HEALING HEARTS NORTHWEST

Thank you, Rwanda, and Good bye

2011-04-28T00:10:00.000-07:00

Last night we were treated to a party hosted by King Faisal hospital. We were each given some Rwandan coffee and treated to a show of traditional Rwandan dancers. Tonight HHNW staff has been invited to the US ambassador's home for a reception. Then the first wave of staff begin the trek home (or on other adventures) tonight at 8:00 pm. Another group leaves Saturday and the last on group on Tuesday. We have attempted to relay with pictures and words the incredible experience we have had here in Rwanda this April. Because of time constraints, technological delays and failures, we will be adding more pictures and postings when we return. We thank King Faisal Hospital, our patients, the Rwandan people, all our donors for helping us realize this mission and you, readers, for following our work and adventures.

Jean Paul: Past Patient, Present Patient Educator

2011-04-27T06:11:00.000-07:00

Jean Paul Iyamulemye is a 34 year old Rwandan who was operated in April 2008 by the Boston team. In 2006, shortly after he married, he became ill and surgery has given him his life back. When HHNW was here last February, Michelle our lead in CCU took a cab ride and Jean Paul was her driver. They spoke about why she was in Kigali and Jean Paul told his story. What a coincidence! Jean Paul now visits the hospital to help interpret to the Rwandan patients and explain what the surgery is about and what to expect. He is an incredible resource to them and us as the patients can hear what he went through and see how he looks and feels now.
He dreams of improving his English and continuing to help people no matter where they are from. He beams with happiness when he speaks of helping the patients understand surgery and recovery. He has immense gratitude for the new life that he has been given through heart surgery.
Jean Paul and his wife take care of 2 orphan boys ages 16 and 18.
He is a taxi driver in Kigali and we are grateful for that service for ourselves sand his help with our patients!

Medical / doc's perspective

2011-04-27T05:02:00.000-07:00

Yesterday marked the last surgical day. It was marked by 2 unexpected events: first the 16 year old female, whose mitral valve was replaced yesterday, developed seizures, evolving into status epilepticus. It was determined that she had a heretofore unknown seizure disorder, quiescent for 3 years and on no meds. She finally responded to the addition of midazolam drip, after failure of diazepam and midazolam boluses to control seizures, to the dilantin drip (after a one gram loading dose.) We were able to text message with Dr Jimmy Nguyen, epileptologist at SHMC, who graciously advised us at midnight, PST. We were able to find valproic acid, but only in oral form. Therefore we loaded her via nasogastric tube and will wean the benzodiazepine. She is stable but still on ventilator and sedated at this time.

Secondly, during placement of a permanent pacemaker in a 22 year old male with complete heart block, asystole ensued prior to placement of the ventricular lead. He was intubated, underwent CPR for about 30 minutes, and developed mild pulmonary edema and hypoxemia. As a result, his body temperature was lowered, beginning while still in theater. We used ice bags in axillae and groins and achieved about 34 degrees celcius in 3-4 hours. He remained chilled for 18 hours, then warmed, and is now awake, alert, extubated and mentating well. To the best of our knowledge, we dare say he is the first cardiac arrest patient in Rwanda to undergo hypothermia protocol, albeit with "primitive" means of cooling.

Our final case tally is as follows:
males: 7 (39%)
females: 11 (61%)
age range: 11 - 54
average age: 20.6 years
median age: 17 years

Cases:
Atrial septal defect repair: 2
mechanical valves: 7
bioprosthetic valves: 5
pacemaker placement: 2
Tetralogy of Fallot repair: 3
Right heart cath: 2 (one for undexplained severe TR in patient who received a mitral valve replacement last year, and another for pulmonary hypertension with VSD, w/ finding of a previously undiagnosed PDA)

One case required re-exploration for bleeding, with repair of a small pericardial bleeder and was extrubated several hours later: she is now out of bed, on room air, and is doing well. There were the usual post-op fevers and ateletasis, but less prevalent to that seen in the US, probably due to the absence of comorbidities in these patients. There have already been multiple discharges to home from hospital.

We are now preparing for departure, packing and doing inventory on a huge volume of equipment. Much will be left in secure storage for the next visit. After-action meetings and reports will be done in order to improve our already successful missions.

Brooke, Lead of Telemetry

2011-04-26T23:49:00.000-07:00

Brooke Hendriksen is our lead in the telemetry unit which is the step down unit from the CCU. She has had a varied career before becoming a nurse only 6.5 years ago. She is from North Idaho and has lived in Hawaii, St. Louis, and Alaska working in logging camps, saw mills, and as a vet assistant. She settled on nursing because of her love of math and science.
She loves cardiac nursing because of the complexities of the heart. She finds the electrophysiology of the heart a fascinating puzzle. She is the daughter of a military family who moved every 2 years. The HHNW mission is a perfect fit for her. It allows her to travel (in place of actually moving) and do the cardiac nursing she loves. She has always wanted to volunteer and after offering to go to New Orleans after Katrina and Indonesia post tsunami and not being called, she became committed to HHNW. We are fortunate she did!
Brooke's other pastimes are horses (she has 2) and fish (130 gallons of water in 4 tanks!). Fun fact: as well as enjoying exotic fish, she raises tiger shrimp and supplies the only store in Spokane that sells them!
Brooke is married to Brad and she has 3 stepchildren and 1 grandchild.

Brooke is pictured above with Dative, a patient we operated on last year and had to be re-operated on this year.

Jim Dixon, Technician Extraordinaire

2011-04-26T23:42:00.000-07:00

Jim is a vital cog in the wheel that turns HHNW. Trained as a biomedical technician he has had a full career of 40 years in the field. Shortly after he retiring in Jan. 2009, he got a call from Sandi Kessler asking him to work with HHNW. He felt he could use his talents and honed skills to help others. He enjoys the challenge of problem solving with all the different variables he finds here in Rwanda. For those who don't know what his work entails, Jim keeps all our machines running. When things don't work as they should, Jim fixes, jerry-rigs, splices or manufactures the solution, often under intense time pressure. No appliance, motor, or crisis is beyond his capabiliies! He endeared himself to the nurses when he went out and bought and installed a toilet seat in the ladies room (previous one was missing)!
Jim has traveled to European countries but never to Africa or a third world country. He really enjoys the Rwandan culture and people. It is the Rwandan people and the close interaction between himself and our doctors, nurses and patients that has brought him back for HHNW's second mission.
When not working for HHNW, Jim volunteers his time to P.E.T., a program based in Mead, Wa. P.E.T. Stands for personal energy transport and they manufacture and assemble a mode of transport similar to a bicycle for persons in third world countries who are missing a lower limb. Jim describes himself as a reserved but when engaged in conversation, he readily shares his wealth of knowledge and experiences.
Jim has been married to Bonnie for 47 years and has 3 children and 7 grandchildren, 2 of whom live with him.

On the light side

2011-04-26T05:50:00.000-07:00

Today is Tuesday, our last day of surgery.
We just received our last trunk!!! Yes, just now. It spent the last week and a half in Amsterdam. We are doing our last surgery, busy repacking the items that return to Spokane, identifying items to store here for next year, and identifying items to give to the hospital here. It arrived just in time to be unpacked and sorted. We are lucky that it didn't have anything we couldn't do without.

Reminder

2011-04-26T00:06:00.000-07:00

Sunday night we had a reminder that we are performing complicated surgery on very sick patients and that there are risks involved. Nathalie is a 17 year old girl who on Sunday underwent replacement of two heart valves and repair of a third. This was a very long complicated operation which went very well. Unfortunately she had moderate persistent bleeding after surgery and with limited access to blood products we felt re-exploration was necessary. She was taken back to the operating room late Sunday night and relatively minor bleeding sites were controlled. She has done fine since the re-operation. Here she is with Dr. Siwek and Lauran the morning after the surgery, already out of bed.

