PICU nurse Erin Serrano recently joined our team on her first medical mission trip to Ukraine. Erin shares her unique story about why she began her career as a pediatric cardiac nurse and how volunteering with Novick Cardiac Alliance was a dream her entire life.
My journey to pursue a career in the Pediatric Cardiac Intensive Care Unit began the day I was born. Just a few days after birth, I was diagnosed with a congenital heart defect and underwent multiple cardiac surgeries and procedures to save my life. Volunteering with Novick Cardiac Alliance to help patients and families with similar stories as my own wasn’t a choice, it was something I knew I had to do. It was my destiny.
Coming to Ukraine and stepping into a healthcare system that I knew nothing about was one of the most challenging things I have ever done. After just a few days, I realized that leaving my comfort zone was more than worth it. From the first day that we arrived at the hospital, I learned just how resourceful the staff members had to be, considering their limited medical supplies, equipment, and medications. Imagine being a parent of a child requiring cardiac surgery and you are responsible for providing part of their medical supplies because the hospital simply cannot obtain enough. I was astounded to see the local nurses using resterilized supplies. These supplies would most certainly be thrown away after one use in the United States. I realize that we take for granted the abundance of simple supplies and they are precious items in developing countries like Ukraine.
Despite the obvious language barrier that exists, Cardiac Alliance has been successful in educating the Ukrainian medical team in everything from basic ICU care to the most complex cardiac surgeries. To be a part of that education process was the most rewarding part of my trip.
One out of every 100 babies is born with a congenital heart defect and CHD’s are the most common cause of infant death among birth defects. If I have helped just one nurse better their practice while caring for these patients, then I know my time spent was worthwhile. I certainly hope I can volunteer with Cardiac Alliance again and again. Thank you NCA for allowing me to be a part of your incredible mission and to the entire Ukrainian team for teaching me more than I could have ever imagined.
When Narges was an infant, her mother noticed she would become blue when eating or crying. She took her to several doctors throughout Iraq, but nobody could give them any answers. Finally a doctor told them that Narges had a heart defect, but nothing could be done in Iraq to help her. They were encouraged to find help outside the country.
At one year of age, Narges’ parents used all their money to take her to India for medical treatment. Here she was finally given a proper diagnosis. She was born with a complex heart defect, single ventricle with mitral atresia. Even in India, Narges was deemed inoperable.
For years, her family watched their beautiful daughter remain blue and ill, which progressively worsened over the years. Narges’ parents took her to several hospitals in Iraq, hoping that someone could help their daughter. Through the strife of war in their country, Narges’ mother never lost hope. She persevered in her search for a heart surgeon that would take her daughter’s case. Finally, she saw an advertisement from Al-Amal Hospital in Nasiriyah Iraq that announced the arrival of an International pediatric cardiac team that was offering heart surgeries.
Dr Novick met Narges in clinic at Al-Amal Hospital in October 2017. At that time, Narges’ blood oxygen levels were only 70%. Her heart was severely enlarged and the improper circulation of blood inside her heart had been causing lung damage for years. Dr Novick prescribed medication to help lessen some of the damage and requested that Narges return to the hospital for evaluation when our team returned the following month.
In November, Narges and her family returned to Al-Amal Hospital to met with our team. Narges’ heart was still severely enlarged and her only option was a palliative surgery that would prevent further lung damage. The hope was that this surgery would improve her quality of life. Dr Humberto Rodriguez performed this surgery and Narges recovered quickly in the ICU. Our team was impressed by her determination, asking to get out of bed the day after her surgery. She wanted to get cleaned up and loved having her hair brushed and braided by nurse Emily. We witnessed the fight inside this young girl, and we understood where she gained her strength from, her mother.
Narges’ mother emotionally described how difficult it was to watch her daughter struggle to breathe, and how she fought to find proper treatment. Both of her parents really understood the severity of their Narges’ heart disease. They were so thankful to our team for offering her this chance to simply have more time in life.
Sometimes, we cannot completely repair a child’s heart, especially those children who have lived for many years with complex defects. This is why we aim to educate cardiologists and pediatricians to diagnose and plan treatment for these children when they are young. For now, Narges will continue to go to school and spend time with her family. This gift of time is what matters most to the families who are barely grasping at hope.
In August 2010, before the end of the Iraq War, Dr. Novick and his teams began traveling to Iraq. We believed that Dr. Novick’s vision to provide cardiac care and surgery to children suffering from heart disease was more important than politics, religion or where these children were born. Over the course of the past 8 years, we have worked in 6 hospitals located in 5 different cities throughout Iraq. In December 2017, we celebrated performing our 1,000th pediatric heart surgery in Iraq.
