Blog : Libya

Cardiac Alliance Begins Pediatric Cardiac Program in Western Libya

“’In Libya, there are several thousand children that need heart surgery, including hundreds of new-borns’, says Dr. Novick. That is why, with the support of the Presidency Council and the UN’s World Health Organization, Dr. Novick has launched a one-year national program, hoping to treat more than 400 Libyan children’s hearts.”

Read more in this article featuring Cardiac Alliance’s work in Libya, by United Nations journalist Abel Kavanagh.

 

UNSMIL/Abel Kavanagh

Witnessing Sustainability in Libya

Two brothers, Four heart defects.

In 2012, we met Abdul, a Libyan boy who was born with four heart defects, called Tetralogy of Fallot. Dr Kathleen Fenton operated on Abdul alongside Libyan pediatric cardiac surgeon Dr Wejdan Abou Amer. Because his heart defects were diagnosed late, Abdul was very sick following his surgery and remained in the ICU for many days. Our team was scheduled to leave the country, but Dr Fenton changed her flight to stay and help the Libyan team care for Abdul. 

Abdul, 2012

In June, our team returned to Benghazi and met Abdul’s little brother Mohammed. Mohammed has also been diagnosed with Tetralogy of Fallot. His parents were devastated to learn their second son also had a life threatening heart defect. It is “life threatening” because he lives in war-torn Libya with limited basic health care available, let alone pediatric heart surgery. 

Mohammed, 2017

Since our team has been visiting Libya and educating the local Libyan medical professionals for several years, we are witnessing the magic our work accomplishes. Mohammed needs a type of surgical procedure that the local Libyan surgeon Dr Wejdan can now perform on her own! Dr Fenton collaborated with the Libyan team and determined that Mohammed’s surgery can be performed by Dr Wejdan after our team leaves the country. From our continued teaching, she has developed the skills to do this, and the ICU team has the skills necessary to care for a patient like Mohammed. 

Dr Wejdan and Dr Fenton operating in Libya.

Without our continued perseverance to travel to Libya, children like Mohammed and his brother Abdul would not survive. There would be no miraculous story to tell. 

And by the way, Abdul is now 6 years old and attending school! 

Cardiac Alliance’s collaboration in war-torn Benghazi brings sustainable healthcare to children

Reuters journalist Ayman al-Warfalli recently interviewed our team in Libya, where there are “more than 300 kids waiting for open heart surgery, maybe 400.” Cardiac Alliance strives to maintain our collaboration with the hospital in Benghazi to care for these children in need.

Read the Reuters article to learn about the desperate need for sustainable healthcare in Libya.

With your support, we can continue our education programs to save more children in countries like Libya.

Why Libya?

Why Libya?

“More than 80% of our hospitals are either closed or not functioning properly” -Reida El Oakley, eastern Minister of Health, Libya.

“The instability exacerbates an already catastrophic situation. The so-called Islamic State group has established a stronghold around the coastal city of Sirte; a bombing campaign by a coalition of western powers is probable. Libya is home to thousands of militias. It cannot control its borders; migrants en route to Europe stream into the country.”

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“A humanitarian emergency is gathering. Almost 2 million Libyans have serious unmet health needs and more than 1 million are at risk of food insecurity.” (Libya’s health crisis looks set to worsen by Talha Burki, The Lancet, April 2016)

Why do we travel to Libya, when other international groups consider it too dangerous? Why do we work so hard with local doctors and nurses to make surgeries happen when it sometimes feels like swimming against the tide?

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Why do we gather donations of supplies from around the world, pack heavy duffle bags, and wrestle with airlines and customs agents in order to have the basic materials we need to work?

Why do we meet with government ministers and hospital administrators, and advocate for the kind of change that will make a permanent pediatric heart programme possible, so Libyan families don’t have to worry that they will lose their children before they get care?

Why do we keep going back to Libya?

It’s because of the children.

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It’s because Libyan children can’t wait for every militia to lay down their arms to get their heart surgeries. They can’t wait for every politician to come to the table and agree on a path of peace before getting their heart healed. Libyan children just don’t have that kind of time.