Abraham Kong'a, Entrepreneur

2011-04-25T07:36:00.000-07:00

Abraham Kong'a is an amazing person. He owns a craft store specializing in crafts made in East Africa in downtown Kigali. Originally an IT major trained in Kenya, he soon realized that he was an extrovert and not someone who should be sitting behind a computer all day. He has been doing this for a little more than three years, driven by seeing beautiful crafts that were not selling, he goes directly to the crafters, pays them on the spot and collects an assortment of jewelry, baskets, sculptures, wooden bowls and other small objects. He started by selling from a small stall with other entrepreneurs. Abraham doesn't bargain with customers as is the custom here. His prices are fair and there is no need. Tourists would find him and they walk past all the other booths to go directly to his booth. The management of the booths became angry with him and now he has opened a windowed shop, triple the size. He welcomes visitors as they browse and engages them in conversation. If you return a second time, he greets you as an old friend with a sincere hug. His English is astoundingly fluent, complete with the latest slang. We asked him how he learned and he says "school and watching a lot of movies". He also used to talk to himself in the mirror, so much so that his mother would have someone in the room with him! Abraham is married to Alice and the have 5 children, ages 2-19. The older two are adopted.
One major motivator of Abraham's is that he now indirectly supports 1500 people just from his basket business alone. Rwandan women make incredible baskets and Abraham goes to his village, Gitarama and purchases the colorful baskets directly, supporting 25 women. Ten more women make jewelry binging his support to 35 women and their families. He and his wife realize that by becoming successful in their business, they raise their livelihoods and that of many others. Abraham is a avid Facebooker! You can follow him on Facebook and bring Kigali a little closer to you!

The first photo is of Abraham and the woman who is the head of the basket weavers, the second is Abraham, his wife, Alice and Jane and Sam Joseph. Note the beautiful baskets in the background.

Lee Siwek, Cardiac Surgeon

2011-04-25T07:13:00.001-07:00

Dr. Lee Siwek is one of our two HHNW cardiac surgeons. Trained at Harvard Medical School, with residency at Massachusetts General, a fellowhip at NIH and a pediatric cardiac surgery fellowship at Boston Children's, he brings 34 years of experience to the OR. He has wanted to be a cardiac surgeon since he was in 3rd grade! His specialties are pediatric and robotic surgery. Ironically he uses robotic surgery in Spokane for mitral valve repair and replacement, ASD and many of the other defects he is repairing here in Rwanda. He has been to China to train the first Chinese, robotic, cardiac surgeons and has returned to give lectures.
He came to Rwanda last year as a favor to his long time friend, Hal Goldberg. He returned this year because he enjoyed his experience so much. He likes the camaraderie of the HHNW team and the total shared experiences. His hope is that with his and other HHNW staffers' teaching, King Faisal Hospital can learn to sustain this heart program. That hope and seeing the patients' gratitude and recovery bring him back to Rwanda.
When not working, Dr. Siwek enjoys spending time at the lake, playing golf, traveling and spending time with his family. He is married to Janine, one of our surgical nurses and they have 4 children. Their youngest graduates this Mother's Day from Gonzaga.

One of Our Rwandan Links-Connie

2011-04-25T05:34:00.000-07:00

Connie Kamali is a Rwandan nurse who is working side by side with the HHNW nursing staff in the CCU at King Faisal Hospital. She moved back to Rwanda last November from Toronto, Canada. In December, she was hired as an ICU manager and is now about to work on organizing a step down unit for King Faisal's ICU. She came to ICU nursing after working with general surgery patients. She likes the challenge these patients require and gets a lot of satisfaction from helping them. Connie has learned to deal with the emotional toll these patients can have on her. It is her hope that she can contribute to King Faisal as she sets up the new unit. She loves nursing and helping others. It is also important to her that she is able to give back to Rwanda and is happy that it is a peaceful country again.
Connie is married and has 2 daughters ages 23 (studying business in Canada), 21 (studying management in India) and a 12 yr old son. She and her family are happy to be in Rwanda and to be near extended family. As you can see from her face, Connie has a most sincere and gentle spirit. HHNW is honored to have her working beside them.

Michelle, Lead of Our CCU

2011-04-25T04:57:00.001-07:00

Please meet Michelle Dearden, RN our lead in the CCU. She brings 15 years of nursing experience to HHNW. She has specialized in cardiac care since 1998. She first worked on a renal floor but having to float to different areas, she decided to overcome her fear of cardiac nursing by jumping into it. She took on its challenge and still greatly enjoys it.
Before studying nursing in college, she studied African Studies. Having the dream of going on a medical mission and her interest in Africa contributed to joining HHNW. What a great chance to experience Africa and contribute through her profession! She loves to see the Rwandan nursing staff learn and grow and she learns from them as well. The patients' cycle of recovery, smiles and gratitude keep her coming back to Rwanda with HHNW. Michelle is also one of our lead nurses who in involved in procuring and packing the medical supplies we ship and carry to Rwanda that are vital to this mission. Thank you, Michelle for your many months of commitment!
Michelle has a fraternal twin, Kristin, as well a brother and older sister. Both Kristin and their mother are busy praying for the HHNW patients in Rwanda. Michelle is married to Bryan. In her spare time, she loves to read, snow ski, mountain bike and spend time at Priest Lake with Bryan.

Our Pharmacist, Jamie

2011-04-25T04:15:00.000-07:00

Jamie Danelo graduated from WSU pharmacy school in 2007. After graduation she moved to Boston to work at Mass General Hospital to experience another hospital. While there, she got a call to see if she would like to join HHNW. She accepted and returned this year for her second visit. She enjoys this mission because she enjoys problem solving and being flexible with equipment, supplies and medications here in Rwanda. Teaching the hospital staff and working with George Shortis of the Australian heart team to help this program become self sufficient is also important to her. Jamie loves traveling and doing medical missions is a way to experience life beyond Spokane. This past year she joined a group from WSU and went to Ecuador. She hopes to go to Guatemala this May. She has the bug!

Training is a large part of this trip

2011-04-25T01:00:00.000-07:00

An important part of HHNW's mission to Rwanda is training. The Nurses and Doctors have conducted formal trainings but informal training is going on continuously. Here is Perfusionist Jim doing impromptu training to two Rwandan nurses.

2011-04-24T23:57:00.000-07:00

Monday, 25th. We have two surgeries today and two tomorrow then we are done. In some ways it seems like we have just arrived, in others it seems like we have been here a long time. From where I stand on the sidelines of the OR each day seems very similar; Mark and Jim are our Perfusionists, Erik, Mitch and Devan take care of anaesthesia, Sandi, Lauran, and Janine are our nurses, Jared and Abbie are our Techs, Jason our PA, and Dr Siwek and Dr Worrall our surgeons. Charlotte takes care of the Echo. Jim Dixon comes in and out keeping all our equipment running. This teams performance has been outstanding each and every day.

But when you watch, each day is very different; our patients have been men and women and have varied in age from 11 to 54 years old. We have done everything from repairing TET's and repairing ASD's to doing MVR, AVR and a TV ring. Some cases have been complicated and challenging others have seemed routine.

Today our first patient is named Triphine. She is 24 and having a MV repair and a TV ring. Our second patient is named Aganoi. She is 17 and having a AVR and may need an MV repair. The OR team is on their game and confident in the ICU and Step-down continuing their excellent care of the patients.

Difficult case,Great recovery

2011-04-24T09:24:00.000-07:00

Patient Judith N., Jason Konyu, and Dr. Worrall the morning after a complex aortic and mitral valve replacement and tricuspid valve repair. She was one of the more difficult cases because of her young age (15) and small aortic auuulas. The surgens used a "sterile shoehorn" to fit in an adequate adult sized valve. She did beautifully after surgery and is shown here less than 15 hours after the conclusion of surgery- a testament to the excellent ICU care and the skill of the entire surgical and anesthesia team.

Martha and Vanessa

2011-04-24T08:52:00.000-07:00

We hope to feature some vignettes of people we meet here in Rwanda. Please meet Vanessa, a patient with ASD (atrial septal defect). She came in for surgery on her 16th birthday. She lives with Martha, her guardian who is an American, single mother of one adopted Rwandan daughter and 3 more foster girls. Martha has been in Rwanda for a little over 20 years where she has done everything from helping women's cooperatives to teaching English. They live very near the Congo/Rwandan border. Vanessa loves to do traditional dance and teach it to younger girls as well. When she grew ill last August, she was too weak to dance. She is looking forward to being healthy again, dancing, swimming and eating chocolate! We hope she will return next year and dance for us! Vanessa and Martha happily went home to the rest of their family on Easter Sunday.

Thanks for the gifts

2011-04-24T04:24:00.000-07:00

A BIG shout out to all the people who spent time and money for gifts for the Rwandan people. They really appreciated them. This handmade quilt is just one of the many items we were able to share with our patients. All our open heart patients are doing great. Happy Easter!

Beautiful Rwanda

2011-04-23T22:51:00.000-07:00

The country of Rwanda is beautiful. Here are some of what yousee while in Rwanda.

Rwandan People

2011-04-23T22:40:00.000-07:00

Some of the followers of the blog have been asking for pictures of the Rwandan people. Here are some pictures that have been taken that shows the beauty of the Rwandan people.