Mohammed was only 17 days old when he received his life-saving heart surgery from our team in Karbala, Iraq. He was born with Transposition of the Great Arteries and without surgery, the chances of him surviving to be one year of age was slim. Weighing just 3 kilograms, Mohammed’s heart was only the size of a strawberry. Cardiac Alliance surgeon, Dr Marcello Cardarelli and Iraqi surgeon Dr Ahmed Ebra worked together to perform this delicate surgery. Mohammed recovered over the course of two weeks in the ICU and is now home with his parents just outside of Karbala. Mohammed may be the 1,000 child, but there are still thousands more children waiting for heart surgery in Iraq.
Since 2010, we have expanded our programs across the country of Iraq, beginning in the north in Sulaymaniyah to the spiritual capitol of Najaf. In the south, we began pediatric cardiac programs in Basra and at two centers in Nasiriyah. Our program in Karbala, located in central Iraq, has flourished with a fast-learning Iraqi pediatric cardiac surgeon. It’s through our collaboration with these 5 centers in Iraq that we have been able to provide life-saving heart surgery for over 1,000 children in Iraq.
Novick Cardiac Alliance is the only organization providing pediatric heart surgeries in Iraq. We strive to fulfill the ever-growing list of children who require surgery to survive. Without our volunteers and supporters, we could not achieve this. Thank you for you continued support.
When receiving the news that Dr. Francis Fontan passed away earlier this week, Dr. Novick’s initial response was “Another giant in pediatric heart surgery passed from our midst.” Dr. Fontan is the individual who pioneered the development of the “Fontan” operation. The Fontan operation made it possible for those children born with one ventricle to have a chance to separate the “red” from the “blue” blood and lead nearly normal lives for many years. Dr Fontan’s contribution to the field of pediatric heart surgery cannot be over-emphasized as it is the final operation which nearly all children born with one ventricle receive thus providing them with a future free of the debilitating effects of chronic cyanosis.
Dr. Novick reminisced about meeting Dr. Fontan.
“As a resident in cardio-thoracic surgery at the University of Alabama from 1987-1991 I was fortunate to meet Dr. Fontan on more than one occasion because of his professional and personal relationships with Dr. John W. Kirklin and Albert D. Pacifico. I will never forget my first encounter with Dr. Fontan. He was visiting Birmingham to work on the finishing touches of his sentinel paper with Dr. Kirklin, “The Perfect Fontan”. On the day I had the honor of meeting him I was assigned by Dr. Pacifico to start the second case of the day. As would have it, by design I am sure, it was a child who needed a completion “Fontan.”
As usual this required a redo-sternotomy, which we performed without difficulty. When I sent word to Dr. Pacifico that the sternum was open, I received an unusual response, “Proceed”, which meant he wanted me to lyse the adhesions and place the cannulation sutures to enable the patient to be placed on bypass. I knew that Dr. Fontan was in the hospital and might be visiting the operating rooms, so I was a bit nervous. Nonetheless we proceeded without incident. When I sent word again to Dr. Pacifico that we were ready for him to cannulate and place the patient on bypass, I was again greeted with “Proceed.” This response was totally unexpected as I had never placed a “Fontan” completion patient on bypass, and I was early in my residency. So, as I was placing the arterial cannula, Dr Fontan suddenly appears above the anesthesia screen and says ‘Good morning Dr. Novick!’ Well as fate would have it, I muffed the cannulation and could not get the arterial cannula in. I stopped and responded ‘Good morning Dr. Fontan, sorry I muffed the cannulation, could you please ask Dr. Pacifico to come now.’ Francis laughed and apologized for spooking me at exactly the time I had tried to place the aortic cannula. Remembering this encounter with Dr. Fontan reminds me of the importance of having a sense of humor even while performing challenging heart surgery.”
Francis Fontan, creator of the Fontan operation, actually considered his greatest accomplishment the formation of the European Association of Cardio-thoracic Surgery. He is truly an innovative leader in pediatric cardiac surgery and one of the main individuals responsible for the progress of cardiac surgery in Europe. The world will miss Francis, but we can never forget his tremendous contributions to the field of cardiac surgery, specifically pediatric cardiac surgery. His legacy to this world can be found in the thousands of adults living with Fontan circulation today. We imagine that he and Dr. John Kirklin are together now, perhaps discussing “The Perfect Fontan.”
Brooke Tracy, a perfusion student from the US, recently joined our team on a trip to Kharkiv, Ukraine. She describes her experience as a student on her first medical mission trip.
“There are no words to describe how amazing and influential my first mission trip with the Novick Cardiac Alliance was, but I can say with absolute certainty I would recommend it to anyone! Not only was the team amazing and so well versed in healthcare skills, but they also were some of the most empathetic and passionate people I have had the opportunity to work alongside. Not to mention the local Ukrainian team. They all were very excited to learn from NCA in ways to improve their practice, and they were incredibly welcoming and appreciative of all that NCA has done for their hospital system.
