Blog : Tobruk

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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Volunteer Story – Caitlin Walker

Volunteer Story – Caitlin Walker

Imagine working in a hospital where the sound of nearby gunfire is a daily occurrence. Where equipment and supplies are rationed and nothing is thrown in the bin ever. Where nurses have to make their own sterilising solution and alcohol hand-wash.

Where nursing autonomy is greater than in most other healthcare settings – nurses have full authority to act in accordance with their professional knowledge , are competent and courageous to take charge in every situation, are incredibly skilled and beyond amazing at dealing with the daily frustrations of this type of work. Caitlin working hard!This outlines the time I spent in Libya with Novick Cardiac Alliance.  Whilst not my first trip of this kind, the complex political and security climate in Libya made it perhaps the most challenging trip I’ve taken part in.  It was frustrating, exhausting, difficult, scary, and incredibly rewarding and enjoyable all at the same time.

I had the pleasure of working with the most skilled and knowledgeable health professionals I’ve ever encountered and learnt something new every day.  In the two weeks that I was there, Cardiac Alliance operated on 17 children that would otherwise not have been given the opportunity to have lifesaving cardiac surgery. Caitlin with Cardiac Alliance teamBefore I left for Libya, I was continuously asked: “Why would you go to a country at war with itself, you must out of your mind?!” Maybe that is true?  But I’d do it again and again without hesitation. For the children that can be saved, for the families that are just like mine and yours and deserve equality of medical care, for the nursing skills and knowledge obtained, for the many children still in Libya that await future Cardiac Alliance trips to have their hearts fixed too. Caitlin assessing a babyTime and time again I meet the most inspirational people in countries that most people wouldn’t dream of visiting – Thank you to all at Cardiac Alliance for welcoming me into your team and helping to make this trip a success.  And to the Libyan children and their families- Thank you for teaching me more than I can ever possibly give.  Caitlin with Libya team   Volunteer with Cardiac Alliance and be part of saving lives today!

Two of the Most Important Aspects Of Our Work

Two of the Most Important Aspects Of Our Work

Ingenuity and patience are two very important aspects of our work around the world. 

When you’re involved with a new heart program in a war torn or developing country, you must be able to think on your feet. You can’t expect the same equipment or help you would get in a well-developed hospital!

For example Sergey, our anesthesiologist, slips two bags into the pocket of his scrubs. A surgery is in process, and he is managing two bags of platelets. Typical western hospitals have a machine to keep the platelets warm and agitated, but the hospital here in Libya is far from a typical western hospital. So Sergey uses his body heat to keep the platelets warm and the constant movement between the operating table and his supply station keeps the bags agitated.

Some issues are expected.

Several key pieces of equipment we are using to operate are borrowed—from other hospitals, and from our own store of equipment in the US.

And surgeries take longer when teaching local doctors and nurses, so our days are long. We continue to invest our knowledge and experience because they are keen to learn.

Some issues are unexpected.

David, our biomedical engineer, sent out for power strips when the ICU proved seriously short of outlets.

The ICU has become extremely hot and uncomfortable for our young patients. The mother of young Malak, a child now recovering from her recent heart surgery here in Libya, purchased an air conditioner for the unit. She and her daughter won’t benefit from the purchase since they’re headed home soon. But they did it for the other families still waiting their turn for surgery.

And then there are the daily periods where there is no water in the hospital. It always comes back, but on dry days we have to use saline to wash patients.

It would certainly be easier to work exclusively in more developed countries. But we choose to work where the needs are greatest.

Some issues are expect, others aren’t, but the opportunity to save children and serve families makes it all worth it!

A Video Update From Dr. Novick In Libya

A Video Update From Dr. Novick In Libya

We’re well into our second surgical mission here in Libya, and things are moving steadily along. Take two minutes to hear an update on our work, straight from Dr. Novick.

Volunteers Reflect On Their First Surgical Mission

Volunteers Reflect On Their First Surgical Mission

The Novick Cardiac Alliance team celebrating after a successful mission

Our most recent trip to Libya was truly groundbreaking.

The first open heart surgery in the city’s history and a hospital flooded with camera crews to document the occasion showed just how thrilled the local Libyans by this first mission, but this was also a first for some of our volunteer nurses. Of all places, Angela and Amalie chose war-torn Libya for their first volunteer experience with the Cardiac Alliance.

Here are a few of their thoughts on the whole experience:

How did nursing in Libya compare to nursing back home?
Angela: “I enjoyed how much more time we had to actually pay attention to our patient. Back home, so much time is spent charting everything.”

Amalie: “It’s really cool to see how much you can do with pure assessment and vital signs. Back home, we send for diagnostic tests from the lab constantly, and it helps. But everything felt more efficient not having to jump through so many hoops.”

Twinkies in Libya!

What made the work challenging?

Angela: Culturally, the accountability and the sense of time was so different.

Amalie: I loved getting to work alongside the locals in terms of cultural exposure, but communication with locals was a big challenge.

I started out frustrated with the local nurses, like they were just a tag-along making my work slower and a bit harder, but I began to realize how valuable they are to the team, especially if you allow and trust them to have responsibilities.

Twinkies in Libya!

Thoughts on training the Libyan nurses?

Amalie: When you do the work for them, they don’t feel accountable. When you give them the responsibility to do it on their own, they can rise to the occasion and it’s amazing to see.

Stacey told me to make a plan with the nurses I was overseeing, and that worked well. I could leave for a couple hours at a time, and when I checked back they’d done everything right. Setting expectations ahead of time really helped.

How did you find working with Dr. Novick’s team?

Angela: In general, Dr. Novick’s team was really supportive and fun. They weren’t intimidating to approach. I was surprised by how well they all knew each other.

