Six Missions by Italian Paediatric Cardiologists

Project location: Morocco, Casablanca
Project start date: April 2006 - Project end date: December 2007
Project number: 2006-25
Beneficiary: THE HEART OF CHILDREN

ITALIAN PAEDIATRIC CARDIOLOGISTS: SIX MISSIONS IN MOROCCO
The Association "the Heart of Children - Onlus" strives to promote the development of pediatric cardiology and heart surgery in underdeveloped countries. Therefore, it helps various foreign centers deal successfully with a wide range of heart pathologies, so that the highest possible number of children suffering with heart diseases may receive adequate care in their own country. The Association:
a) provides the selected centers with the necessary practical and scientific assistance in order to bring them gradually to full autonomy;
b) takes care of the personnel formation, helping foreign doctors attend the Master at the International Heart School directed by Prof. Lucio Parenzan in Bergamo;
The Association pursues its aim sending out a highly qualified specialist team to the selected sites, in order to provide the local personnel with diagnoses, care, and formation. Each group is composed of surgeons, anaesthesiologists, cardiologists, technicians and health workers who are very experienced in treating pediatric patients affected by congenital heart diseases. These specialists work together as a team, without getting any salary and acting on purely humanitarian motivations.
Pediatric heart surgery is still at its outset in Morocco. The need for care is therefore extremely serious for all children suffering with heart diseases, who are practically left to themselves, except in case their families can afford the huge expenses needed to get medical care in an advanced country.
The Institute with which the Association is collaborating in Casablanca is called "Les Bonnes Oeuvres Du Coeur". It was built and is run by the Association bearing the same name, whose mission is to assist poor children with heart diseases. It is the first humanitarian heart pediatric Institute in Morocco, and was inaugurated on December 2004 by His Majesty, the King Mohammed VI. The startup was facing severe difficulties, due to the lack of apparels and economic resources, insufficient number and poor formation of the medical and assistance personnel.
In December 2005 the team from "the Heart of Children" helped perform the first open heart surgeries, but it was crucial to follow up with regular missions.

 

METHODOLOGY AND RESULTS

The project supported by Ferdinando Peretti Foundation consisted of 6 periodical missions in Morocco, approximately every 4 months, to provide surgery and formation.
From June 2006 to December 2008, 6 missions were carried out at the Casablanca Institute by a specialized voluntary team of 5-6 people, including one or two heart surgeons, an anaesthesist, a cardiologist, a perfusionist, and an intensive care nurse.
The missions lasted 8-10 days, during which the team joined the local personnel in the regular hospital activity, performing surgery, teaching classes, checking patients. During every mission our team visited children who had already got surgery, performed operations on new children, followed them up during the postoperative period in collaboration with the local doctors, to whom it tried to transmit its own expertise. Furthermore, the Association team participated to a number of operations performed by domestic doctors, with whom it shared the treatment of patients in ICU and in the ward. There have been informal meetings and discussions of the cases already operated or to be operated and lectures given by our team.
At least 8 operations were accomplished in each mission and at least 50 children were visited every time; interventional and diagnostic catheterisations were also performed.
Medical materials have been brought that are useful for cardiologic interventions, operations and for postoperative treatment (oxygenators, devices, drugs, consumables).

It was also essential to donate sanitary equipment to the Moroccan Institute, necessary to improve the facilities of the Unit and helpful to accomplish the project. In particular, 2 sets of surgical instruments for operating room, 2 neonatal respiratories , and 4 monitors for intensive care unit were supplied.
The main result of this project was to offer to many Moroccan children the opportunity to access the best heart surgical care in their country.
With this activity and the important donations to the Clinic, the project promoted the development of the Paediatric Heart Institute "Les Bonnes Oeuvres du Coeur", that is becoming a reference point for all children with heart diseases in Morocco; the cultural and professional growth of the local personnel has also been fostered.
The project had a remarkable fallout on Moroccan civil society, as an example of North-South collaboration in humanitarian initiatives.

DETAILS OF THE 6 MISSIONS

1) 20-30 June 2006
12 cardiac surgery operations have been performed, 3 interventional procedures and 10 catheterizations. 30 patients have been visited and screened with echo;

2) 10-20 January 2007
12 cardiac operations have been done and at least 50 children have been examined. The entire team went for one day to Settat, a little village at about 100 Km from Casablanca and screened 40 patients in a very small first-aid humanitarian post, next to the desert. 4 patients were in so bad and dramatic conditions that were immediately transferred to the Hospital in Casablanca, where they were operated with good results;

3) 7-15 September 2007
8 open cardiac operations have been undertaken, 8 catheterization have been performed and 52 cardiologic consultations carried out;

4) 8-16 December 2007
4 children have been operated on and 30 examinated;

5) 7-17 July 2008
4 children have been operated on, 50 children examined, 3 catheterizations performed;

6) 11-22 October 2008
5 operations have been done, plus 1 mitral dilatation by cardiologic intervention; 20 children examined by echo. During the first period of the mission, part of the team went to Zagora, in a depressed area of the South, near the desert, and visited 60 patients: 8 of these needed urgent treatment and were sent immediately to Casablanca for an operation.


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