International Children's Heart Fund
	Haiti 1997 - 2003
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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 is  slowly evolving 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. The International Children's Heart Fund is planning to return in November, 2006 for 2 weeks, to perform both adult and pediatric cardiac surgery. Additionally a broad based initiative to study the incidence and prevalence of  rheumatic  fever and rheumatic heart disease is planned.

(A testimonial from the Team Testimonial page can be viewed here, 3.6M MS Powerpoint)

Haiti 2003 Team I

Haiti 2003 Team II

Because of the political unrest and security issues, further trips to Haiti have been suspended.  Hopefully future initiatives will take place. In the interim, efforts will be made to have some patients referred and operated on in the Dominican Republic.

The first open heart operation done in Haiti at three year follow-up