” Taylor said.
A new heart-lung machine typically costs more than $200,000, an amount that can rarely be budgeted for in the developing world. The refurbished equipment makes this type of intervention possible, Taylor said.
But teaching local doctors to operate the equipment is just as critical, he said. This time, he operated the machine, but part of Isaac’s and Baby Heart’s mantra is to cultivate the skills within local hospitals.
For Isaac, that began in 2012.
Guyana’s health ministry invited the cardiologist to assess the region’s resources; she brought with her a portable echocardiogram machine to help locals diagnose heart disease.
“Within about 10 minutes, I recognized that no one knew there how to use it, no one knew how to interpret the images and nobody knew what to do with the images if they had them.
“And then there was no capacity to do anything with those results.”
Isaac and other volunteers have since trained 11 physicians in Georgetown during eight-week sessions in how to perform and analyze images of the heart. Isaac and her team do regular followup and, for the first year of the program, could read scans remotely to confirm diagnoses.
“You need to build the local capacity and (not) make them reliant on somebody who comes for a little while.”
The new technologists and Isaac’s volunteers have performed 2,000 echocardiograms in Georgetown, mapping the traces of disease in hearts. About 40 per cent of those were performed on children.
“I’ve never seen such a high volume (of pediatric cardiac disease) before, but we have to remember that none of these kids were previously treated or previously diagnosed,” Isaac said.
“Kids who would be operated on in Canada before they (turned) six months old, I’m seeing them when they’re four, five, nine, 12.
“And for every one I see who is eight or nine years old with significant heart disease, there’s probably quite a number that I never see who have just died.”
Isaac returned from Guyana last week after a followup session, reporting that all the heart patients seemed healthy. She will return in November and Taylor will likely accompany her.
“I get all these hugs from the kids and it’s absolutely great to see,” Isaac said of her return visit.
“But it has to be tempered by the fact that I see them, and then I see five kids who need operations tomorrow and I know that there are only so many that can be done.
“It breaks my heart not to be able to give everything to everyone right away, but we’re getting there. We’re really getting there.”