Saturday

2011-04-23T22:29:00.000-07:00

Saturday: Our patient today is Elisabeth. She is our youngest patient at 11 years old. We are doing an ASD for her.

This picture is of Mitch who is looking dapper while preparing for the case.

Recovery

2011-04-23T22:21:00.000-07:00

Friday. I am a little behind keeping up on the blog. I will try to catch up today.

It is nice to see our patients recovering. I found Evaristew and Innocent (our first two patients) playing with an Etch-a- sketch while sitting out in the nice weather. It looks like they will be going home today (Easter Sunday).

OVER THE HILL

2011-04-22T11:00:00.000-07:00

Brooke's 40th Birthday Celebration was fabulous thanks to all of the pre-planning by April! The venue was Heaven Restaurant, a local ex-pat hangout with delicious food, wonderful community enterprises (selling objects d'art for local women and hosting art shows for local painters and sculptures) and great service all surrounded by a beautiful nighttime skyline view of Kigali. We were served a delicious pumpkin bisque and protein of choice while Hal handed out Kudos to our team for making it to the halfway point of our surgery schedule. Then the Party began! Alison provided both a heart warming and heart wrenching video greeting from home that made Brooke get the ugly-cry-face. Heaven employees fixed that by singing Happy Birthday; we fixed it like all fiends do, we ate cake! Thanks to Brooke for turning 40 so we at least had a reason behind the Mutzig! And thanks again to Avril, you are the Queen of Excursion Planning!

Friday.

2011-04-22T04:01:00.000-07:00

Friday: We arrived at the hospital at 6:50. Our patient ( 12 Y.O. boy) was waiting. We got the OR ready and brought him in. As you can imagine he was scared. A nurse comforted him while he was prepared for surgery.
Our second case is a 15 Y.O. girl for a MVR and AVR.
The OR has been real warm. Even with the air conditioner running the room is close to 80 degrees. It is even warmer under the flood lights.

TET-A-TET

2011-04-21T21:02:00.000-07:00

Both of our TET kiddos from yesterday did fabulous, thanks to the great care by the 2 pediatric nurses we brought from Providence Sacred Heart Medical Center's Women and Children's Hospital. Yvette and Nicole tag-teamed our youngest 12 and 15 year olds, settling and caring for them with swift hands and kind hearts. I have never seen someone so exquisitely tuck in a patient so expediently as Yvette. She truly is a master of her profession. Then our adult cardiac nurses took over for night shift (Katie and Sarah S.) Fortunately, in preparation for our Mission, they had an intensive 2 hour Congenital Pediatric Care Course provided by Barb and Beth, our pediatric education specialists from SHMC. And we could not have done it all without the support of "Dr. Dan," as Rwandans say. Brutacao to us. He recently arrived from the grueling Boston Marathon finish line. The long flights cross country stoved him up a bit but he gimped into the groove like he'd never left. Thanks Peds team for taking the responsibility for our little ones!

OUR AUSTRALIAN FRIEND

2011-04-21T07:09:00.000-07:00

George Shortis is an Australian pharmacist who is a founding member of Operation Open Heart of Sydney, Australia. He works with Team Heart of Boston and HHNW and King Faisal Hospital in Kigali, Rwanda. He has an incredible background in international medical work. In 1994, he and several other “young agitators” as he describes himself and fellow “conspirators”) worked to convince his hospital, Sydney Adventist, to create an international mission. In 1996, OOH’s first mission was to Tonga to do heart surgery on patients with rheumatic heart disease. Their next trip was to Papua New Guinea and after 15 years, they have trained local surgeons to hopefully have a self sustaining program within the next 2-3 years. The Australian mission work has expanded to 10 countries and 4 medical specialties drawing volunteers from across Australia and abroad.

He gladly shared what motivates him to continue his 100 flights per year. “I really enjoy seeing lives changed and the response of the people we have helped. I like seeing people working together in stressful situations and seeing the outcome. I grow as an individual and see others do the same”.

He first came to Rwanda in 2004 and has come every year since. He has noticed much more coordination with the local hospital especially the nursing staff. Dr. Joseph, the head of the cardiology department inspires George with his incredible dedication to the Rwandan people. George helps to coordinate the three visiting teams (Australia, Operation Heart-Boston and HHNW) so that there will be less duplication and more sustainability.

George brings his great sense of humor and playfulness along and enriches the lives of all HHNW staffers! We thank him and applaud his efforts! (George is pictured above with Jamie Danelo HHNW) pharmacist)

Visiting Patients

2011-04-21T04:51:00.000-07:00

Thursday. I had a chance to go to the Step-.down Unit and visit patients from the first day OR schedule. It is real nice to see our first patient (Evaristew) sitting beside his bed eating breakfast and visiting with Jason (PA). Next to him is our second patient, Innosent, laying in bed talking on his cell phone to friends. Both have great smiles. The step down nurses tell me how much they enjoy working in Step-down because they get to help the patients recover and get to interact with the patient's family

Bushwacking for Gorillas

2011-04-21T02:40:00.000-07:00

April Williams is our extraordinary excursion creator of HHNW. She organizes various trips for the staff who have days and/or shifts off duty so that we can all enjoy our experience in Rwanda.
Seven of us had signed up to visit the National Volcanoes Park to trek and track mountain gorillas. We sleepily met our drivers at 4:30 AM to make the 2.5 hour drive to the Volcanoes National Park. The drive was anything but boring. As the sun rose, the countryside showed it's many hills (Rwanda is called the "land of a thousand hills").

The very modern, well-built roads were lined with streams of people walking or biking with heavy loads on their heads or bikes towards the nearest or not so near morning market. What an impressive and humbling sight--women, small children and a few men, so industrious and diligent at 5 am!

The hillsides are lush and terraced. Every possible area is farmed on the steep hillsides. Rwanda is an agricultural country, growing most of it's own food, so that it is not dependent upon other countries for it's subsistence. Most of the farming appeared to done by the women and children (on school holiday) wearing the colorful traditional dress.

After arriving at the park and being assigned our guide, we drove over an incredibly rocky road to our "entrance" closest to the family of gorillas we were to view. Our hike began by walking through potato fields that encroach the park. This nation park is one of three bordering each other, one each in the adjacent countries of Rwanda, Uganda, and DRC. They are the protected home to the gorillas and the only place in the world where they live! How lucky are we to be in their habitat! The hike gave a new meaning to the word bushwacking. Porters carried our packs, sometimes led us by the hand, breaking trail using a machete through the jungle-like vegetation. Our guide was led by walky-talky messages from the three trackers who had found our family of 15 gorillas. As an aside, the trackers are mostly former gorilla poachers who have been employed in this far more acceptable vocation.) After 2.5 hours of climbing and traversing and wondering if were ever going to see gorillas, the trackers came into view. We quietly followed, cameras in hand and around the brushy bamboo, we saw our first female. What an incredible site! We watched her eat, stare at us, lay on her back and stare at us some more! We spent the next hour following 3 females, a two month old, a four year old and 2 silverbacks (males) move through the forest, eating, preening, playing and relaxing, showing no fear of the humans observing them. We hiked out a shorter way, tipped our guide and porters and into our cars, exhausted but thrilled with our amazing experience.

Medical blog, Apr 17, 2011

2011-04-21T02:35:00.000-07:00

Having the ICU and Or thoroughly and expertly prepped by the advance teams, surgeons Drs. Worrall and Siwek started the HHNW 2011 season with 2 successful valve surgeries. The first was a 24 yo with rheumatic aortic stenosis; he came through surgery was was extubated via "fast track" in a few hours, all with no complication. The second, a combined aortic and mitral replacement was performed on a 27 yo male. It too proceeded without a hitch, with ICU/ post of care provided by Dr Jim Elmer.

Meanwhile, Drs. Hal Goldberg and Sam Joseph saw those patients scheduled for surgery over the next few days, along with other add-ons as per Chief Rwandan Cardiologist, Dr. Joseph Mucumbitsi. Included were three 12 yo patients, 2 with severe rheumatic aortic insufficiency and mitral valve stenosis, and one with a widely patent ASD (atrial septal defect). In addition, a 45 yo female with mitral valve stenosis was evaluated and felt not to be ill enough to merit surgery at this time.