As a perfusion student, I didn’t really know what to expect as our field is pretty dependent upon technology and supplies. I had done some research on the Ukrainian healthcare system, but was vastly underprepared when it came to fully understanding the difficulties in which the local team has in acquiring, what in our practice, is simple equipment. But the lack of equipment never stumped the local perfusionist. Alex and Olga were some of the most innovative perfusionists I’d ever met. In order to make the most of each piece of equipment, their circuit design and construction was innovative. Both were incredibly knowledgeable, but it was humbling to see how much they each were looking to learn more and grow in their practice.”
What she gained as a student:
“In the end, the most inspiring thing about this trip for me was to see the passion and moral of the local team. The nurses were so compassionate and went out of their way to comfort their patients. They really did an amazing job, especially those that were medical students working night shift to gain experience! You could tell that this hospital served their local community in more than just physical care, as the empathy was overflowing with every patient. The parents were allowed back in the ICU with their children post-op and it made a world of difference in the recovery of our patients.
After returning from this trip, not only had I gained a ton of knowledge and skills from both the NCA team and the local team, but I also had a better appreciation for all of the resources that we have at our disposal in the US. I have developed some new practices and little tricks that make my perfusion practice more resourceful and limit my medical waste since returning from the mission.
I can not only recommend missions to anyone in the field, but especially to students because I feel that it gives you a advantage to being a resourceful, motivated, and passionate perfusionist, which is exactly what this world needs more of.”
-Brooke Tracy, Perfusion Student, South Carolina, USA
There are thousands of children with undiagnosed heart defects waiting for someone to find them to save their lives. On our inaugural trip to Lebanon, Cardiac Alliance met a child who traveled from West Africa to southern Lebanon in search of a definite diagnosis and hopefully life-saving surgery. How was is that four-year-old Emmanuel, or E-man as his village calls him, who was so sick that he would sleep most of the day, could possibly travel across the entire continent of Africa?! This is a story of perseverance that emphasizes each person’s ability to help a child in need, even when the task seems dauntingly impossible.
Emmanuel was born in July 2013 in the small village of Garplay, Liberia. His mother Kuku describes his inability to eat as an infant, needing to take breaks to breathe rapidly and he didn’t walk until age two. His family was finally able to travel to Monrovia, the capitol of Liberia to find a specialist. Emmanuel was presumed to have hole in his heart, though there is no an echocardiogram machine anywhere in the country to actually check his heart. His symptoms of extreme difficulty breathing, keeping his oxygen levels high enough, and playing with his 4 siblings were tell-tale signs. He would often pass out for hours at a time while his family would gather around and pray over him until he came to.
Liberia was ravaged for 14 years during a civil war from 1989-2003. Because of this war, the country was left with no electricity or running water and very little medical care. While the country is now growing and improving slowly, the medical system is still very primitive in many areas. When it came to E-man, there were no services available to help him, the only way for him to get healing was to go out of Liberia. But that would cost money and with the majority of Liberians being subsistence farmers, including E-man’s parents, Emmanuel and Kuku, saving the money to get heart surgery in another country would be impossible. So they waited and prayed. For four years, E-man miraculously kept fighting; every time he saw a plane overhead, he would say, “My plane is coming to get me!”
This is where Emily and Brian from Florida, USA enter the picture. Emily and Brian work on the child sponsorship team for Light Evangelism Ministry and traveled to Liberia in March 2017. Emily describes meeting E-man for the first time, as “..heartbreaking. He was laying on a bench, gasping for air, and whimpering. His lips were blue. He didn’t even have the energy to sit up.” Emily and her organization committed right then and there to exhaust all efforts to get surgery for E-man.
They made dozens of phone calls, just stabbing in the dark, trying to find a hospital in America that would work pro bono to save this child. After months of trying, they finally found a hospital in Florida willing to do the surgery, but were quickly devastated when the American Embassy in Liberia told us they would not grant a medical visa for any reason.
Back to square one. After putting out a general plea on Facebook, one of Emily’s friends connected her with Elizabeth Novick, a founder of Novick Cardiac Alliance and wife of Dr. Bill Novick. Dr Novick accepted to repair E-man’s heart, as long as they could get him to any of the locations where Novick Cardiac Alliance was working. The first available country was Libya, but within days of travel, the visa fell through. Ukraine was next. But their hopes were quickly dashed as they found out E-man and Kuku would have to fly to Senegal to get a visa for Ukraine. The extra travel would be impossible for E-man in his condition and the money for the extra flights was more than anyone could afford.
After some research, Emily discovered that Lebanon had an embassy in Monrovia, Liberia’s capital city! Now, just three weeks before Cardiac Alliance was scheduled to be in Lebanon, Emily and her organization were pressed for time to raise the money to fly E-man across the continent.
