International Children's Heart Fund
	Dominican Republic 1996 to Present
	You may click the flag for further  information about the Dominican Republic

    In 1996 following a visit to the Dominican Republic a relationship developed with Corazones Unidos.  This is a humanitarian program for indigent children and young adults founded by Dr. Luis Cuello Mainardi, a dedicated and caring Dominican cardiologist.  This Program has sponsored Dominican Patients going to the United States for free operations and care.  The open -heart program at Corazones Unidos in Santo Domingo has grown slowly and progressively to over 200 patients per year, including both private and non-paying patients. Over the past six years the ICHF has worked with Corazones Unidos, initally performing operations at UMASS Medical Center and Saint Vincent's Hospital in Worcester, MA. For the last four years the focus has been working with the cardiac surgeons at Corazones Unidos to introduce new techniques in cardiac surgery.

    In January, 2002 Dr. Yvon Baribeau (Pictured Center Below) from Catholic Medical Center in Manchester, NH, helped the local cardiac surgical team perform the first off pump (OPCAB) operation in the Dominican Republic.  Future projects include innovative techniques, as well as support to build and equip a second operating room for cardiac surgery at Corazones Unidos.

In March of 2003, William Northrup, MD and the Cardiac Surgery Team (pictured below) performed the first Two Cryolife Aortic valve  Homografts on two Dominican patients at Corazones Unidos

Three additional trips to Corazonas Unidos took place in November, 2003, May, 2004, December, 2004, and December 2006. Continuing upgrade of surgical skills has been the focus. The support of a second operating room continues with additional equipment.  Dr Northup again returned in March, 2005 to introduce advanced mitral valve repair techniques.

Current Project - Pediatric Cardiac Care
Dominican Republic
(prepared by International Hospital for Children)

Background

The Dominican Republic is a Spanish speaking country of over nine million people in the upper Caribbean basin. Cardiovascular disease remains the number one cause of death, with stroke and myocardial infarction the primary causes. Additionally the incidence of congenital heart disease is estimated at 5-8/ 1000 live births This amounts to 1500-2000 cases per year. Rheumatic heart disease continues to plague the country, especially in the pediatric age group.

At present there are three units routinely performing open-heart surgery in Santo Domingo, the capital. These are primarily adult procedures. The total number of operations including those done by humanitarian NGO groups from abroad is less than 400 operations a year. Approximately 30-40 children go abroad, primarily to the USA for free or discounted evaluation and surgery. Another 200-300 adult patients are treated abroad, mostly CABG, in Miami, New York, and Cleveland. These are either insurance covered or private pay patients.

As the economic and political situation improves more adults will have access to open-heart surgery. However, the pediatric patients will require government or private funding, since the insurance coverage plans are beyond the means of the lower income section.

Over the past decade several strategies have been developed to extend cardiac surgery to this pediatric population:

1. Evaluation and selection of cases to be done in the USA. Although, beneficial to those selected, and valuable for fund-raising efforts in the USA, this is not cost effective or fair to those not selected, given the expanded waiting lists.
2. Foreign based NGO teams coming to Dominican Republic for one to two weeks and performing ten to twenty operations. Again beneficial to a select group but not effective for the "teach to fish" concept.
3. Several attempts of Dominican Republic based foundations to establish centers for pediatric cardiac surgery. Once again, without sustained foreign or domestic financial support they have not succeeded to handle increasing annual caseloads, improve quality, or approach younger and more complex patients.

International Hospital for Children (the lead affiliate), Caribbean Heart Menders, CardioStart, Rotary Gift of Life, and the Aldo Castaneda Foundation are the initial USA based NGO's involved. A separate initiative with International Children's Heart Foundation is ongoing in Santiago, DR.   It is hoped that the coordinated and organized approach of these organizations will facilitate and accelerate the ultimate objective of a hub for pediatric cardiac care in the upper Caribbean basin. Subsequently, other humanitarian organizations, both USA and foreign based, with interest in the upper Caribbean basin, will be encouraged and invited to join in this collaborative effort

Simply stated, this effort will hopefully achieve the major goal of the creation of a center that will encompass a product line of pediatric cardiac care-prevention, promotion, diagnosis, treatment, and rehabilitation. Within three to five years the host program will hopefully become independent and totally managed with domestic private and government fluids. This coalition will offer help and assistance in three major areas: limited financial finding, equipment/supplies, and clinical training/mentoring of selected local medical staff both in Dominican Republic and out of country locations (eg. Guatemala City, Guatemala).

Susan Rickman, President of International Hospital for  Children (IHC), on initial feasibility trip to Santo Domingo, DR	Working with the IHC cooperative program at Centimed Hospital in Santo Domingo, DR, December 2006.
IHC Cooperative Meeting Santiago, and Santo Domingo, July 2007