Conversely, a 33 yo female, whose mitral valve was replaced last year for rheumatic mitral stenosis, returned with extreme fatigue and ascites, her ECHO showed severe tricuspid regurgitation. She was felt to represent possible portopulmonary hypertension, vs idiopathic PAH, vs Chronic Thromboembolic Pulmonary Hypertension, vs schistosomiasis / POPH. Plan is for right heart cath w/ hepatic vein pressure determination and pulmonary vasoreactivity testing w/adenosine. Treatment options may be limited by cost and availability.
Another confounding patient was a 22 yo female with minimal dyspnea and known mitral stenosis who surprisingly has an estimated PA pressure by ECHO of over 80 mmHg. She will be further evaluated, perhaps w/ right heart cath.
Overall, it was a wonderful beginning, reflecting a remarkable amount of work by a truly wonderful team.

Thursday- Two kids

2011-04-21T00:08:00.000-07:00

Thursday. We have two kids today. Our first case is a 13 y.o. girl for a TET. Our second case is a 12 y.o. boy, also for a TET. Dr. Siwek is doing the first case and Dr. Worrall the second. The power went out and we went on generator first thing in the morning. We were still on by-pass at 8:58am.

Day two

2011-04-19T04:36:00.000-07:00

Tuesday, April 19. Day two. We have two cases again today. Our first patient turned 16 yesterday. Our second patient is 21. Both women. The power did go out for a while, but came back without problems. We could be done around 5:00 today. Good day.

FIRST DAY OF WORK

2011-04-18T08:00:00.000-07:00

Except for the trunks that keep filtering in with each wave of staff flights, we are all unpacked and prepared to begin our first OH surgeries. This is the recently paved street down to KFH with a lovely cobblestone sidewalk and fresh grass sidelines.

After many years of preparation, they have just received their Accreditation from "The Council of Health Services Accreditation of Southern Africa (COHSASA)." This is the equivalent of our JCAHO and so they were frantically pulling their hair out just like us when the surveyors arrive on site. King Faisal is beautiful and clean and we love working with the staff who have been more than accomodating.

Surgery has begun

2011-04-18T00:53:00.000-07:00

Monday April 18. Surgery has begun. ICU is ready for their first patient. Nine of our patients are under 20 years old. We will keep you up to date.

Getting ready

2011-04-18T00:33:00.000-07:00

Sunday April 17. We headed to the hospital early to finish unpacking trunks and do some setup. The first team arrived yesterday and has most of the work complete. It rained hard during the night but the day starts nice. Around 3:00 the skies open up and rained extremely hard for about 10 minutes then it is nice again. We stopped at "Jimmy's" our favorite pizza place for dinner and visited with some local kids.

DEPARTURES AND ARRIVALS

2011-04-15T14:49:00.000-07:00

It's always good to begin and end a journey with some consistency, for us this was the universality of beer. Heffy in the States and Primus in Africa. Especially when the country welcomes you with open arms into it.

Our first group of travelers made it here safely, including all of our personal luggage. Our trunks are having a sleep over in Customs. Sandy, Hal and Dr. Mucumbitsi plan to retrieve them on the morrow.

The rest of us will also be up and at 'em on our way to King Faisal Hospital to unload all of our beautiful shipping boxes. And it will be like Christmas going through all of our belongings we left here last year.

Good luck to the three remaining waves of travelers, we will see you all soon. And you will be just as happy as Brooke to take off your support stockings!!

TACKLING TRUNKS

2011-04-12T00:59:00.000-07:00

Ever hear the phrase, "We will never do that again"? Yeah, we could have coined it. After all of the time-consuming work ordering and packing, then unpacking and re-packing, rearranging, weighing and re-weighing ....

It seemed like a never-ending job, we ate, drank and slept it. Labels, numbers, Flight Groups, zip tieing, counting and recounting. Finally! Handling all of these trunks is over.

Sunday, HHNW Mission Volunteers came to SHMC Women and Children's Hospital Entrance to pick up their trunks.

And today we found out that all of the supplies we shipped one month ago have all cleared Customs with flying colors!! What a relief for those of us who put so much effort into shipping and what a relief for our Medical Mission - now we can actually perform the surgeries we have been planning for so long.

After all of this good news, maybe we too can relax on the sofa.

AMATEUR VS. PROFESSIONAL SHIPPERS

2011-04-05T22:21:00.000-07:00

What a site to behold. We were so proud of ourselves, just look at how uniform those boxes are and those beautiful, colorful numbers. We thought we were pretty hot stuff. Thanks to these Berg Company employees for moving our massive pile-o-boxes from our Mission Room to the Sacred Heart Medical Center loading dock.

Then we received the photos from Berg Company, our god-send of a shipping company ... Holy Cow Bat Man! Look at those lovely pallets, protective corner guards, that beautiful "saran wrap," and who wouldn't want to be strapped in like that. A swaddled baby never had it so good.

And it definitely paid off. We just received word that ALL of our supplies made it to Kigali, and in the same 7 pieces Berg Co. sent them in. If you recall from our Mission last year, missing supplies became quite an issue. We are still waiting to exhale, as they say. This week our supplies will be inspected by Rwanda Customs - cross your fingers, get on your knees and say a prayer, burn some candles and incense, cross your legs and say "ohmmmm", nod your head and twinkle your nose - we are prepared to do whatever it takes to get our supplies into the country! Go team go!

CICU and TELEMETRY NURSE ORIENTATION

2011-03-27T02:11:00.000-07:00

Part of working on a Medical Mission of this magnitude is knowing what we are doing and how to impart that information to our own Healing Hearts Northwest (HHNW) Nursing staff and then to the King Faisal Hospital (KFH) Nursing staff.

To this end, HHNW CICU and PICU nurses have had 2 hours of ventilator training and the CICU, PICU and Telemetry nurses have had 3 hours of Pediatric Congenital Open Heart Training and also a 2 hour Orientation Course on what to expect and how to function at KFH in Kigali, Rwanda. That is a lot of unpaid classroom hours, which gives a whole new meaning to volunteers.

Add on top of this, the 5 HHNW staff that plan on presenting during our full day Cardiac Education Day for the KFH nurses and staff. They will be teaching Ethics, Blood Product Administration, Pediatric Congenital Heart Surgery, ECG Rhythm Interpretation and Coumadin Pharmacology. I am telling you, we have some amazing staff volunteers.

As mentors, we plan to implement a more formalized documentation system of whom and how we have mentored the KFH nurses. Hopefully, this will assist us in future Medical Missions, deciphering who has been trained and is capable of recovering Open Hearts on their own and who still needs full training or just a little refresher.

This is no easy task for any of us, on either end. Traveling clear across the globe, to a foreign country in a foreign city and still having our wits about us to teach appropriately. And, on their end, coming to work one day, seeing all of us Muzungus (white people) and being paired up with one of us to learn as much as possible through a language barrier.

The most fascinating aspect of the above is that it actually works! It is amazing how universal sickness, hospitals, nursing and charades actually is. Unbelievably, we all seem to communicate in the same way about the same subjects or ideas. Although we may struggle to find words or props to show what we mean, somehow each party gets their point across.

And it works because we have such amazing nurses volunteering their own funds to pay for their trip, volunteering their own vacation time and volunteering all of their years of expertise. Sometimes we do not realize what a plethora of useful information we hold within ourselves. My hope is for each HHNW and KFH nurse to find and share and rejoice in each other's knowledge, for this is true collaboration.

So wish us all godspeed in our success, for this will bring King Faisal Hospital one step closer to performing their own Open Heart Surgeries with their own Open Heart Program with wonderfully capable nurses and staff.

ANNUAL NURSES' DINNER

2011-03-10T23:25:00.000-08:00

A chance to get to know each other and to relax

Great venue, great food, great conversation and best of all, getting to know exactly who we will be working with over at King Faisal Hospital in Kigali, Rwanda. Thanks again to Brooke for organizing this wonderful party, a precursor to the great time we will have working together soon and very soon.

Click here to see more Nurses' Dinner Pictures [Courtesy of Charlotte]

MAKING RESPIRATORY THERAPISTS OUT OF NURSES?

2011-02-22T15:10:00.001-08:00

Well, hosting a whole surgical group in Kigali is very expensive for the Ministry of Health of Rwanda. To defray these costs, we have reduced our group size by not taking Respiratory Therapists this year. Thank gosh we took them last year though. Otherwise, Sally Lutz would not have the first hand quirky experience to teach us about the Avea Viasys ventilators we use at King Faisal Hospital. Sally and her colleague Scott have been gracious enough to teach all of the CICU nurses the ins and outs of the ventilators we plan to use in Kigali, Rwanda. We thank both of them for giving up their personal time to instruct us so thoroughly!

MARTINI PARTY, YOU DON'T SAY? ...