On October 11, Kuku called Emily. E-man had had a horrible couple of days. He wasn’t eating. He was sleeping a lot and was not able to get off the floor. He was so very sick. Again Emily took to Facebook and posted a video explaining the call she’d just received. The money started to pour in, and in just one day, raised more than the amount they needed! They were fully funded, and E-man would have his surgery!
One more hurdle. The Visas. Emmanuel and Kuku went to the Embassy and were told the man who wrote the letter from the Lebanese hospital would have to call the Embassy to confirm the validity of the case. From America, Emily called Rashaya Governmental Hospital and was connected with the hospital medical director Dr. Yasser Ammar. Dr. Ammar called the Embassy, and E-man and Kuku were immediately granted their visas… just 5 minutes before the Embassy was closing for the day!
No more hurdles. No more mountains. E-man’s surgery was on its way.
Emmanuel arrived at Rashaya Governmental Hospital in southern Lebanon on October 23, and our team performed an echocardiogram and officially diagnosed E-man with tetralogy of fallot. This diagnosis explained why E-man would often squat when playing with his siblings, his body’s attempt to get more oxygen. His surgery was scheduled immediately.
On October 25, Emmanuel received his healing surgery and we know he has a beautiful future ahead of him. It is people as determined as Emily that can help us save these children. This story brings us encouragement that individual people in the world have the power to bring awareness and treatment for the number one birth defect, congenital heart defects.
We all have hopes that E-man will provide great change in his home country of Liberia one day!
Artur was born on the 1st of September in Luhansk, the easternmost city of Ukraine. Luhansk has been under the control of the separatist rebel group since 2014, and is known as “Luhansk People’s Republic.” This city was nearly destroyed by the war in 2014 and many public services are difficult to obtain, including quality care at hospitals.
When Artur was 5 days old, his mother noticed he was breathing very fast and turning blue. She took him to the hospital in Luhansk but the doctors were unable to give a definite diagnosis and sent him home. Weeks continued and Artur’s mother became more concerned with her baby’s blue color. Again she went to the hospital and after several tests, the doctor thought he noticed something wrong with Artur’s heart. Finally the doctor in Luhansk called the Kharkiv Cardiac Center. This doctor sent a photo of Artur’s chest x-ray to Kharkiv pediatric cardiac surgeon Olga Buchevna and she recommended Artur be transferred immediately to Kharkiv.
Upon his arrival at the hospital in Kharkiv, cardiologist Daria Kulikova performed a echocardiogram and diagnosed Artur with Transposition of the Great Arteries, plus a tiny ASD and tiny VSD. This heart defect usually must be repaired within two weeks of age, and Artur’s was very severe. He was not getting enough blood to his body or brain, with oxygen saturation levels barely 50%. His surgery would be complicated. Luckily our team arrived three days later and on October 9th, Artur received his life saving heart surgery. Kharkiv pediatric cardiac surgeon, Olga Buchevna, performed this surgery flawlessly with assistance from Cardiac Alliance surgeon Kathleen Fenton. Artur recovered quickly in the ICU and was drinking milk two days after surgery. His serious facial expressions proved to us that this little boy has a strong will to survive.
There are babies like Artur around the globe, fighting for their lives, waiting for medical assistance to mend their heart defects before it’s too late.
Each year, the American Society of Extracorporeal Technology offers a scholarship to one Perfusion student to travel on a medical mission trip with an organization of their choice. This year’s winner is perfusion student Kim Morris and she will be traveling with Novick Cardiac Alliance to Ukraine early next year.
Kim moved across the United States from Alaska to New York to pursue education in perfusion. From her experience, she has learned that “a successful perfusionist is reliant on gaining the trust of a room full of people that may come from completely different backgrounds. You treat your patient with your equipment and knowledge, but you also treat the surgeon and a room full of professionals with careful communication and a calm demeanor to ease a stressful situation.”
Several years ago, Kim was a medical volunteer in Ghana and from that experience realized she aspired to gain more personal knowledge to more directly help people in need on her next volunteer trip. Becoming a perfusionist was her answer. She now is feeling more qualified to utilize her skills to directly assist those in developing countries. Kim is excited to join Novick Cardiac Alliance as a perfusion student, honestly stating, “I’ve learned to participate in a highly skilled team to give a patient a permanent, life changing surgery.”
We look forward to having Kim join our team as a perfusion student in Ukraine!
Cardiac Alliance has been featured on ShareAmerica, a platform produced by the US Department of State. Our story has been shared to all the US Embassies worldwide. This particular story can be translated into seven different languages. Read the article on ShareAmerica to learn more about our life-saving work in war-torn areas.