Amalie: I remember handing a little boy to his mother and was impressed that Pasha (ICU Intensivist) was right there helping position chest tubes and IV lines. No doctor back home would be that involved, helping handle the patients.

Twinkies in Libya!

Highlights of your time in Libya?

Angela: I loved getting to work with the locals. I’d like to experience more of the culture, and I enjoyed visiting Libya because it isn’t a place I could easily travel on my own.

Amalie: It was really cool hanging out with the local nurses, Fatma and Naima, outside of the hospital. It’s great getting to know locals outside of the ICU.

Would you do it again?

Angela: I’d do it again, but I probably wouldn’t come back to Libya. It’s a little more challenging and restrictive than I thought it would be.

Amalie: I may come back to Libya, but I’d like to work in a few other places. I think the main reason I’d come back was to work with the Novick Cardiac Alliance regulars. They’re just really cool and really experienced and fun to be around.

Final thought?

Amalie: This is real nursing. On trips like this, you do things because they need to be done, not just because it’s protocol or a hospital standard. I think that’s what made this all feel so ‘pure’—it’s all about the patient rather than following protocols for their own sake.

Amelie caring for a baby in Tobruk, Libya

Angela caring for a baby in Tobruk, Libya

Meet Munam, His City’s First-Ever Heart Surgery Recipient

Meet Munam, His City’s First-Ever Heart Surgery Recipient

This is Munam.

This lucky little guy just became the first open heart surgery recipient in the history of his city!

Having no access to treatment and very little money, Munam’s mother and father spent their savings renting cars and buying expensive Egyptian visas to travel back and forth across the border seeking care for their son. Despite the endless border-hopping, in the end Munam’s parents simply couldn’t afford the cost of surgery in Egypt.

Baby Munam after heart surgery

They had nearly given up hope when they heard about a ‘foreign team’ of heart specialists who were coming to do operations in their own city! Munam’s parents could hardly believe it, but they began to hope again.

Novick Cardiac Alliance arrived and, after assessing Munam, decided that Munam could have his operation and that he would be the very first operation! It was a complete success, and four days later he was ready to go home.

Shortly after Dr. Novick and the team provided Munam with surgery, his mother told us,

“My life was only night, but you brought the morning. Thank you!

Munam ready to go home

Are you ready to ‘bring the morning’ for more moms like Munam’s? Your donation helps us continue our lifesaving work around the world. Click here to give now.

Volunteer Story- A Vision of Nursing

Volunteer Story- A Vision of Nursing

By Amalie Smith

I’m not sure how to begin writing about my first volunteer trip with Cardiac Alliance. I could write about my feelings throughout the two weeks, the experience of working with the local nurses, the awesome Cardiac Alliance staff, patient stories, and more.

The first thing that struck me is the reality of having limited supplies and resources. At home, our stock seems endless. When I run out of something on the unit, I call central supply and get more. If we ran out, we’d have to get creative and make do with what we had by cutting, taping, cleaning and reusing, or simply going without. For example when we ran out of blood test cartridges, we had to rely on accurate physical assessment skills instead of lab tests. In addition to limited material supplies, I was stripped of my usual informational resources. When questions arose, there was no internet or computer to look up the answer. My team members became my sole resource.

Amalie teaching in ICU

The incredible teamwork and teaching that occurred are the other major things that stick out in my mind. I was the youngest and least experienced nurse in the group – both at working in PICU and at doing any sort of medical volunteering. Even so, I always felt supported by the other nurses, the nurse practitioner, and the intensivist. We all worked in the same room together, which at times was cramped and hectic. However, I think it led to better teamwork and teaching as everyone was always right there to lend a hand or to answer a question.

Amalie with other team members
Another thing that really struck me was how the doctor and NP on the trip often pitched in with things that are considered “nurses duties” at home. Without even asking, they would jump in and help transfer patients out of bed, figure out how to use pieces of equipment, or draw up medications. Most importantly, they were some of the best teachers I’ve spent time with.  It seems to me that this mutual respect and trust are the reasons why the Alliance staff nurses are so amazingly knowledgeable, critically thinking and confident.

Amalie in Theatre Libya

The thing I missed most about working at home was my ability to easily communicate with parents and children. One of the most rewarding things about nursing is comforting a worried mother, so a major language barrier can make you feel useless. Sometimes the only thing I could do was put my arm around a mother, and tell her that the baby was doing well using one or two Arabic words.

Amalie in ICU LibyaAs the other nurses had predicted, I initially felt very disoriented and scared to be without my hospital’s supplies, protocols and resources. But in the end,

I learned what pure nursing looks like.

It was challenging work, and I felt like a new graduate again at times but I believe it’s what I needed to get a vision of the kind of nurse that I can strive to be. I honestly hope I get the opportunity to go back for more.

A Tale of Two Cities

A Tale of Two Cities

Cardiac Alliance has been working in Tobruk, Libya and Kharkiv, Ukraine over the last few weeks and we have operated on 43 children in these 2 cities.

Both Libya and Ukraine are experiencing uncertainty and conflict that many of us will struggle to imagine. However, it is not so hard to imagine the heartache that a parent feels when they have a sick child. These mothers and many like them in developing nations all have a child with a congenital heart defect and are faced with the real possibility that their child will never receive surgery.

Sad baby Libya

The Novick Cardiac Alliance strives to help these parents and so, despite the conflicts, we have been working in these countries to provide much needed surgery and care to children.Though we feel a sense of satisfaction in being able to help these children we also feel a sense of urgency and disappointment-  Because for every child that receives surgery there are many many more that will not.

Small baby and nurse

The sad truth is that some children will die waiting. We all have the power to change a life together and give a family a brighter future.

Donate your time and expertise by volunteering with us  or give today and save a life.