2011-02-20T21:20:00.001-08:00

This was a fundraiser of divine providence. Our graphic designer prepared our giraffe advertising poster absolutely beautifully. None of us could believe it. Celeste and Dan Coulston graciously donated their Chaps venue, a fabulous shabby chic food and dessert "destination." Jane Joseph and Lauren Gilbert did a fabulous job organizing all of the following people - Abby and Ralph Oscarson and their crew (including their nephews in the Music Corner) worked tirelessly decorating Chaps with our African decor; April Williams planned for the Silent Auction ahead of time, knowing full well she would be on a beach in Mexico during the party; so Pam Miller and Larry Keyser displayed our irresistible Silent Auction items; Sandi Kessler and her crew (including some encouragement from her "Costco" friends) chopped and prepped and prepared scrumptious appetizers; Ralph, Lisa Chapman and Jennifer Day were more than happy to take your money at the registration table; Elisa and Naomi eloquently served up our appetizers; and as usual, Sandy Goldberg was the undercurrent keeping it all moving in the right direction.

None of this would be possible without several people behind the scenes: we thank our personal bartenders for donating their time, their martini making instructions and their refreshing pours for us; we thank Roast House Coffee for their special roast and serving of a nice strong cup-a-joe; we thank Dan Coulston for tirelessly cleaning up after us, even on his Birthday; and last but not least - Andy and Lorri (Albin) Turner for donating an outing for "Jeffery the Giraffe." Here is the scoop (straight from the Giraffe's mouth): I have known Lorri for 35 years and I happened to run into her in Seattle the weekend before our Martini Party (hadn't seen her for 10 yrs). We got to chit chatting about HHNW and Africa and how her husband goes Big Game Hunting (ears perking up) ... how he collects all these big animals (you don't say). I asked her if he had a giraffe (dreaming). She said yes (jaw dropping) and agreed that we could use him at our Martini Party (Hallelujah!). The best part was, he was already in Spokane. Voila! We just rented a U-Haul and he was able to have a sleepover with us. This was a great asset to an even greater party.

Thank you to all of the attendees for buying our Silent Auction items and for buying all those drinks! We appreciate all of your support and we had just as much fun as you mixing and mingling. The best part ... we may do it all again in July! Save our blog to your Favorites and we will keep you posted.

CLEAN YOUR ROOM!

2011-02-12T15:12:00.000-08:00

You will notice tables in the background. Yeah, I know it's hard to tell what they are because they look more like heaping mounds of blue but there are actually tables underneath that.

Now looky here. You can actually see table tops. Sandi Kessler and Lauran Gilbert thought that would never happen. But they did it! Which means most of that mound is tallied, packaged and organized into shipping boxes.

"Look Ma, we cleaned our room!"

It is an odd crew that gets excited over "great shipping boxes!" Doesn't take much to make us happy. Can you believe it, we are nearly 4 weeks ahead of schedule. Just have last minute items to pack. All those boxes will help us perform 13-14 mitral valve surgeries and 4-5 congenital surgeries on young adults in Kigali, Rwanda. We leave April 14th! Yikes, just around the corner now.

SKI TO AFRICA

2011-02-11T23:04:00.000-08:00

Believe it or not HHNW pulled off another successful fundraiser in less than 5 days. We had a few guests who tried to Ski to Africa, but most of us tried to eat our way there. And why not when the food was that delicious. Mt. Spokane is a beautiful venue; crisp and clean, viewing the air you breath. Again, we had great organizers in Randy and Marianne Foiles and April Williams. They were able to convince several restaurants (Italian Kitchen, Luigi's, Lasagna on Ya, SYSCO) to donate delicioso Italiano food; caesar salad, rolls, pasta, vino and red velvet cake to celebrate Valentine's Day. What more could a person want? Thanks again skiers and eaters, can't wait to see you again next year.

SMASHING TARTS FOR OPEN HEARTS !

2010-11-22T10:23:00.000-08:00

Who said Ace Inhibitors and Beta Blockers were used to slow the heart rate? Not here. This is fast paced, rough and tumble fundraising going on here Babe. In fact, it was faster than my shutter speed. Instead I took video - which gives you ambience, audio, bodies flying by, wind-in-your-hair speed. And an educational fundraiser: we learned all about Bouts, Blockers, Jammers and Pivots. And those are only the words I can mention in this blog. Watch them at work. And I mean work - all those skates and elbows and bodies whipping by.

A special shout out to Ida B Cho Azz for inviting us to watch her in action. Without the invitation some of us would never have been privy to the Roller Derby Underworld in Spokane.

How can I become a VIP you ask? Put your money where your mouth is! I think we had a few imposters in this section however.

Hal Goldberg, Steve & Lauran Gilbert, Sandi Kessler, Jason Konyu

The REAL VIPs are the Lilac City Roller Girls, their coaches, their Zebra Jam Commanders and their play-by-play caller. We thank all of them for donating their proceeds from this Smashing Tarts for Open Hearts Bout to our Healing Hearts Northwest Rwanda Medical Mission!

ONLY 5 KILOMETERS TO WALK TO AFRICA ?

2010-10-30T18:28:00.000-07:00

Really? Yes, for us anyway. All you have to do is walk a beautiful route through Riverfront Park, Gonzaga University and Spokane's West Side; tally the sponsorships; and "wa-la," you have helped earn $4,000.00 dollars for staff airfare!

Our First Annual 5K "Walk to Africa" is the first fundraiser that will be designated for staff costs, instead of supply costs. The Walk Organizers were friendly, organized and fun - hiring a few bongo drummers for our entertainment and inspiration.

And thanks to all of our friends and family (even small children) who sponsored us, this fundraiser was also a huge success (even after a late-night Wine Fundraiser!).

Thanks for all of the SHMC CICU Support Pam, Lindsae (and kids) and Heather!

WINE AND CHOCOLATE GALA COMPLETE SUCCESS

2010-10-28T10:34:00.000-07:00

We really are about Healing Hearts, even before we get to Rwanda! Some red wine, some dark chocolate ... what more could a heart want? Our fundraising team of ten were able to find numerous food donors and numerous wine donors to make for a successful event. Let me reiterate, this event would not have been possible without our donors. Not to mention the creativeness of our team: they did not just decorate, they created an atmosphere of a Rwandan Paradise at the Lincoln Center: resplendent with authentic woven baskets and carved wooden bowls filled with coffee beans, displayed over palms leaves atop safari animal fabric-laden tables.

We had silent auction and live auction items that I am sure made their buyers happy, but not as happy as those buyers made us!

Thank you to all of the participants who arrived, imbibed and bought: without all of you we would not be able to purchase our medicines or supplies. We hope to see you all next year.

John from Vino, A Wine Shop
- educating our pourers.

Dr. Brutacao, Pediatric Intensivist
- serving our guests.

GIDDY UP

2010-09-22T18:31:00.000-07:00

Our Annual Barn Dance was a great way to start off our fundraising season for our upcoming Medical Mission to Kigali, Rwanda this April 2011. The participants were quite cooperative, even if the weather was not. A more beautiful setting we could not have asked for; green pastures, real live farm animals, horses to mount, even moose heads to wear, all the while listening to great musical entertainment. Thank you to everyone for your generous donations, you have all started off our fundraising season in a grand way!

BBQ, Music, and Fun

Click here to see more Barn Dance Pictures [Courtesy of Charlotte]

TEAM SET FOR 2011

2010-09-15T12:21:00.000-07:00

After our more formal application process this year and lots of face-to-face recruitment, our Healing Hearts Northwest Team for 2011 has been (mostly) set. We also have a new date for our trip, April. We look forward to both changing Rwanda lives and having our lives changed by Rwanda, especially during the commencement of their Genocide Memorial period, April through June.

Now that our team is set, we will have more hands to assist in our fundraisers. First will be our Barn Dance, October 3. Then we have two back-to-back: our Wine and Chocolate Gala, October 22 and our 5K Walk to Africa, October 23. Our first fundraiser for 2011 will be a fantastic Martini Party on Valentine's Day, February 14th.

BACK AT IT

2010-06-01T13:16:00.000-07:00

Well, we have been preparing again for next year. We had our first post-February 2010 and pre-February 2011 meeting. We are all excited about the work and lives we were able to serve and cannot wait to do it all again. Our first order of business will be recruiting our team and ordering and gathering supplies.