It’s because we can be part of the solution. Instead of waiting for conditions to be right, we can help local health care professionals to make conditions right. We can teach surgical and care skills that spill out past the pediatric cardiac unit and into the wider health care arena. We can partner with dedicated local professionals who have vision—and help to make it happen.

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You don’t give to Cardiac Alliance because we work in your neighbourhood. You don’t give because you believe in quick solutions. You give because you know that few will go to the places that need the help most, that change can take time, and because you know it’s possible—together.

Salima and the Complexities of Down Syndrome Babies

Salima and the Complexities of Down Syndrome Babies

The large room was lined with beds, each a home-base for a mother and her child as their waited their turn to have surgery and graduate out of the ICU. Mothers whiled away their time talking and fussing over their babies.

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I made my way to Salima’s bed, and sat on the edge beside her mother. “Salima is beautiful.”

“Really? Come with me…” Salima’s mother hopped off the bed and waved for me to follow. She was dressed in a long, black abaya that brushed the floor, and took a moment to quickly fix her face veils into place before we we walked out of the ward. We made our way down the long hallway and out to the open area where the fathers, leaning against tile walls, spent their time waiting.

She motioned her husband over and we stood in a little circle facing each other. Salima’s mother, with a big grin on her face said “She says Salima is beautiful!” Without missing a beat, her husband leaned in and asked me “Who does she look more like…her mother or me?”

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It was easy to fall in love with Salima—doe eyes, a darting tongue, and hands that clasp in the sweetest way. It was also easy to fall in love with her because we got to spend a lot of time with her.

Children with Down syndrome, like Salima, often have complicated heart defects and complicated recoveries. Their recoveries take longer, and there are sometimes setbacks. Setbacks are particularly hard to take for parents who watch other children recover quickly—sometimes within a day—and leave the ICU, while their own children stay. It’s hard.

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Long recovery times can make ICU management complicated. The number of surgeries performed is directly related to the capacity of the ICU—if there aren’t open beds and the corresponding staff available to receive children after their surgery, then the surgery can’t be performed. As a result, other children have to wait longer for their surgeries.

In many parts of the world, children with Down syndrome have a hard time getting surgery at all. They are often deemed unworthy of scarce resources.

Our team intentionally includes children with Down syndrome, like Salima, in every surgical mission. We know the value of these children, both to their adoring families, as well as to the wider community.

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Before she was discharged, Karen—one of Salima’s nurses—got a photo of the two of them together. During her stay in hospital, Salima’s hair has filled in—grown longer and darker. She is bigger and more active. More of her personality is shining through—with lots of busy squirming when she feels well, and quiet little bird-like squawks when she doesn’t.

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Upstream

Upstream

“Where does the blood flow come from? And where does it go?” Dr. Rodriguez paused a moment before repeating “Where does the blood come from, and where does it go?”

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Dr. Rodriguez was talking as much to himself as he was to the local cardiologists beside him. He carefully studied the illuminated echocardiogram screen, then turned back to the cardiologists. Dr. Miriam passed the ultrasound wand over each child’s chest—again and again honing in on particular spots of each small body. They spent as long as necessary with each child to figure out their own unique physiological puzzle.

But isn’t every heart the same?

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When an adult develops a heart condition, doctors look for disease or damage to a “normal” heart. The doctor knows exactly where to look, and has a good idea what will be found before ever seeing an image of the heart. “Normal” hearts are all made pretty much the same way.

In children born with congenital heart defects, every heart is different. Some children have 3 heart chambers instead of 4. Some are missing ventricles, or have them crossed. There are countless problems and variations, so it’s a challenge to determine exactly what path the blood takes.

Dr. Rodriguez coached the cardiologists to look further than the defect itself—to figure out the larger picture. Often the first answer—the obvious answer—doesn’t provide the best solution for the child’s overall health.

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Zaid and his heart provide a perfect metaphor for Libya and the troubles it’s facing.

Libyan children need heart surgeries—so providing heart surgeries is the best solution. Unless, of course, it isn’t.

When we provided Zaid with heart surgery, we helped him and his family. When our doctors and nurses spent crucial time teaching local doctors and nurses—honing diagnostic skills, developing new surgical techniques, reinforcing best nursing practices—we didn’t just help Zaid. We helped the whole country.

