Physical Health Uganda Project #41362

Children's Heart- LIFE-SAVING CARDIAC SURGERY

by Mission Bambini

Children's Heart- LIFE-SAVING CARDIAC SURGERY

Project Report | May 20, 2024
CUORE DI BIMBI (Children's Heart) - 19 YEARS OF OPERATION

By Clotilde Minghetti | Project coordinator

FOLLOW UP ON CUORE DI BIMBI PROJECT

The project Cuore di Bimbi (Children's Heart) is the most complex and multidimensional intervention activity of Mission Bambini in the field of child health, both in Italy and abroad. Started in 2005, in 19 years of operation, the Cuore di Bimbi (Children's Heart) project has enabled us to operate on and save 2,726 children affected by serious heart diseases and to conduct medical visits for over 31,000 children in 12 countries worldwide (data updated as of December 31, 2023).

The aim of Cuore di Bimbi project is to promote children's health and ensure timely access to quality care, particularly focusing on pediatric heart diseases in countries with inadequate healthcare systems. This is aimed at reducing infant mortality related to congenital and acquired heart diseases, with a particular emphasis on the most vulnerable segments of the population.

Cuore di Bimbi is a direct implementation project: Mission Bambini defines its achievements together with Cuore di Bimbi Project.

Accomplished Results:

- 2,726 children operated on the heart

- 31,262 children visited

- 523 local doctors trained

Reference Period: 2005-2023.

The project is currently active in 7 countries and is structured around three main lines of action: life-saving interventions, prevention activities, and training and capacity building.

3 Lines of Action:

1. Life-Saving Interventions:

Heart defects are among the most common congenital anomalies and thus represent one of the most significant health problems for children globally. It is estimated that one million children are born with a congenital heart defect worldwide each year. In the absence of surgical intervention, 50% of them risk sudden death in the first years of life. Every 10 children born with congenital heart defects, 8 are born in a country with an inadequate healthcare system that has not yet developed pediatric cardiac surgery and therefore cannot guarantee essential care for survival.

Thanks to Cuore di Bimbi project, Mission Bambini has established multi-year partnership agreements with several qualified and adequately equipped foreign public hospitals, especially in Africa and Asia, where international surgical missions are also organized. These missions aim to operate on the most urgent and/or complex cases and to train local medical personnel during surgeries and through specific training sessions.

The missions last between 7 and 10 days and, with the involvement of an international team of volunteer doctors, nurses, and healthcare technicians, allow us to operate on an average of 8 to 10 children and visit about a hundred in follow-ups. Since 2005, more than 100 healthcare professionals in pediatric cardiac surgery have volunteered with us: cardiac surgeons, cardiologists, anesthesiologists, physicians, perfusionists, operating room nurses, intensive care nurses, and technicians from leading hospitals in Italy, Spain, the United Kingdom, and the United States. As for healthcare volunteers working in Italy, we can count on professionals operating in the most prestigious national hospital facilities such as ASST Grande Ospedale Metropolitano Niguarda in Milan, Ospedale Regina Margherita in Turin, ASST Papa Giovanni XXIII in Bergamo, Hesperia Hospital in Modena (in collaboration with Hesperia Bimbi Onlus), and G. Pasquinucci Heart Hospital in Massa (in collaboration with "Un Cuore, Un Mondo" Massa).

2. Prevention of Acquired Heart Diseases:

In addition to partnerships with local public hospitals, numerous partnerships have been initiated through Cuore di Bimbi project with non-hospital healthcare facilities and local non-profit organizations where screening activities (diagnostic visits) and post-operative follow-ups can now be carried out. These interventions are essential to prevent or mitigate the development of acquired heart diseases. It is therefore essential to ensure timely care for children under 10 years of age, to treat ear, nose, and throat infections that can lead to rheumatic disease and its complications such as heart diseases, which were very common in Italy until the 1990s but fortunately eradicated today thanks to early diagnosis and prompt antibiotic therapy. To achieve this goal, in the countries of intervention, we work to ensure continuous medical check-ups and cardiac screenings for children aged 6 to 10, which we carry out in schools or at health centers, supplemented by disease awareness sessions for parents.

3. Training and Capacity Building:

The importance of training in the care and prevention of heart diseases is one of the key aspects of Cuore di Bimbi. Especially concerning rheumatic heart diseases, training activities are crucial: in several intervention countries, many healthy children develop heart diseases due to poor hygiene conditions and untreated or poorly treated infections. During our screening missions, the training component dedicated to local healthcare personnel is essential and takes place on multiple fronts, both theoretical and practical (e.g., joint echocardiographic procedures). Even during surgical missions, local healthcare personnel actively collaborate with our healthcare volunteers to transfer skills and knowledge. To ensure continuity in training activities, partnerships with local hospitals are multi-year, and missions are repeated several times in the same hospitals. Each year, one or more local healthcare professionals selected from the staff of partner hospitals can access a scholarship and attend the 2nd level Master's degree in Cardiothoracic Surgery, Cardio-anesthesia, and Cardiology at the University of Milan Bicocca, for which we offer 3 scholarships per year, in collaboration with the International Heart School of Bergamo.

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Jan 22, 2024
Improving the lives of children with heart disease

By Tidy Minghetti | Project coordinator

Signing the memorandum of understanding MB and UHI

Our commitment is improving the lives of children with congenital heart disease.