Saying Goodbye

2010-02-22T12:42:00.001-08:00

Things are coming to an end for the mission trip. Most everyone has returned to Spokane. The OR team completed 16 open heart operations plus 3 pacemaker cases. The CICU nurses provided outstanding care for some very sick patients and over time, were able to move them to step down. The step down nurses continued to give outstanding love and care until it was time to send the recovered patient home. All of us have grown very attached to each patient and as much as it was our over all goal to see each patient be able to go home, it was difficult to see them go. It is with tears of happiness and sadness that we say good bye.
As one nurse pointed out, "They have done more to change us then we have done to change them".

Thank you to all the people who supported us on this mission trip!

2010-02-16T21:09:00.000-08:00

Last night at 7:15 pm the OR group completed their 16th and final surgery of this mission trip. They spent a total of 96.25 hours in the OR over the eight days of surgery,or slightly more than 12 hours each day. The shortest day was 9.5 hours, the longest was 16 hours.
Everyone (that wasn't working) met for a dinner put on by the Minister of Health last night. Staff from KFH attended also. There were many great speeches by KFH leaders, Dr. Goldberg, and the Minister of Health.It was a wonderful time to reflect on why we came to Rwanda.

2010-02-16T03:48:00.000-08:00

Today is Tuseday, February 16th. Dr. Siwek (right), Dr. Worrall (left) and Jason PA (center) and the OR team have completed the first case of the day and are currently working on the second case of the day. This will be the teams 16th and final surgery of the mission trip. It seems like we have just arrived but, 5 of the patients have already recovered and gone home. It won't be long till this trip is a fond memory for both us and the people of Rwanda that we have operated on and the many people we have met.

Project Rwanda—Hearts and Bikes

2010-02-15T00:52:00.000-08:00

One of many challenges encountered by the HHNW team in addition to the medical staff at King Faisal Hospital is tracking the proper prescriptions for Rwandan patients, pre- and post-op. Several of the 16 HHNW patients live in rural areas, anywhere from three to four hours from the capitol city of Kigali and King Faisal Hospital in addition to their local clinics and drug dispensaries. And since 90 percent of Rwandans work on farms and live in the countryside, modes of transportation consist of foot or bike.

In response to the 1994 genocide and growing need for utility farming bikes, renowned mountain bike rider and manufacturer Tom Ritchie founded Project Rwanda in 2005 to help Rwandans rebuild their country and economy via a bicycle.

CICU pulmonalogist Dr. Sam Joseph read about Ritchie's efforts and project in Bicycling magazine prior to leaving Spokane on the HHNW trip. An avid road biker himself, Dr. Joesph reached out to Project Rwanda and even linked up with a few of the team riders last week for a ride about two hours north of Kigali.

So when Dr. Joseph and Physician Assistant Larry Keyser listened to two male patients speak of needing a bike or some mode of transport to get their vital prescriptions post-op, they immediately contacted Project Rwanda and purchased two utilitarian, seven-speed coffee bikes.

The bikes showed up at the hospital yesterday to the delight of the two patients and Dr. Joseph and Keyser. Actually, we all celebrated in the generous gifts. Although happiness by all was a given, it became difficult to decipher who was happier--the patients or Sam and Larry. Regardless, it was another display of compassion by the hard-working and selfless HHNW crew. Thanks for letting us all enjoy the moment of seeing those two patients smile wide while staring at their shiny, new bikes.—Johnny Stifter

2010-02-14T06:26:00.000-08:00

Dr. Worrall and Jane RN, CICU doing morning rounds.
As you can see, things are very busy in the morning.

2010-02-14T05:25:00.000-08:00

Saturday was the first day off for the OR group after five days of doing two surgeries per day. People went shopping, on treks and safaris, and to a football (soccer) match.

Rwanda played Angola. The match ended in a 2-2 tie.
Photo by Dr. Worrall

2010-02-14T05:01:00.000-08:00

Dr. Worrall and the OR group continue their work as the echo is reviewed.

Dr. Worrall and PA Jason work together in the OR. Two cases a day have been completed over our first five days. Saturday is a day off.

Dr. Worrall and patient Rebecca (TET on 2/8) and Rebecca’s aunt all smile about her results. Rebecca now has returned home. It is very rewarding to see the patients as they recover and to see their smiles and the smiles of their family members. They have thanked us in words and by holding our hands and smiling. (This picture is worth clicking on in order to see it larger)

From OR to Conference Room, Training is in Full Swing

2010-02-13T21:15:00.000-08:00

Watching the HHNW Operation Room team perform their work LIVE acts as nothing short than scientifically astounding. And, yes, as fascinating as it is inside the OR, it's almost just as amazing outside of it. How so? The team wired a live feed to a TV monitor down the hallway from the OR with headcam footage from Drs. Lee Siwek and Neil Worrall that provides a clear, introspective look at the heart and the surgery.

In turn, the live action on screen serves a higher purpose than merely raw surgical action: Rwandan doctors and nurses sit and watch the action while HHNW physicians and nurses explain what's happening on screen. The whole setup—headcam to monitor to dialog—proves to be one of the many key training opportunities for the Rwandan staff at King Faisal Hospital.

Following surgery on Friday, the two surgeons—Siwek and Worrall—in addition to the two cardiologists on the trip, Drs. Goldberg and Williams, led a PowerPoint seminar on their respective skill sets for the inquiring minds of Rwandan physicians and medical students.

From Operating Room to the classroom, it's obvious that the external training aspect is central to the principle of this mission.—Johnny Stifter

At Last! All The Boxes Have Arrived

2010-02-12T08:30:00.000-08:00

Dr. and Mrs. Goldberg slept soundly last night. As did Dr. Williams and the rest of the Healing Hearts Northwest crew. Reason being for their sound sleep? The 56 lost boxes that traveled a circuitous route through Africa--from Kenya, to Burundi, and finally Rwanda--arrived yesterday to the relief of the entire crew, especially the aforementioned who either spent countless hours at Kenya Airlines' office or managed the original pack effort. As has been noted earlier on the blog, Rwandan Customs--specifically, for medical equipment--is quite meticulous and that's a massive understatement. Suffice to say, the shipment of so much equipment from Spokane, WA, to Kigali, Rwanda, acts as another key cog in this overwhelming effort. So the arrival allowed for a deserved celebration and sent a surge of positive energy throughout the entire 50-plus person crew.

Now that the remaining boxes have arrived, the team is now equipped with all the necessary items to continue administering care. After today, all 10 surgeries have been a success, with patient's post-op recovery exceeding expectations.—Johnny Stifter

(Click on photo for enlarge image)

2010-02-12T04:15:00.000-08:00

Dr. Siwek having his hands washed at an Ethiopian restaurant. It was nice have some thing other than hotel buffet.

Abbie and Rwandan John Paul prepare for the next surgery.

We have had many different Rwandan medical staff in the OR with us.

2010-02-11T12:25:00.000-08:00

The OR team hard at work as Rwandan physicians watch the procedure via TV in the hall. Rwandan physicians and nurses also work beside our team in the OR.

Dr. Siwek and Sandi with some of our new Rwandan friends.

Abbie with a patient only three days after surgery. This patient has been referred to as our team’s poster child because she has recovered so quickly and is such a ball of fire.

2010-02-11T12:17:00.000-08:00

These pictures were taken at 6:30 in the morning as we walked to the hospital.

2010-02-11T12:06:00.000-08:00

People in Spokane have been making positive comments about our blog. Thank you for all your interest and support. One thing that has been asked for is pictures of the scenery.
Most of us have not had the chance to go siteseeing. We have only walked between the hotel and the hospital. We are finding interesting things along the way, so here are some pictures.

You can click on the pictures to make them larger.

FINALLY!

2010-02-10T04:30:00.000-08:00

Well, it is finally happening! All those months of planning are paying off. Several HHNW nurses, HHNW respiratory therapists and our King Faisal Hospital (KFH) nursing colleagues assist with settling our second Post Open Heart (POH) patient on our first day of surgery. We have at least one and sometimes two KFH Intensive Care nursing staff per shift to mentor. These nurses are very knowledgeable and eager to learn the specifics of recovering POH patients.

Yvette (Peds ICU Nurse) and Merry (Respiratory Therapist) explain POH surgery paraphenalia to a family member. Many of the HHNW staff are quickly learning the Kinyarwanda word for thank you very much (mwakoze cyane) simply because the families are telling it to us constantly. Many family members are very stoic before surgery. It is gratifying to see them smile, revealing their relief, once surgery is finished; not to mention the smile on our patients' faces once we get the endotracheal tube out of their mouth!

MORNING PATIENT ROUNDS

2010-02-09T07:00:00.000-08:00

Drs. Goldberg and Elmer check the results of a chest xray during morning rounds. Rounds consist of all doctors, nurses and respiratory therapists gathering together and discussing the care and plan for each patient for that day. We were successful in safely transferring both of our surgical patients on post-op day one.