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Libya doesn’t have the skilled professionals it needs to take care of it’s own children. Every time we return, pairing surgery with education, we bring them closer to never needing us again. We work toward rising the tide in the Libyan health care system—encouraging a culture of highly skilled excellence.

The situation in each country we work in is a little different. And just as we make sure that each child’s heart gets the right correction, we make sure that the solutions we bring to each country help the broader needs. When you donate, that’s what you help to make happen.

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Two Parts Engineer, One Part Macgyver—The Biomedical Engineer

Two Parts Engineer, One Part Macgyver—The Biomedical Engineer

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The bright operating room lights were trained on the precise place where the repair needed to be made. It was a delicate operation—getting to the heart of the problem.

But the “patient” in this case wasn’t a Libyan child—it was the anesthesia machine, and things weren’t looking good. And without an anaesthesia machine—no surgery.

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When we think about heart surgeries, we imagine surgeons cutting and stitching, and doctors and nurses managing patient recovery. We see beeping monitors, and patients attached to tubes, and wires—and we assume it all just works.

Until it doesn’t.

There is one member of our team you rarely hear about: the biomedical engineer.

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Meet David (left side of above photo). David makes everything work.

For programmes in developing countries like Libya, David goes in far ahead of the rest of the team. He helps to design operating room and ICU lay-outs, consults on needed equipment, and problem solves practical issues that are are obvious to him the moment he walks into a room—for example, knowing how many machines should be at each bedside, you can immediately see when there aren’t enough electrical outlets at each bed.

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Our most recent surgical mission in Libya provided countless instances which illustrated the biomedical engineer’s integral role with the medical team. When the mechanism that raises and lowers the operating table broke mid-surgery, David began to diagnose the problem as soon as the patient was wheeled out of the room. He was able to make the needed repairs quickly, so the afternoon surgery could go ahead as scheduled, and a critically ill child didn’t need to wait any longer to get their lifesaving surgery.

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He sorted out oxygen supply issues at patient’s bedside, repaired sorely needed monitors languishing in hospital storage and put them back into service, and he tackled the problem with the broken anaesthesia machine—which ultimately involved bringing in a machine from another hospital and getting it functional.

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With his specialized bags of tools, years of experience around the globe, and curious nature, David keeps operating rooms and ICUs functioning, which allows the surgical and critical care teams to do their jobs well.

David’s work not only makes our surgical trips possible, but he leaves hosting hospitals in better shape than when we arrived.

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The Hardest ‘Yes’ of Ramadan’s Life

The Hardest ‘Yes’ of Ramadan’s Life

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A terrified, skinny boy arrived at the hospital. The cardiologist from Benghazi is looked at his heart, recommending urgent surgery. 

“Ramadan, will you let them operate on you?”

The 14 year-old has heard this question again and again for the past seven years. “Will you accept?”

His answer is always the same: “No.”

Fatherless and culturally an adult, Ramadan is old enough to make his own decision whether or not he will undergo surgery. He is also old enough to know what this will mean, what the process will be like, and what the outcome could be.

“He’s too afraid, he won’t accept,” his mother shared later. 

Ramadan lives in Derna, a Libyan city with heavy jihadist leanings and that was recently under ISIS control, but his heritage is southern Libyan, what many people here call “original Libyan.”

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Arabs, Greeks, Italians, Turks, and others have conquered and settled this part of the world, but Ramadan’s people were here long before that.

The cardiologist slides her probe over the bumps of Ramadan’s ribs as Dr. Novick leans forward, looks in his eyes, and says “Ramadan, we can make you feel better.”

Someone translates the words as Ramadan stares back.

His mother wipes Ramadan’s chest and helps pull his shirt down, a worried expression on her face. Ramadan’s face is blank the entire time.

Goodbyes are said, and the family begins to leave.

A few feet from the door, the cardiologist calls out more time: “Ramadan, will you let them operate on you?” 

“…yes.”

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A few days later, Doctor Novick and the team gave Ramadan the lifesaving heart surgery he needed, his recovery went beautifully, and he even told Stacey he didn’t want to leave! Thank you for sending our teams to serve children on the margins, in war-torn, ISIS-disputed territory like Libya.

You are giving families the chance to finally say “yes.”