On April 14th 2013, an all-volunteer team of CardioStart International embarked on its third cardiac surgery mission to the continent of Africa. The Republic of Ghana is in West Africa. Kumasi lays West of Accra, the capital, and this second major historic city was once the capital of the Ashanti Empire. It continues to serve as the cultural centre of the Ashanti people.
There is a single cardiothoracic centre in Accra. The National Cardiothoracic Centre is performing a small number of cases each year (approximately, 100, mostly valves). Accra cannot do more than a small volume of cases due to varying types of restrictions and some of their cases are fee-paying and privately arranged.
The Komfo Anokye Teaching Hospital (KATH) in Kumasi has already received assistance from teams, which have included Dr. Philip Wendschuh, a cardiologist volunteer member of CardioStart, and the Boston Children’s Hospital under the direction of Dr. Fynn-Thompson.
A CardioStart team of healthcare professionals performed the first cardiac surgeries in the new Trauma and ER facility at KATH in Kumasi, in February 2009. A total of 8 procedures were performed with no fatalities, and the new facilities were tested to confirm it was fit for this purpose. During its second visit in 2010 Cardiostart performed a total of 11 procedures.
The objectives of the current mission in April 2013 were to provide:
1. Cardiology Service and Cardiac Surgery for Impoverished Adults in the Region
2. Teaching and Direct One-on-One Training
CARDIOLOGY SERVICE AND CARDIAC SURGERY
The principal objective in introducing complex heart surgery is for the local team to progressively take over their own program; each mission has been designed to permit the local team to be a central part of the management of increasingly complex presentations. As the days passed, this routine became more established. The local team was cohesive and much better prepared on this, our third visit.
Working in close collaboration with the KATH surgeons, physicians, nurses, laboratory and perfusion staff, the CardioStart International team prepared the surgery suite and intensive care unit for its first patients. The first 2 days of the mission on reaching Kumasi were devoted to setting up the facility to accommodate cardiac surgery patients; an immediate challenge was to convert an empty operating theatre and ICU to a functional cardiac facility. Pacemaker insertion began on Tuesday the 16th April. Cardiac surgical operations began without incident, on the third day, Wednesday, 17th April 2013.
Twenty two cardiac procedures were performed including adult heart valve repair/ replacements and permanent pacemaker insertions.
Operative activities ceased on Wednesday the 24th April 2013 to ensure satisfactory recovery of all patients and facilitate general tidying of the ICU.
CardioStart’s container of needed medical supplies sent to Ghana arrived just before the mission. Valuable donated soft disposables and equipment were checked, sorted, and labeled for storage in the Cardiostart storage rooms. Some items e.g. unused prosthetic valves have been stored in the Boston storage room. Items not required for the programme have been distributed for general hospital use. An improved inventory and labeling was achieved to assist setting up during future mission activity.
TEACHING AND TRAINING
Education was strongly emphasized in all areas of program during this mission. Because of the local doctor’s strike no formal teaching took place. However each volunteer led informal teaching during the course of the mission.
Cardiostart’s international database was fully implemented during this mission. This will provide useful information both for KATH and Cardiostart for its future missions.
CardioStart gratefully acknowledges the wonderful support from the following individuals and organizations:
1. Abbott Laboratories-ISTAT cartridges
2. Children’s Lifeline International
3. DELTA airlines- suitcase carriage allowance
4. Project S.A.V.E. container contents
5. Sorin-perfusion packs and tubing
6. Medtronic Pacemakers and accessories
7. University Hospital Coventry and Warwickshire, UK for providing heart valves.
CARDIOSTART TEAM MEMBERS
Professor Uday Dandekar MS, M.Ch, FRCS (Edin&Glas), FRCSEd (CTh), CardioStart Mission Director for Ghana
Clement Akomea-Agyin – United Kingdom
Christina Chin – United States
Faye Creechan – United Kingdom
Alison Freeberg – United States
Caroline Ghosh – United Kingdom
Kyler Hunter – United States
Linda Lundeen – United States
Phomola Machika – South Africa
Tania Manso – Portugal
Giampalol Martinelli – United Kingdom
Caitlin Mell – United States
Andrea Myers-Koepping – United States
Edward Newton – United States
Kristie Stiles – United States
Sher Stiles – United States
Veero Subramaniam – United States
Jennifer Timberlake – United States
Phil Wendschuh – United States
Chassie Wiersma – United States