Chain of Hope Florida takes time, care in saving young Jamaican lives
THE LIFE-SAVING open-heart surgeries performed by Chain of Hope Florida at the Bustamante Hospital for Children since 2004 have been time-consuming but rewarding for Professor Jeffrey Jacobs and the medical teams which in the 16 missions to Jamaica over that time, have operated on at least 160 children.
The success of these operations is evident in the fulfilling lives their patients go on to lead, but the extensive pre-planning that goes into each mission is critical to the outcome.
On Wednesday, The Gleaner caught up with Jacobs, chief of cardiovascular surgery of the Andrews/Daicoff Cardiovascular Program at Johns Hopkins All Heart Institute, at the Bustamante Hospital for Children in St Andrew as he prepared for another round of operations and spoke about the nature of the surgeries to save 10 more young lives.
“Open-heart surgery on a child is always complex. There are a million things that can go wrong, and if you make a mistake in any little step, bad things will happen. So to do successful open-heart surgery you need surgeons, cardiologists, nurses, ICU (intensive care unit) doctors, and other professionals, and the team has to work together perfectly. The complexity is the need to have every single member of that team perform perfectly, and if one part doesn’t perform perfectly, it will all fall apart,” he explained.
“What is fascinating about this is we have surgeons from Jamaica working with surgeons from Florida and cardiologists from Jamaica working with cardiologists from Florida and an anaesthetist from Jamaica working with an anaesthetist from Florida, and everybody comes together with one goal: the goal of making the baby well.
“All of these children that we are operating on this week, without heart surgery, would die of their heart diseases in childhood. With surgery, if everything goes well, they’ll be able to live fairly normal lives, go to school, work and have children. These are true, real life-saving surgeries. There is no doubt without surgery, these children would not live. With the surgery, they recover, go home and do well.”
For this mission, the Florida team arrived on Sunday and met with their local counterparts from 11:00 a.m. until 4:00 p.m., planning and strategising the different operations they would perform, starting the next day.
“Every Monday night at 9:00 p.m. our team has a Zoom call to plan this trip, and we plan it for a year, we raise money, we assemble the team and we communicate continuously with Nola Phillpotts-Brown (general manager of Chain of Hope) and with Dr Sherard Little (consultant cardiothoracic surgeon) to make sure that all the pieces are in place for a successful mission trip. We talk to all the patients and exchange information about their diagnosis and what operation they will need, and by the time we come down here, we know more or less what we are gonna operate on because we have exchanged information before surgery,” Jacobs disclosed.
Some 200 to 300 babies are born in Jamaica each year needing heart surgery and Jacobs noted that some die before they get surgery while others who survive without surgery are sickly throughout their lives, unable to participate in the usual childhood activities.
“They either get their surgery in time or they die,” he declared. “Some babies with holes in the heart die before they have their surgery, others live but they can’t keep up with their peers.”
He was happy to report that children the team had operated on only days before were already showing signs of progress.
“The children we operated yesterday and today, are actually walking around in the Intensive Care Unit now. So they are doing great, and our goal is to have nine or 10 children leave here with their hearts fixed so that they can lead normal lives. We have a beautiful four-year-old that we operated on, on Monday who has already gone for a walk down the hallway outside. So that’s what it’s all about.”
The Florida team, comprised entirely of professionals who had volunteered for the Jamaican mission also, were motivated to do so, according to Jacobs.
“We come because we have a love for Jamaica, and we have a love for the children. That’s why we come back every year... it’s tremendous fun. It’s a wonderful feeling to operate on the children, but also, it’s just nice to be in Jamaica. You have a beautiful country.”
HAVING BEEN a part of the Chain of Hope Florida missions to the Bustamante Hospital for Children since 2004, Professor Jeffrey Jacobs is impressed with the significant progress Jamaica has made in paediatric cardiac care since that time.
Talking with The Gleaner inside the reception area of the Cardiac Unit, the doctor recounted the difficulties they had been facing before the unit was built.
“This building has a l ot of technology that wasn’t available before it existed. One piece is the catheter lab because when a baby has a hole in the heart or other problems with the heart most commonly it’s surgery where we open the chest and repair the heart. Many times to get the diagnosis right we put catheters in the heart to measure pressures and to figure out the best way to repair the heart,” he explained.
“Ten, 15 years ago there was no catheter machine at this hospital, so the children had to go somewhere else to get their catheter study,” he continued. “Now there is one in this hospital and it’s exactly right next to the operating room so the cardiologists and the surgeons can work together in the same operating room to take care of the children. If they are separated by 30 minutes in two different hospitals across the city, healthcare is not as good as it can be in one building.”
Jacobs noted how the acquisition of newer technology has also helped to solve logistical issues.
“The outcomes have been better and the ability exists to care for sicker children. Before this building was here, those sicker children needed to have their surgery done in another country. There are different levels of complexity of heart operations and with the presence of this building and a catheter lab here and all this critical knowledge right here, we can now take care of sicker children. Before, some of these sicker children, they would either die or they would have to go somewhere else. Now they can have their care here,” he said.
However, with all the state-ofthe-art equipment and its own operating theatre, as well as a standout cardiothoracic surgeon in Dr Sherard Little, Professor Jacobs is concerned that these gains could be undermined by the absence of a critical cadre of support personnel – nurses.
“The problem was that Dr Little didn’t have an operating room. Now he has one and there is a catheter lab. Then we needed to have good bypass machines to run the open heart surgeries by putting the patient on the machine to pump the heart and we now have that, so the next gap is we need more nurse,” he admitted.
Professor Jacobs pointed out that 30 of the 50-member Florida team were nurses, and with good reason.
“I bring all these nurses to take care of the patients and when I leave all these nurses are out of here. So you can’t do all the operations that need to be done. So the gap right now is nurses. You need to find a way to have Jamaican nurses learn how to take care of patients that have heart surgery and get them to stay here,” he declared.
Professor Jacobs, who is director of the Andrews/Daicoff Cardiovascular Programme at Johns Hopkins, said having dedicated a cadre of nurses assigned to the cardiac unit would be building on the overall investment, which has been paying great dividends in terms of the many lives saved and the families healed.
“We have to be smart enough to say if we build this building, we get all this equipment and we have this surgeon, you have to find a way to get the nurses to want to stay here. We’ve got to find a way give them the appropriate salary differential that they are not tempted to leave the country,” Jacobs urged.