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One of the great accomplishments of medicine is to treat not only that which is external, but also that which is internal. This is the purpose of surgery: treating that which cannot be resolved with changes in nutrition, exercise, drug therapies, vaccinations or rehabilitation. Access to quality surgical care can have broad ramifications for a country, both social and economic.
Surgical conditions represent approximately 30 percent of the global burden of disease. Surgical care is needed throughout life, across all levels of care, and is used to treat a broad range of diseases. Surgery has proven to be a cost-effective intervention, while failure to treat surgical conditions threatens the productivity of countries. Five billion people lack access to safe and affordable surgical and anesthetic care.
An important initiative in global public health partnerships is the development and support of surgical centers of excellence, where surgical specialties are developed and implemented in line with the needs of a particular region. A prominent example is the Salam Center for Cardiac Surgery in Khartoum, Sudan, which is a project of the international NGO EMERGENCY, based in Milan, Italy.
EMERGENCY provides high-quality, free health care to people affected by war and poverty. The organization views health care as a basic human right, even in war and conflict, and it operates clinics, first aid posts, birthing centers, rehabilitation centers and hospitals in Afghanistan, Iraq, Sudan, Central African Republic, Sierra Leone and Italy. Since 1994, the organization has treated more than six million people in 16 countries, free of charge.
The Salam Center, which opened in 2007, is a response to the pandemic of rheumatic heart disease in Africa, caused by rheumatic fever resulting from a bacterial infection. It is estimated that 15 million people worldwide are affected by rheumatic heart disease every year, leading to 200,000 deaths. Sub-Saharan Africa has the greatest prevalence of the disease.
In early 2013, while searching for an NGO with a focus on cardiac surgery, I came across the trailer for the Oscar-nominated documentary, Open Heart byKief Davidson. It’s the story of eight Rwandan children, all of whom required cardiac surgery to correct heart valves damaged as a result of rheumatic fever, that travel to Sudan for surgery at the Salam Center. I was immediately convinced that I should be a part of the Salam Center’s efforts. I resigned from my job as a perfusionist, applied for a position at the center, and made preparations to leave my life in Los Angeles.
In the course of six months working with the Salam Center, I participated inabout 120 surgeries that included adults and children from Sudan, South Sudan, Ethiopia, Eritrea, Senegal, Sierra Leone, Chad, Central African Republic and Afghanistan. The center is very impressive in its capacity to deliver high quality cardiac care, its attention to efficiency and cost effectiveness, its employment of local staff, and its commitment to reduced environmental impact. Personally and professionally, I will long remember the opportunity to spend six months there, offering the best of my clinical skills, and restore health and bring life to those who needed help.
Recently, the Salam Center extended its impact beyond Africa by treating a 17-year-old boy from the Philippines named Reynaldo Nilo. After his sister Sarah watched Open Heart, she got in touch with EMERGENCY. Reynaldo had suffered from rheumatic heart disease since the age of 15 and had few treatment options available to him in the Philippines. At the Salam Center, he will undergo cardiac surgery, free of charge, and the medications he needs will be provided by the hospital at no cost.
The Salam Center for Cardiac Surgery represents a model for planning, implementing and developing global surgical centers of excellence. We hope to replicate this model in other regions, and adapt it to the treatment of other health problems, in order to have an even greater impact and benefit even more people.
Kyler Hunter is a Board Member with Emergency USA.