Pre-Operative Assessment Presentation

2010-02-09T06:49:00.000-08:00

Tuesday marked the second day of surgery administered by the HHNW crew. It also acted as the first of several PowerPoint presentations given by one of the HHNW members. Sara Morasch R.N. led this morning's discussion titled, "Pre-Operative Assessment and Evaluation."

The room was full of Rwandan nurses and medical personnel—28 to be exact. They listened intently to Sara's clear, informative speech regarding rheumatic heart disease and all of its subsequent effects—most notably, the physiology of pulmonary edema. Although nearly every Rwandan medical staff member can speak English, they were a bit reticent in responding to her questions. Nevertheless, it's obvious the class and its loads of information are helpful.

"I've learned a lot," remarked George, a nurse in Kenya for eight years prior to coming back to Rwanda two years ago to continue nursing. "They [HHNW] have a lot of knowledge."

The seminars will continue throughout HHNW's project here in Kigali.

Also of note today, the first patient—a 26-year-old female named Clair—moved from the ICU to the telemetry room for her post-op recovery. And like everything here or anywhere foreign, really, we quickly learned that we couldn't roll her bed from the ICU to the telemetry room because the bed was too wide to pass through medal gates. But it allowed for another remarkable moment, as a confident Claire walked comfortably to her new bed in the telemetry room. Yeah, Claire...Cool times, indeed, here in Rwanda.

High performance

2010-02-08T21:49:00.000-08:00

Yesterday (Monday) was our first day of operating. We did two cases, one a 26 yo women, the other a young child. Both cases presented some challenges but the results were great. We walked to the hospital at 6:30 am and walked home in the rain at 8:00 pm. It was a long day but a great day. Both patients are in CICU doing very well. The CICU nurses are taking great care of them. Today we have two more case. The first is another young child that is really ill.
I am not a medical worker, my wife is. I have always respected the field, but after having the privilege to help them and see what they do, well, all I can say is they all are amazing. The level of expertise, the amount of hard work, and above all the love and care of their patients was beyond imagination. I stood and watched them perform with better team work than any professional sport team. They are all heroes in my eyes.
Today more nurses begin there work as patients can leave CICU. These patients will never know better care.
We will do five days in a row of surgery (a change from the planned four days). Then surgery will have one day off to let the CICU clear some patients.

2010-02-07T10:49:00.000-08:00

Here on Super Bowl Sunday, Spent all day at KFH unpacking and setting up OR. Met a lot of great people. Excited to start surgery at 8:00 am tomorrow. The first patient is 26 years old and the second is nine. We have to stay flexible.

MISINTERPRETATION (aka WEIGHT=WAIT)

2010-02-06T21:10:00.000-08:00

As it turns out this number of boxes at King Faisal Hospital does not translate into the number of boxes that left Spokane, oops. So while we were ecstatic that our shipment cleared Kigali Customs, we did not realize only two thirds of the shipment had arrived. (The weight of the Supplies that left Spokane did not equal the weight of supplies that arrived in Kigali.) We believe one third of our shipment is still in London somewheres. We are like hound dogs on a fox hunt trying to locate them.

Katie Bland, Jane VanTassel, Jim Dixon and Jennifer Day helping to unpack the Supplies that actually arrived.

Our second, mostly surgical, team arrived tonight. Finally able to relax and have a bite to eat at the Top Tower Hotel before going to King Faisal tommorrow to assess the situation.

Wish us luck as we try and locate the rest of our supplies and deal with our ever-changing surgical schedule. We are hopeful we will still be able to commence surgery on Monday, since we are all eager to start changing young adults' lives.

WE HAVE ARRIVED!

2010-02-05T20:23:00.000-08:00

Dr. Hal Goldbert, Sandy Goldberg and Jim Dixon relieved to finally be on the plane.

Andrea Daugherty, Katie Bland and Morgan Lonsford entertain themselves while waiting in the San Francisco Airport.

Jane Vantassel at the "Yotel, Motel, Holiday Inn..." at Heathrow's Airport in London.

The first team arrived at noon yesterday. We cleared Customs at Kigali International Airport with no problems and we were greeted by our wonderful colleagues from King Faisal Hospital, there to make sure our Customs experience went smoothly.

It was great to see all of our pallets of supplies unloaded in the CICU and ready for us to unpack tomorrow. We are all looking forward to a quick dinner and a long rest as we plan to start this organizational process.

Great article

2010-02-04T07:02:00.000-08:00

Tomorrow morning the rest of the team heads to Rwanda (ten left on Wednesday).
There is a great article in today’s Spokesman Review. Check it out.
http://www.spokesman.com/stories/2010/feb/04/medical-team-taking-expertise-to-rwanda/

Here we go!!

2010-02-03T07:05:00.000-08:00

Our first group gets on the plane early this morning to head to Kigali, Rwanda! Additional groups will leave at several different times on Friday. This trip has been over a year in the making and thousands of hours have been put in by many, many volunteers.

Four of our amazing nurses and surgical staff becoming familiar with a hippo.

Five of the nearly 30 pieces of luggage containing supplies for the mission.

Eleven pallets of supplies and equipment have already arrived in Kigali.

A dedicated nurse’s home refrigerator storing supplies for the trip.
She has an understanding husband.

Team members discussing the needs of the mission trip.

Team Work pays off.

2010-02-01T07:33:00.000-08:00

I am sharing parts of emails from Sandi K and Michelle D. I think they say it best.
(From Sandi K)
The supplies all cleared customs and will arrive at KFH on Tuesday! I am going to put in here a bit of the email received today from Dr. Mucumbitsi,,,,can you pass this along to all from your big email list?
(From Dr. Mucumbitsi in Rwanda)
I have to congratulate you and your team about the clear packing list and respected expiration dates. All items were cleared by Friday but we have not been able to take them to the hospital because it was late in the evening when the checking was finished. So, the whole cargo will be brought to the Hospital on Tuesday.

(From Michelle D)
Sandi downplays this feat just a bit. Australia has been to KFH 4 times, Boston has been there twice - each and every time these groups have had problems clearing customs. We need to thank these previous teams for running the gauntlet before us, we have learned a lot from them and it has definitely paid off.

And a huge thanks to everyone who picked up the last of our supplies yesterday! Only 2 more trunks left to be picked up and then we are done, done, done. Again, huge kudos go out to Sandi K and all of her OR staff for packing and weighing and labeling each and every trunk; her daughter for organizing all of our lists (which is why we cleared customs so easily); and to everyone who has agreed to haul medical supplies in addition to your personal gear, thank you for that great volunteer spirit - this is what will make our work at King Faisal so productive yet fun - volunteering. They will be changing our lives more than we change theirs.

Last minute tasks.

2010-01-28T09:46:00.000-08:00

Last night volunteers were at Sacred Heart to address, stuff, and place stamps on thank you letters to people who have supported Healing Hearts Northwest on our upcoming mission trip. We have 400 letters to send!!
We also worked on packing some of the more than 20 hard plastic trunks and various wheeled duffle bags full of medical supplies that many of us will take with us as checked luggage. We are each allowed 2-50lb checked bags and 1 carryon. Saturday people will come and pick up the trunks/duffels so they can take them to the airport when they go.People begin heading to Rwanda on Feb. 3. We travel in several groups due to the number of people going.

I also scanned Abbie and my passport, vaccination record, and travel insurance information and emailed the files to my email so we have access to electronic copies if something happens to the originals and copies we are carrying.

We leave next week. Everyone is so excited and ready to go!

Supplies are in Rwanda

2010-01-26T07:52:00.000-08:00

I was informed that the 11 pallets of supplies have arrived in Rwanda. They still have to clear customs then be sent to King Faisal Hospital.
Tomorrow Abbie and I will be at Sacred Heart packing surgical instruments. These are one of the many things people are carrying with them as we travel.
Our first group leaves Spokane for Kigali, Rwanda on the 3rd of February. Our group leaves early on the 5th and others leave later in the day.
Things are really coming together!

2010-01-20T08:25:00.000-08:00

January 19, 2010
Seventeen more days till we leave to Rwanda!! Our supplies (11 pallets) have made it to London and shouls be in Kigali, Rwanda on January 23. Pray everything gets there as planned.

