At the Jakaya Kikwete Cardiac Institute (JKCI) Dar Es Salaam, Tanzania, Africa
October 26 – November 5, 2022
After a year of COVID restriction, CardioStart was finally able to return to missions and a fourth return mission to JKCI (The Jakaya Kikwete Cardiac Institute), Dar Es Salaam. This mission was cautiously undertaken as Tanzania’s medical systems were severely stretched by the covid pandemic. It was ambitious in intent with a program that included resuscitation techniques, surgery, cardiological teaching and outreach projects. It was successful and will assist the hospital hold a firmer footing in providing advanced cardiological care. Accordingly, a team of 21 volunteers joined together to bring their talents and commitment to educating others in their specialties.
EDUCATION:
Under the direction of Emergency physician, Prof. Richard Harper, Dr. Barbara Ferdman, and Derek Rivera, the team included EMT/paramedics and nurses provided lecture and hands-on training in ECG, ACLS, PALS & ECHO interpretation. The education team assisted JKCI in presenting a three day course “Updates in Emergency and Critical Care”. The program provided 20 hours of much needed CME credit for hospital staff. Topics in adult and pediatric care were covered. The course was well received by those attending the sessions. The course was made possible by the hands on assistance of many of the mission team and the kind donation of equipment used for training by Mr. Mike Pyalora of CalMed TC.
CARDIOLOGY:
This was a non-interventional cardiological mission asanother charity was visiting and covered most aspects of interventional care.CardioStart’s cardiologist, Dr. Rolando Rodriguez made regular rounds, helped prepare patients for surgery and gave general educational recommendations for peri-operative patient management.
SURGERY:
Each operative scenario was held with the local team operating mostly in the primary surgical position and CardioStart surgical team working as assistant surgeons.Technical skills in coronary revascularization, valve repair and replacement were given special attention. The local perfusionists were supported by two expert perfusionist and an Amsect student. The local perfusionists were provided with protocols and practical educational tips as part of their program development.Generous perfusion-related disposables were donated to support the caseload being undertaken during the week of operations.
ANESTHESIA:
Our CardioStart anesthesiologist, Dr. Michael Schupp taught intra-operative echo techniques and finer points of anesthetic intra-operative management.
NURSING:
CardioStart ICU nurses led by Ms. Rachal Dorval, worked in the ICU area to develop protocols of clinical management, and during the week they provided help to put formal and bedside teaching routines into daily practice.
DATABASE EVALUATION:
During the mission, CardioStart’s Statistical biosystem research expert, Prof. John Connett evaluated the level of efficiency to improve and advise on techniques of data recording and information gathering for patients passing through the surgical programs.Ms. Sylviah Nyamu carried out the clinical assessments and documentation in all cases.
OUTREACH:
Help was offered with some of the needs of the Valentine Children’s Home in Buza, Dar es Salaam where 32 children live in extremely poor conditions.Over 40% of the children have been victims of trauma and suffer from frequent urinary infections / bed-wetting due to the lack of fresh drinking water when the pump goes out; the team leaders have very few medical supplies and receive almost no instruction on general medicine and antibiotic use. Hand-held Water filtration systems were donated by Wine-to-Water co inc.Roof repair, mosquito window netting and other vitally important construction projects were undertaken in collaboration with an engineer introduced by the Valentine Project.Sunglasses, crayons, pencils, were also donated
SURGICAL CASES
AGE
GENDER
SURGERY
OUTCOME
55
Male
DVR
Satisfactory
72
Male
CABG
Satisfactory
23
Female
MVR
Satisfactory
65
Male
CABG
Satisfactory
35
Male
TOF Repair
Satisfactory
46
Female
MVR
Satisfactory
61
Male
CABG & AVR
Satisfactory
49
Female
MVR
Satisfactory
58
Male
AVR
Satisfactory
Some members of the CardioStart team
CARDIOSTART MISSION TEAM
Donato Sisto, MD
Surgeon & Mission Director
USA
(In alphabetical order)
Mohammed Al-Jughiman, MD
Surgeon
Saudi Arabia
*Brittani Anderson
Outreach
USA
Shawn Bernier, RN, EMT
Education & OR
USA
John Connett, PhD
Research
USA
Jessie Dombach, RRT
Database & RT
USA
Rachal Dorvall, RN
ICU Nurse & Charge Nurse
USA
Victoria Duszak, EMT
Perfusion Student
USA
Barbara Ferdman, MD
Ped. Cardiologist & Intensivist
USA
Jenifer Fielding, CCP
Perfusionist & Outreach
USA
Susannah Galloway, CCP
Perfusionist
USA
Anasi Griffin, RN
ICU Nurse
Kenya
Richard Harper, MD
Education Director
USA
Aubyn Marath, MD
Surgeon
USA & UK
Laura McMahon, RN
ICU Nurse
UK
*Jack McNulty
Outreach
USA
Sylviah Nyamu, MPH
Research Database
USA
Derek Rivera, RN
Education & Mission Coordinator
USA
Rolando Rodriguez, MD
Cardiologist
USA
Virginia Rogan, RN
ICU Nurse
Canada
Michael Schupp, MD
Anesthesiologist
UK
Ashlyn Tinsley, RN
ICU Nurse
USA
*Led outreach team projects
Acknowledgements:
We acknowledge with deep gratitude several individuals and corporations who facilitated this mission and/or made generous in-kind and/or financial donations
Dr. Mohamed Janabi, Dr. Peter Kisenge and colleagues at JKCI: (local organization, hospitality and logistics).
Dr. Peter O’Brien’s team and colleagues (Madaktari charity).
Accuware Consultants Inc. Ohio, USA (equipment).
CardioStart Administration Team USA (logistics).
CardioStart ReSale Thrift, Oregon, USA (Funding for outreach flight).
Americares USA(donation of meds and sunglasses).
Eugene Southtowne Rotary Club, Oregon, USA (Equipment donations & Logistics).
United Methodist Church, Lake Oswego, OR, USA) (patch dolls, hearts & patient hygiene kits).
Mrs. Jennifer Fielding and the Splendid Church Foundation: (outreach support).
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