Mending Hearts in Rwanda

KIGALI, Rwanda—Celestin Gasamaza never dreamed having the life-saving heart surgery he needed was possible. Yet last week, the 25-year-old student became Team Heart’s first surgical patient as he underwent atrial septal defect repair.

“I did not expect to be operated on in Rwanda,” he said. “I expected that I would grow up with this sickness. I want to congratulate this team… they did miracles, they performed wonders.”

Gasamaza is one of 11 patients that Team Heart, a volunteer group of BWH cardiac surgeons, nurses, therapists and others, operated on at King Faisal Hospital here this past week.

“The members of this team have done nothing less than lift a death sentence from those served, all of them symptomatic and facing grim prospects, at the same time that they have lifted the spirits of the patients, families, staff and students here in Rwanda,” said Paul Farmer, MD, PhD, associate chief of BWH’s Division of Social Medicine and Health Inequalities and co-founder of Partners In Health, who visited Team Heart at King Faisal earlier this week.

At the request of the Rwandan Minister of Health, these open heart surgeries coincide with the country’s annual week of mourning for the one million victims of the 1994 genocide and offer a symbol of renewed hope for the future. Half of Team Heart’s patients lost family members in the genocide; all witnessed the violence.

“That we are here trying our best to put lives back together stands in stark contrast to what has gone before, and the people here are quite moved by it,” said R. Morton “Chip” Bolman, III, MD, BWH’s chief of Cardiac Surgery. “It is truly a privilege to be here and to try, in some small measure, to leave things maybe slightly better than we found them.”

Team Heart’s ultimate goal is to help King Faisal Hospital establish a self-sustaining cardiac surgery program in the next 10 years. The team worked in collaboration with Partners In Health to identify candidates for the valve replacement and repair surgeries performed in the past week. The nurses, doctors, therapists and others at King Faisal have watched surgery and cared for patients alongside Team Heart in the ICU and step-down ward as patients recovered.

“When we took out a patient’s breathing tubes after surgery, his first words were ‘thank you,’” said Leslie Sabatino, BSN, RN, clinical coordinator of Team Heart, who was moved to tears. “The months of planning, working with donors and coordinating logistics were worth it for that one moment.”

The success of this first mission is thanks to the collaboration of the 36 team members, who creatively solved problems and provided safe patient care with limited resources. One of the most challenging situations arose when the heater-cooler, a machine that controls the patient’s temperature during surgery, broke. Perfusionists Mike McAdams and Amy Patel created a way to manually keep the blood at the right temperature during surgery while the team awaited delivery of a new heater-cooler from Kenya.

“I’m incredibly proud of the way the whole team has come together and worked with the staff at King Faisal to provide these patients with the best care,” said Ceeya Patton-Bolman, MSN, RN, program coordinator for Team Heart. “This has been so rewarding, and we look forward to returning next April.”