Patient selection complete

2010-01-15T07:51:00.000-08:00

January 12, 2010
A note from Dr. Goldberg, Mission Director.Last night, our staff completed review of the cases for selection for surgery. There were 16 patients chosen with a plan do 2 cases every day starting Monday Feb 8 through and including Tuesday Feb 16. The plan is that Friday Feb 12 will be a 'no surgery' day to allow recovery of staff... and to allow patients to move through ICU to Telemetry.Regarding case selection......... this was one of the most difficult tasks to carry out. We adhered to some principals that we set out..Operate on people who are sick, but who are most likely to have good long term outcome. Operate on people who can move through ICU quickly, so as to not create a bottleneck and prevent surgery from being done .... and therefore, denying surgery to some individuals.Dr. Bishop had seen over 100 patients in December and he whittled the list to 30... we then had to further reduce the list. But in the end, we can help a significant number of people with an average age of 20. The youngest is 9 and the oldest is 33. The second youngest is 10 and then we jump to 16. This is what the mission is all about... a life saving operation for young people... and your help to accomplish this is greatly appreciated

Patient screening

2010-01-15T07:50:00.001-08:00

Case review:
Last night, January 7th, the second 15 of the cases were presented by Dr. Bishop for consideration for surgery. The first 15 were reviewed on Tuesday night. On Sunday night, we will make the final decisions re the approximately 14 best surgical candidates and 5 alternates.

Patient screening

2010-01-15T07:49:00.000-08:00

12/24/2009
In the last week we have had exciting events:1. We had the return of our screening team from Rwanda - Dr. Bishop, his wife, Don (echo technician) and Phil (Medtronic representative) were all in Rwanda for about 10 days to see patients, perform echocardiograms, and assist in pacemaker implantation. Dr. Bishop saw over 100 patients and we have at least 35 potential candidates for surgery, of whom probably 25 excellent candidates. Don set a record of 27 echoes in a day!In the first week of January, over the course of probably 3 meetings we will review the cases to select the 14 patients for surgery and 5 alternates.Thank you to the screening team who worked tirelessly and traveled hours to accomplish this.2. We had a blast at the Smashing Tarts for Open Hearts - Roller Derby last week at Patterson’s.Those ladies can skate and dish out a mean elbow!They raised $1500 for us !!!! Thank you to Jason for organizing that and to the Roller Derby ladies who donated the funds.

Cravens Coffee

2010-01-15T07:48:00.000-08:00

12/17/2009
Thanks to Cravens Coffee for the UJAMAA blend. Cravens Coffee will donate a portion of the receipts from sale of UJAMAA blend to Healing Hearts Northwest.In addition, it will bring attention to UJAMAA and to Healing Hearts Northwest in the community.South Hill:Huckleberry’sRosauers Lincoln Heights (29th Ave)Rosauers on 14th and LincolnSuper One Manito – 29th and GrandTrading Co Stores LatahOther locations:Yokes Argonne – Spokane ValleyYokes Market Street – MeadYokes Indian Trail – Northwest SpokaneRosauers 5-mile – NorthRosauers Heritage – NorthN Idaho:Super One stores – Post Falls, Couer d’Alene, Hayden Lake

HAPPY NEW YEAR

2009-12-30T17:01:00.001-08:00

We have been hard at work since July gathering our supplies for our February medical mission. We have had several consumable supplies and several pieces of equipment donated and we are very grateful for those companies who have partnered with us to make our medical mission a success. Since Thanksgiving we have been packing and labeling all of our 65 (and counting) shipping boxes to be picked up on January 7. We are beginning to see the light at the end of the tunnel.

PERFORMING SURGERY OUTSIDE THE BOX

2009-11-28T15:24:00.000-08:00

Operation Open Heart from Australia allowed me to shadow their each and every move so our Healing Hearts Northwest team knows what to expect.

RWANDA SCOUTING TRIP

2009-11-12T17:16:00.000-08:00

I am in Kigali to witness with my own eyes exactly how surgery is performed in a foreign country. One of our mentors, Operation Open Heart from Australia, is performing pediatric surgeries.

After two full days of travel with some long layovers, I arrived at 0200 with no ride to the Top Tower Hotel. My seat-mate and his wife were nice enough to "drop" me at my destination. After a quick rest, having no formal means of communication (no MTN phone and my own cell phone "locked"), I was forced to locate the Australians the "old fashioned" way - on foot. I familiarized myself with Kigali as I tried to locate King Faisal Hospital. However, after seeing most of the town and still unable to locate the hospital, I broke down, donned my own green helmet and climbed aboard a "taxi-moto." These are mopeds driven by green uniformed and green helmeted Rwandans, zipping in and around larger vehicles without a care in the world for any concept of traffic rules. Only later did I find out that travel insurance will not cover any untoward events that may occur while hanging on for dear life.

I finally found a member of the Australian team, Alison, who was more than welcoming, showed me around the CICU, updated me on their plan for the next two weeks and introduced me to several of the King Faisal Hospital staff; including Maureen, the Nurse Manager of the CICU and Kumar, the biomechanical engineer who has been so helpful in making sure we bring the correct type of equipment. Kumar took me on a "3-hour tour" of the Hospital, all four floors and every nook and cranny, very helpful to see the gears of KFH work.

I had my first harrowing experience last night coming home from dinner at Sol e Luna. In a raging downpour, our taxi was forced to perform a hill start on the busy thoroughfare with what looked like a solid windshield it was so overcome by fog. Then we ran out of "petrol" and had to walk home anyway. Other than that is has been great!

This morning I had breakfast and a team meeting with the Australians and am trying to commit all their names to memory. They have been very welcoming. Then we all tromped down to King Faisal Hospital and all 35 of us helped unpack, the ICU was done in 3 hours and the OR was done in 7 hours. After begging and groveling with customs for some bags, including missing instruments, OOH hopes to start surgeries tomorrow.

WHO IS HEALING HEARTS NORTHWEST?

2009-06-30T12:25:00.000-07:00

Healing Hearts Northwest is a fully equipped medical-surgical team from Sacred Heart, Deaconess and Kootenai Medical Centers who will perform 15 cardiac surgeries on young adults afﬂicted with rheumatic heart disease. We are led by Dr. Hal Goldberg, Cardiologist and Drs. Leland Siwek and Neil Worrall, Cardiothoracic Surgeons. We are one of three medical mission programs invited to perform cardiac surgery on a rotating quarterly basis by King Faisal Hospital’s Director General.

We are traveling to Kigali, Rwanda this February for a Medical Mission with Healing Hearts Northwest (HHNW) to help rebuild the Rwandan healthcare system. Seventy-ﬁve percent of the Rwandan medical community was murdered or ﬂed the country during the 1994 genocide, resulting in the destruction of their existing medical systems of hospitals, medical schools and trained medical personnel. Thus, Rwandan physicians founded the Health Development Initiative (HDI), an independent, non-governmental, non-proﬁt organization. HDI has partnered with UJAMA, a diverse group of Spokane physicians, including HHNW, to help eradicate rheumatic heart disease. Rheumatic heart disease, one of the most common medical problems in Africa, leaves young adults suffering for years, on the brink of death as a result of injured heart valves from untreated strep throat. Rwanda lacks the resources to deliver chronic interventions, such as penicillin, and the operations to save the most critical patients since they only have 2.5 cardiologists and zero cardiothoracic surgeons for 10 million Rwandans.

In collaboration with UJAMAA, King Faisal Hospital in Kigali and the Rwandan Ministry of Health, HHNW aims to develop a comprehensive program to address prevention and treatment of rheumatic fever and rheumatic heart disease and also help King Faisal Hospital set up a self-sustaining cardiac surgery program to serve the thousands of Rwandans desperately in need of life-saving heart surgery.

During our two-week stay in February, HHNW will work side-by-side with doctors, nurses and staff educating and mentoring them in anesthesia, cardiac surgery and post-operative care. Our 40 member team consists of cardiologists, cardiothoracic surgeons, anesthetists, an operating room team, CICU nurses, telemetry nurses and other support staff. We are paying our own way and using vacation time to serve, but as you can imagine, prosthetic heart valves, ventilators, and every single piece of medical equipment from cardiopulmonary bypass machines to gauze will not be cheap. And then we have to ﬂy it to Rwanda.

Even though HHNW is applying for grants, there are many ways you can help us achieve our goals. Gifts of cash, medical equipment and medications, medical journals and nursing textbooks or fundraising sponsorship are appreciated and go a long way in making our effort successful. With your donation, many medical personnel will receive quality training. Your contribution will not only help make Healing Hearts Northwest’s initial trip a success, but also help guarantee that we may continue returning to Rwanda to provide ongoing supplies, education and training until staff at King Faisal Hospital are able to support their own cardiac surgery program.