Children's Heart- LIFE-SAVING CARDIAC SURGERY

Cardiovascular diseases remain a major cause of morbidity among children living in rural areas of Nepal, where access to specialized healthcare services is extremely limited. Geographic isolation, scarcity of trained personnel, and inadequate diagnostic infrastructure often prevent early identification of congenital and acquired heart diseases, exposing children to serious and potentially life-threatening complications.

Within this context, Mission Bambini continues its long-term commitment in Nepal through the Children's Heart Program. From November 24 to 30, 2025, Mission Bambini organized a cardiological screening mission in Bhanu Municipality, Tanahu District, in partnership with Save the Heart Nepal. The initiative aimed to improve early diagnosis of pediatric heart diseases and strengthen local referral pathways in rural and underserved communities.

The mission was carried out by an international medical team of three Italian volunteer doctors, supported by Mission Bambini staff, and working closely with a local healthcare team of 24 Nepalese professionals. This close collaboration ensured an efficient organization of activities and a high standard of clinical care, enabling the team to respond to a very high demand for cardiological evaluations in a limited timeframe.

Thanks to a structured screening approach and the availability of three echocardiography machines—including equipment provided and previously donated by Mission Bambini—thousands of children were evaluated. Overall, 3,247 patients received clinical examinations and cardiac auscultation, while 845 underwent echocardiographic assessments and 405 received an electrocardiogram. As a direct result of the mission, four children were identified as candidates for cardiac surgery and were taken into care by Save the Heart Nepal, with surgical interventions scheduled at the Manmohan Cardiothoracic Vascular and Transplant Center in Kathmandu.

Beyond its immediate clinical impact, the mission contributed to strengthening local capacities. Three local healthcare professionals were directly involved in the screening activities and benefited from on-the-job training alongside the international team, reinforcing diagnostic skills and promoting sustainable knowledge transfer.

During the mission, Mission Bambini also engaged in discussions with local partners to explore future collaboration opportunities, including the potential expansion of screening activities to other remote areas characterized by a high prevalence of undiagnosed cardiac conditions.

Despite some challenges related to outdated diagnostic equipment and the limitations of auscultation-based pre-screening, the mission highlighted several strengths, including the strong organizational capacity of Save the Heart Nepal, effective logistics in a complex rural setting, and rapid clinical pathways with immediate feedback to patients and families.

The Tanahu screening mission confirmed the strategic importance of early diagnosis in reducing pediatric cardiovascular morbidity in rural Nepal. By combining direct healthcare delivery, capacity building, and strong partnerships, Mission Bambini continues to work toward a healthcare system where children’s access to life-saving care does not depend on where they are born.

Congenital heart defects are among the leading causes of infant mortality worldwide. In Uganda, the challenge is particularly serious: only 65% of the population has access to basic healthcare, with much lower rates in rural areas. Access to specialized services such as pediatric cardiac surgery is extremely limited, due to a shortage of trained personnel, lack of technologies, and weak continuity of care.

The current surgical output at the Uganda Heart Institute (UHI - located within Mulago National Referral Hospital in Kampala) is approximately 100 open-heart (pump) cases per year for children with congenital heart disease. In addition, between 60 and 70 closed-heart procedures are performed annually. Although these numbers represent significant progress compared to the past, they remain far below the national needs, leaving many children without timely access to life-saving surgery.

In this context, the contribution of partners like Mission Bambini is essential to bridge the enormous gap between children’s needs and the services available.

The Mission Activities

From May 25 to 31, 2025, Mission Bambini organized a new surgical mission at Mulago Hospital, continuing a collaboration active since 2014. The Italian medical team, joined by a Mission Bambini staff member, included 7 professionals from hospitals such as Niguarda (Milan), Gaslini (Genoa), Ospedale del Cuore (Massa), and Regina Margherita (Turin).

Working side by side with Ugandan colleagues, the team successfully performed 7 life-saving surgeries on children affected by severe congenital heart diseases, ranging in age from just 1 month to 12 years. Each intervention represented a crucial step in giving these children the chance of a healthier future.

Beyond the surgical interventions, the mission included the donation of more than €8,000 in medicines and medical supplies, a post-operative follow-up on a child previously treated in Italy, and monitoring visits for two children awaiting future surgeries.

As in every mission, training was a central component. Over the years, Mission Bambini has delivered more than 200 hours of on-the-job training to Ugandan staff and financed scholarships in Italy for three young doctors, ensuring knowledge transfer and strengthening local capacities.

Institutional Relations and Partnerships

This mission was the 11th camp organized in Uganda since the start of the partnership. Even during the Covid-19 pandemic, the collaboration never stopped: between 2020 and 2022, Mission Bambini funded 22 urgent interventions performed by local staff for children who could not wait.

In 2023, the partnership took a further step forward with the signing of a three-year Memorandum of Understanding (MoU) with the UHI, allowing for more structured and effective planning of activities. During the May mission, Mission Bambini representatives met with Dr. John Omagino, Executive Director of UHI, confirming the shared will to renew the MoU beyond 2026.

The mission also opened the way to new collaborations. One of these is a large-scale cardiac screening program targeting around 4,000 students of Bishop Cipriano Kihangire School in Kampala, to be completed by the end of 2025. Early diagnosis is a crucial step to reduce mortality and guarantee timely access to care.

Future Prospects

Building on the results achieved, Mission Bambini and UHI are working on a renewed three-year plan that will include:

• Maintaining and possibly increasing the number of surgical missions per year;
• Expanding training for doctors, nurses, and technicians, both in-person and online;
• Reinforcing supplies of medical equipment and pharmaceuticals;
• Extending cardiac screening programs to schools and rural communities.

The shared medium-term goal is to consolidate Mulago Hospital as a regional reference center for pediatric cardiology, able to diagnose, treat, and follow up on congenital heart diseases with growing autonomy.

Conclusions

The May 2025 mission confirmed the effectiveness of Mission Bambini’s integrated approach: combining direct care through surgeries, the donation of essential resources, and long-term investment in local training and capacity building.

Thanks to this mission, 7 children in Uganda received life-saving treatment, while many more will benefit from the strengthened skills and systems left behind. The continuity of this partnership shows how long-term commitment can produce lasting change and reaffirms Mission Bambini’s vision: that no child should die from a treatable heart condition.