A 'Heart-to-Heart' Cardiac Surgery Mission to the Dominican Republic - Dr. Niloo Edwards' Blog

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On Friday, October 26, Niloo Edwards, MD, head of the division of cardiothoracic surgery at UW Hospital and Clinics, joined a Wisconsin delegation that journeyed to the Dominican Republic, there to spend a week providing free cardiac surgery to indigent residents in Santiago.
During his stay, Dr. Edwards and other surgeons operated on 11 patients, survived hurricane conditions and gained a greater perspective on health care in Latin America.

The following is Dr. Edwards' blog of his experience.
Day 1: October 26, 2007
Leaving Madison
Leaving Madison
PHOTO (above): Leaving Madison
We all meet at the Madison airport at 7am. It is cold, damp, grey and wet: a perfect English summer morning.

Jake arrives with his donated heart-lung machine equipment in a bag he bought for a dollar at the St. Vincent De Paul store. The suitcase has one wheel and most of the fabric is torn and held in place with duct tape. We are all surprised that nobody thinks it's an IED and calls security.

Joel Stevens (also known as Captain America) meets us in Chicago. Joel is an ex-Marine and the sales representative for St. Jude Medical, who are donating the artificial valves and supporting much of the trip. Even though he has no medical training he has volunteered to come with us and help with anything the mission needs. Like the rest of the team he is using his vacation time for the trip.

There are four of us from UW Hospital and Clinics: Jake Young, the perfusionist, who runs the heart-lung machine; Jody Baird, an operating room technician who was probably the inspiration for the TV show "MacGyver"; Annette Macias-Hoag, ICU nurse and B4/5 unit manager; and myself, a cardiac surgeon.
Jake, Annette, Jody and Joel at the Miami airport
PHOTO (above): Jake, Annette, Jody and Joel at the Miami airport
In the spring of this year we were invited to join a team from Wausau, Wis., to travel to Santiago in the Dominican Republic to do free open-heart surgery. I was asked to provide a perfusionist, OR tech and an ICU nurse; and almost as an after-thought to bring as much surgical equipment as we could carry.

Joe Egan, the UW cardiothoracic surgery administrator, helped the rest of the team scrounge up 12 large boxes of equipment that was Fed-Exed to Miami. From there, the boxes were sent to the Dominican Republic by boat. We have visions of our generously donated medical equipment rotting in the hold of a banana boat.

Joe, Jody, Jake Joel and Annette have been tirelessly rounding up equipment for the mission. Every hospital in Madison has donated some equipment for the heart-lung machine. Annette, who is from Puerto Rico, has spent the last month going home after work and translating our pre-operative and post-operative patient instructions in to Spanish. She is still working on it in the Miami airport.
Annette translating patient instructions in the Miami airport
PHOTO (above): Annette translating patient instructions in the Miami airport
Despite the months of preparation we are apprehensive about the conditions in the Dominican Republic and if we have the equipment we need to get the job done.

It is 7pm and dark when we land in Santiago. The air-conditioned airport is warm and damp. While waiting to go through customs the electricity goes out and everything is pitch black until the emergency generators kick in. We are grateful that we weren’t landing when that happened.

The customs officials are courteous but ask us to go back to a desk, hidden by the stairs, to pay a $10 visitor's fee. Ten dollars and they give you a ticket; you walk 10 yards further and give them back the ticket. We are still wondering about the purpose of the ticket exchange when out luggage arrives – all of it. We find out later none of the Wausau crew’s luggage arrived.

No one wants to take ownership for Jake's suitcase – now affectionately called the IED. Surprisingly the customs officials only check Captain America’s carry-ons, which contain the heart valves. The must IED look quite at home with the local suitcases.
Jake with the 'IED'
PHOTO (above): Jake with the 'IED'
Dr. Bob Pascotto meets us at the airport with Dr. Fritz Riveron and Mary, the Wausau ICU nurse. They escort us to the bus and start distributing cold "Presidente" beer. This is to become the standard protocol, any time we get in the bus, our driver opens his well stocked cooler and distributes cold Presidentes. The trip to the hotel is unremarkable and as soon as we check in we are escorted to the hotel restaurant for dinner, where we meet the rest of the group.

The "Heart-to-Heart" mission is the brain child of Dr. Robert Pascotto. Dr. Bob started coming to Santiago five years ago to do free heart surgery for the indigent patients in the area. He established the heart program at the Hospital Jose Maria Cabral y Baez. This hospital serves three million indigent people in the northwest corner of the Dominican Republic. As far as I can tell it is the only heart surgery program for adults in the area other than the program at Santo Domingo – on the other side of the island of Hispanola.
Hospital Jose Maria Cabral y Baez
PHOTO (above): Hospital Jose Maria Cabral y Baez
Dr. Fritz Riveron is the heart surgeon from Wausau, Wisconsin. He invited us to join his team on this trip. This is their second trip. Three years ago Sean, the perfusionist on the Wausau team, responded to a web request to help with the Heart-to-Heart mission; he convinced Fritz to come the following year; and after realizing the amount of work that needs to be done, Fritz asked us to join them to help this year.
The Wausau team includes: Fritz, Jeff (anesthesiologist), Jamie, Renee (aka "the Rookie"), Jill, Sean and Mary. The other three mission members are Joan, Dr. Bob's wife, who is also a nurse and helps in the operating room, Jose, a nurse anesthesiologist from Florida, and Bonnie, Dr. Bob's operating room nurse.
The group on the bus
PHOTO (above): Bonnie, Dr. Bob (front row left), Jose (2nd row left), Mary, Annette (2nd row right), Jeff (3rd row left), Jamie, Jody (3rd row right), Renee, Sean, Jill (back row left to right).
Read More of Dr. Edwards' Blog

Date Published: 11/12/2007

News tag(s):  heart

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