Heart defects are among the most common birth defects and represent one of the most important

children’s health problems in the world. Globally, it is estimated that one million children are born each

year with congenital heart malformation. If one does not intervene in the first years of life with surgical

correction 50% of them risk sudden death before adolescence. Out of 10 children born with congenital

heart disease, 8 are born in a country whose health system is inadequate and where pediatric

cardio surgery is non-existent or insufficient to guarantee quality care, free and essential for survival.

Since 2005, with the implementation of the “Children’s Heart” project, the organization Mission Bambini

(MB) and Mission Bambini Switzerland (MBS) are committed to provide free and quality care to children

worldwide with rheumatic and congenital diseases. “Children’s Heart” is the most complex and

multidimensional project among the intervention activities of MB and MBS in the field of child health, in

Italy and internationally. In 18 years of activity, the program operated and saved 2,635 children suffering

from serious illnesses and visited 24,120 children in 12 countries around the world.

The strategy is based on three pillars:

• Allow children with heart disease to receive treatment free heart that will save their lives.

• Help empower local partner hospitals to deal with children’s heart disease care issues (including

diagnosis, from surgical treatment to follow-up).

• Contribute to the prevention of heart disease secondary to rheumatic disease in children 5 years and

older, to avoid complications of the infection.

Challenges and Solutions

During the implementation of the “Heart of Children” project in Uganda, one of the main challenges

was the supply of medical supplies necessary for surgical procedures for pediatric low on age and weight.

Currently, the Heart Institute of Uganda relies primarily on the international missions of Mission Bambini to

the purchase of highly specific medical equipment and consumables. However, to meet

these challenges, MB and MBS with the Uganda Heart Institute are working together to

Achieving two key objectives in the coming year:

Establish a network of local suppliers to ensure national procurement, increasing the independence of the center from its partner in this area supply of medical supplies.
In case it would not be possible to obtain material locally, MB undertake to purchase the necessary medical devices on behalf of the Heart Institute of Uganda, ensuring that the purchase’s list is finalized two months before the international mission to ensure the choice of the most competitive material in terms of technology, price and quality. In addition, MB have built up a small internal stock of medical consumables on the basis of their long experience in this field, in order to guarantee a timely medical equipment and dynamically adapt to any need emerging from the lists of operations.

Impact and sustainability

To ensure the sustainability of its activities, Mission Bambini have launched a three-year ongoing training

for local medical staff, aimed at making the Cardiac Institute Uganda an autonomous center of excellence in

pediatric heart disease management. By involving local Authorities and collaborating with International

organizations, the Foundation aims to maintain effective care over time. The MB approach is not limited to

the immediate care of children, but extends to the creation of a resilient structure capable of continuing to

serve the local community in a way that is independent and sustainable. In fact, a pediatric cardio surgeon

began her Master’s Degree in Italy at Niguarda Hospital which will last until May 2024.

Lessons learned and recommendations

The implementation of the” Children’s Heart” project in Uganda and Nepal in 2023 made it possible to

learn many valuable lessons. First, it was essential to adapt the objectives project to specific local needs,

recognizing the diversity of contexts health and resources available. In Uganda, for example, the program

has focused on the issue of autonomy in medical supplies, highlighting the need to develop networks of

local suppliers. In both contexts, the importance of continuous training and multidisciplinary collaboration

between staff international and local was confirmed as a crucial element to further develop for ensure the

long-term sustainability of initiatives. The goal is to provide training between two teams also outside the

specific time of the mission, by investing in ad hoc web tools and telemedicine programs.

Recommendations for the future include the implementation of concrete strategies to reduce dependence

on international missions for provision of medical supplies and implementation of on-site activities, as well

as strengthening the diagnostic and surgical capacity of local staff. In addition, it is suggested to continue to

work closely with health institutions local authorities to scale up intervention, expand partnerships and

actively involve communities in education and prevention.

Cardiac surgeon Sabrin Abboud of Niguarda Hospital

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Sep 24, 2023
In preparation of the next Int. cardiac surgical mission with Mission Bambini and Mulango Hospital

By Adalgisa Caraffini | Int. Program coordinator

Since 2013, thanks to the initial efforts and dedication of Dr. Arioli, Dr. Ammirati and later Dr. Marianeschi, Mission Bambini established a fruitful collaboration with Uganda's Mulago Hospital and its medical teams.

In view of past success, a new cardiac surgical mission is organized starting October 22nd through the 28th of 2023 in which volunteers of Mission Bambini will participate in this important experience.

With this short update, Mission Bambini would like to provide an inside look at our surgical mission work abroad and show all the professinonal contributions of our volunteers.

The most complex aspect of a surgical mission is its preparation and organization but thanks to Mission Bambini's 15 years of experience, these challanges are overcomed. Planning priorities include determining what type of surgical mission to be performed and in consequence the necessary skilled personnel, professional equipment, supplies and other logistical matters.

Rearding Mission Bambini's personnel, it is important to note that the staff consists primarly of volunteer health workers, most of them highly specialized in their field of expertise, all necessary attributes as our beneficiaries are children and sometimes newborns. The health staff involved can be surgeons, anesthesiologists, intensive care physicians, perfusionists and nurses and are coordinated with the health team of Uganda Heart Institute in order to cover the needs of the patients.

Another critical point and an area of great concerns are supplies and equipment due to the difficulty of local market availability and the high costs of medical supplies, which largely depend on donations.

Our surgical missions are directly and indirectly supported by hundreds of individuals who really believe in our cardiac surgical program.

A cardiac surgical intervention can really change the life of a Child

Links:

https://missionbambini.org/

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