The Pain, Tears And Guilt Of Healing Hearts

THE VIEW FROM HERE-A friend of mine recently returned from her third trip to Africa in three years.  Why so frequently, you might ask?  She is part of a medical team which hails from Washington state and travels to Rwanda once each year to perform a variety of heart-involved operations and other treatments, free to the patients.

Of the 100 cardiologists and nurses who volunteer their time, staff have come from such places as New York, Massachusetts, Texas, California, Oregon, and Washington state as well as countries like Australia and Belgium.  

Saudi Arabia has built the modern King Faisal Hospital in Kigali, the capital of Rwanda, and works in conjunction with the Rwandan Minister of Health on behalf of this noteworthy Healing Hearts medical project.  This undertaking is also fortunate to partner with such organizations as St. Jude Medical Center (which provides heart valves), Medtronics (whose headquarters are located right here in Northridge, California), and Providence Medical Centers (which provide surgical equipment) and have locations across the country, including two local hospitals--Providence Holy Cross in Mission Hills and Providence St. Joseph in Burbank.

In addition, there are a number of other groups, such as the Rotary Club, that provide grants of varying amounts to help defray the enormous costs which are incurred by the Healing Hearts program so that it can fulfill its commitment to the Rwandans. 

There are four medical teams which converge on East Africa, bringing with them around 6,000 pounds of medical equipment to serve potential patients (from 500 to 1,000) who are anxiously waiting to be selected for vitally essential services.  The teams, in essence, must triage the people they interview.  Those selected are mostly females ranging in age from 15 to 35.  Part of the selection process is based upon who has the best possibility for full recovery.  However, out of that entire number of applicants, only about 50 each year are in a position to receive the treatments they require.

Providence provides grant money to those of its own employees who wish to volunteer their vacation time to work in Rwanda for this important cause.  Team members, on average, spend between $4,000 and $5,000 of their own money on this campaign and leave behind much of their own clothing and medical equipment (such as stethoscopes) for both patients and staff--in addition to the many gifts of food and other items for those with whom they have become involved. 

With each new year, the teams bring more state-of-the-art equipment to assist the Rwandan doctors and nurses.  There are also training sessions and seminars to keep these medical professionals up-to-date and proficient.  Yet so much more needs to be done!  In my estimation, it is, without question, a daunting and even heart-breaking venture but one well worth pursuing.

Despite valiant efforts and dedication, there is only a finite amount of money to go around.  Rwanda, mind you, is just one small country on the African continent.   It is frustrating to those involved and for those who learn about the pressing needs of the ill, that the entire continent, let alone spots around the world too numerous to mention, also need this kind of assistance.  Maybe, we as individuals and those who represent companies and other organizations can do something to draw attention to the vast vacuum that can and must be filled by our own efforts (as well as theirs).

The situation in Rwanda, however, also presents a quandary for those on the medical teams.  The fact they have to pick and choose among the long list of those waiting for help poses an ethical dilemma.  Worry that adequate follow-up will not occur is another moral issue.  Much of the post-operative process is accomplished through long-distance technologies with only intermittent updates on patient status.  It becomes a frightening matter for team members when considering the ramifications of not being on site to oversee what should be ongoing care.

My friend is choked up and near tears when she considers her involvement.  There is a sense of unfinished business.  Although African nurses and doctors receive ongoing training in the pertinent procedures, and though patients are educated about the consequences if they do not adhere precisely to instructions, questions remain: Are the teams doing more harm than good?  Will the operations and treatments in the short run result, in fact, in long-term recoveries?  Are they playing God (having had to choose these patients in the first place) when teams (whose stays are only about three weeks) have to leave before patients are completely ready to resume their day-to-day lives?  

Are they taking into consideration the cultural differences that may interfere with the ultimate success of the medical procedures?

For instance, the girls and young women must commit never to become pregnant since their treatment regimen necessitates their taking the blood-thinning coumadin for the rest of their lives, and this medication could cause hemorrhaging.  This internal blood loss could, in turn, cause natural abortion of the fetus or deformities if the child makes it to delivery and/or even death of the mother.  Yet, these young women come from communities in which they are expected to have 4-5 children!

A substantial portion of the teams’ work is done on patients with heart valve issues.  A condition as relatively simple as an untreated strep throat can lead to rheumatic fever and ultimately heart valve deterioration.  Obviously, early preventive care can head off a lot of the more severe long-term health consequences, but this requires a different kind of mind-set--a broader education for the citizens as well as a different focus and perspective on the part of the Rwanda medical professionals who serve these patients throughout the year.

If you would like more detailed information about this very remarkable program, you can contact the Medical Director of Healing Hearts Northwest in Washington state, Dr. Harold Goldberg, and/or his wife, Sandy Goldberg, who serves as his exceptional assistant.

As a believer in the Healing Hearts concept and after having weighed the pros and cons, I intend to pursue my own examination of this program in the hope that Los Angeles can become an additional arm of this service.  With two Providence hospitals already here along with UCLA and USC and other California medical schools, there ought not to be any legitimate reason why Los Angeles cannot provide a partnership with this extraordinary undertaking!


(Rosemary Jenkins is a Democratic activist and chair of the Northeast Valley Green Coalition. She also writes for CityWatch.)