Pediatric Cardiac Surgery Mission to Guayaquil, Ecuador

March 5-17, 2023.

All positions filled.

Gateway to the Galapagos Islands

 Hospital del Nino Dr. Francisco de Icaza Bustamante


Those specializing in Pediatric heart care are cordially invited to participate in the third CardioStart mission to the Hospital del Nino Dr. Francisco de Icaza Bustamante in Guayaquil, Ecuador. 

The Children’s Hospital, Dr. Francisco de Icaza Bustamante received gold level accreditation by Accreditation Canada International (ACI) on November 20, 2014, after meeting international quality standards of health care. This is the first hospital in Ecuador and Latin America to receive international accreditation as one of the first medical units to meet international standards of quality care and services provided to its citizens. The hospital has 442 beds, modern equipment, as well as several clinical and surgical subspecialties. 

Services provided by the hospital include cardiology, endocrinology, genetics, dermatology, gastroenterology, nutrition, hematology, oncology, infectious diseases, nephrology, neurology, pulmonology, neonatal intensive care, intensive care unit, pediatric outpatient palliative care unit, pediatric gynecology, and emergency medicine.

Despite this quality facility the hospital still lacks the expertise, manpower and funding to support a heart surgery program for children with congenital heart disease.  The hospital has also recently been hit with severe equipment breakdowns which further frustrate the budget restrictions it faces. Without visiting teams these children will not receive the care they need.  You will play an integral part in saving lives.

Mission Goals:

  1. To help build a self-sustaining cardiac surgical pediatric surgical program.
  2. To support the efforts of the cardiac surgical team by having a presence in the community. Working in concert with the Fundación El Cielo Para los Niños del Ecuador to provide treatment to the underserved population and assisting to create a  sustainable infrastructure base for the Fundación El Cielo Para los Niño’s to work from.
  3. To assist with rural clinic work and compassionate care in Guayaquil.

The situation provided by the Covid pandemic has been disastrous for Ecuador and particularly for the Children’s hospital which has also suffered loss of vital cardiac surgery equipment through breakdowns. The result has been that they have not been able to do procedures requiring the heart lung machine for two and a half years.  Over 40% of the children on their waiting list have died.  

Team Composition Needed: 

  • 2 Pediatric CV Surgeons 
  • 1 Pediatric Cardiologist with echo experience
  • 1 Pediatric Anesthesiologist
  • 1 Pediatric Intensivist
  • 1 Pediatric Perfusionist
  • 1 Research Assistant – Database  
  • 4 Pediatric Cardiovascular ICU Nurses 
  • 1 Pediatric Respiratory Therapist


  • 1 doctor
  • 1 clinic nurse
  • 1 non-medical support person

Mission Director: Dr. Andrew Lodge

Mission Logistics:

Airfare: Airfare costs and VISA will be self-funded by each volunteer flying into Guayaquil. Miami is a convenient US starting point.   After you have submitted all documents, when instructed to do so you may book your own flight or consult Mission Nation Travel at:  

DO NOT BOOK FLIGHTS UNTIL YOU ARE CONFIRMED ON THE TEAM.  You will receive a CONFIRMATION letter when all required documents have been submitted and approved.

Lodging:  This will be provided by the local Foundation.  CardioStart will assure that certain minimum standards to ensure volunteer safety and comfort as well as keeping the team together.  Volunteers should expect there may be same-sex room sharing required in order to help reduce the costs.

Meals: During the day, meals will be freely provided at the hospital.   Evening meals/snacks, etc., will be at your own expense and are available at the hotel or other area establishments.

Mission Responsibilities:

We recommend you travel on to be in Guayaquil by Tuesday, 20th September 2022. 

On that day, during the afternoon, you will be formally introduced to the local team and the cardiac conference will be held to discuss the cases being planned for the mission.   We appeal to you to collect with permission any pediatric disposable items you can to help with the mission’s success.

Safety:  Ecuador is listed on the website Travel.State.Gov as being a level 1 advisory:  Exercise Normal Precautions.  Do not travel to Esmeraldas, Carchi, or Sucumbíos due to crime.  These cities are listed as Level 4 (Do Not Travel).


For patient safety reasons, we do need the medical personnel to be available to the hospital until the Friday morning during the second week. Upon completion of the mission, you may wish to take a few days’ vacation.  You can visit some of the many natural wonders of Ecuador, and the local Galapagos Islands which are best accessed from Guayaquil; or you can book yourself additional nights before heading back.  

Although we cannot directly assist with the tourism arrangements, the Amazonian rainforest and the breathtaking heights of the Andes are within easy reach. Ecuador may be a small country, but it has a dazzling array of wonders.

Cultural Beauty

 The historic centers of Quito and Cuenca are lined with photogenic plazas, 17th-century churches and monasteries, and beautifully restored mansions. Wandering the cobblestone streets amid architectural treasures from Spanish colonial days is a fine way to delve into the past. Beyond the cities, the Ecuadorian landscape unfolds in all its startling variety. 

There are Andean villages renowned for their colorful textiles and sprawling markets, Afro-Ecuadorian towns where days end with meals of fresh seafood and memorable sunsets, and remote settlements in the Amazon where shamans still harvest the traditional rainforest medicines of their ancestors.


The famed Galápagos Islands, with their volcanic, otherworldly landscapes, are a magnet for wildlife lovers. Here, you can get up close and personal with massive lumbering tortoises, scurrying marine iguanas (the world’s only seagoing lizard), doe-eyed sea lions, prancing blue-footed boobies and a host of other unusual species both on land and sea. The Amazon rainforest offers a vastly different wildlife-watching experience. Set out on the rivers and forested trails in search of monkeys, sloths, toucans and  river dolphins. Some lodges also have canopy towers offering magnificent views (and a better chance to see birdlife). 

Setting off on a trek into the Andes can seem like stepping into a fairy tale: there’s the patchwork of small villages, gurgling brooks and rolling fields, with a condor slowly wheeling overhead. Although the view from the top is sublime, you don’t have to scale a mountain to enjoy the Andes. Ecuador’s other landscapes offer equally alluring adventures, from surfing tight breaks off the Pacific coast to white-water-rafting Class V rivers along the jungle-clad banks  of the Orient.


Thankfully, this is diminishing in South America., BUT… Monkeypox, Covid & Omicron variants are becoming increasingly evident elsewhere.  The MOH staff are quite reasonably being very cautious as they want to minimize the risk of international travelers bringing anything in that could raise levels of infection even though they desperately want tourism to return.  You are advised to make sure you are vaccinated, have a card available confirming this before you consider joining this mission. Covid rules change often and rather quickly, so it may be necessary to adjust the precautions or demands for tests, as the Summer goes on. Currently, if we are passing through the USA, travelers are still required to show proof of vaccination against COVID-19 before boarding a flight that includes the United States. 

How to apply:

Complete the volunteer interest form here.