The Starship Paediatric Cardiac Unit has a long history of service to Pacific Island children with either congenital defects or acquired rheumatic valve disease. In the last decade the number of regular outreach clinics has markedly increased creating productive links between the specialists in Starship and local paediatricians in Samoa, Tonga, Vanuatu, the Solomons, Tuvalu and Fiji. Echocardiograms can now be performed overseas and transmitted electronically to Auckland to help diagnosis and allow our cardiologists to advise on management.
As a unit we have been open to accepting patients for operation with simple defects or valve problems, but in reality many of these babies and children do not make it safely to Auckland for surgery . The reasons for this include:
- limited funding from charity and government sources ($NZ 45 000 for each open heart repair)
- Limited ability of a family member to accompany the child and get a visa, or
- Processing delays, which are often accompanied by a significant deterioration in the child’s condition - thus preventing travel or increasing the operating costs to a prohibitive level.
On average about 30 operations per year are performed in Auckland on Pacific Island children.
The population of Fiji, Solomon Islands, Samoa, Tonga, Vanuatu, Tuvalu and Kiribati is collectively 2.2 million and the average birth rate is 23 births per 1000 per year. This equates to 50,000 births, and thus about 350 infants born with congenital heart defects each year.There are also many more who develop rheumatic heart disease (which forms at least a third of the current cases referred). Some children make it to India and Australia, but there are many children who do not access surgery, yet have heart defects which are completely curable with a single operation.
Our Inaugural Trip (2014)
Heart operations range from simple to complex, curable to palliative. In the congenital heart field there are a number of operations that are reasonably simple and yet provide a life-saving cure with little or no specialist follow-up. With careful attention to case selection, planning and surgical repair, quality of life afterwards is usually excellent. Knowing the huge need, an expatriate Fijian and adult cardiac surgeon, Dr Parma Nand established the Friends of Fiji Heart Foundation (FOFHF) . This team has been tirelessly providing care for adults in Fiji with heart disease for the past 10 years.
In April 2013 paediatric cardiologist John Wright and paediatric cardiac surgeon Kirsten Finucane visited paediatricians and health officials at Suva and Lautoka to discuss how to improve care for children in Fiji with heart conditions. The Fijian paediatricians explained there was a real need for:
- More clinics, provided by an experienced heart specialist.
- A visiting cardiac surgical program for children. Open Heart International had been, and continues to provide one vital cardiac surgical program annually; unfortunately, this program was unable to single-handedly meet the need for cardiac surgery in children. Furthermore, by spacing the two programs, some children could be given a curative operation that would have died while waiting 12 months for the team to return.
In September 2013 John Wright and Kirsten Finucane revisited Lautoka Hospital, whilst the FOFHF adult mission was in progress. They determined that the environment would allow paediatric cardiac surgery to take place safely, when accompanied by careful planning and case selection.
In 2014, FOFHF generously agreed to provide full funding and logistic support in order to allow our paediatric team to join the 2014 adult FOFHF program. With careful planning and funding estimated at NZ$50 000, a team of 24 professionals who were willing to donate their holidays (and many pay for their own flights and accommodation) were identified.
In September of 2014, we undertook our inaugural program. Using the equipment shipped to Lautoka by FOFHF and financed by FOFHF, we performed heart surgery on 12 patients over 4 days. The youngest was 5 weeks of age and all patients survived and were discharged home safe and well. Follow up by our team members and communication with Fijian medical staff has confirmed that all 12 have been ‘cured’ and should now have a normal life expectancy and function. Of course, we look forward to reviewing them on our yearly visits to confirm the great outcomes. The 12 operations were performed at a cost of NZ$60,000 which is around 15% of the equivalent cost if brought to NZ for surgery (See stories).
Our current situation
After the success of 2014, we were keen to repeat the process in 2015. Unfortunately funding had become a problem and FOFHF were unable to finance an ongoing childrens heart surgery program. They are still able to support us logistically, including shipping over all our equipment and providing equipment shipped over for use in the FOFHF 2015 programme, such as ventilators and cardiac bypass machines. However, we need to fund many other costs, examples of which can be seen on our donations page.
One of our future aims is to transport children from other Pacific Islands to Fiji for this much lower cost surgery - an aim shared by the Fijian paediatricians, who already accept transfer of children for other subspecialty care, from the Pacific Islands.
The Hearts 4 Kids Trust has been established in order to fund the costs associated with providing an annual cardiac surgical program to Fiji, to operate on Pacific Island children with heart disease. The repair of simple congenital heart defects is one of the most lifesaving and cost-effective operations to be done in the field of medicine today.
Our vision is to extend life-saving cardiac care to children born in our neighbouring countries of the Pacific.
We also plan to continue the education work we began with our inaugural 2014 program. Many of H4K team have a passion for ongoing medical and nursing education. We plan on rolling out even more structured and informal teaching programs for the Fijian staff over the coming years. This increasing skill set will undoubtedly improve care for Fijians requiring hospitalisation after the team has left. This includes general principles not just applicable to children with heart disease, but to all critically unwell patients.
We are looking for community supporters that will enable us to be committed to this project for several years, which then allows us to develop the local facilities and educate the local staff. This would create sustainability for future visits as the more medical and nursing staff become up skilled in this field, the less team members we need to take with us. Skills learnt in this area of medicine will also undoubtedly result in improved outcomes for other children requiring complex care in the hospital.
Why give to H4K
There are lots of good causes around. The H4K team believe we are a worthwhile charity because of:
- All time required to establish and administer our trust (and of course time spent by the clinical team caring for the children) has been provided free. Running costs such as website design and hosting are donated for by team members. Your money goes exclusively to the care of children requiring heart surgery, and none to administration or marketing costs.
- Commitment, enthusiasm and hard work
- The trustees, team members and support crew are committed to running this trust as efficiently as possible, with the best outcomes possible for the children on the most frugal budget we can.
- Great outcomes
- We'll keep you updated on how our cildren are doing, and hope you are a little touched by the incredible difference your contribution has made to these children's quality of life.
Our team consists of some of the most experienced nurses and doctors in Starship heart unit, and we enjoy the privilege of using our skills and giving up our time to reach some of the poorest children in the world and change their lives. These are people who know that without our help, the future was dire - the smiles on the faces of the children and family as the children recover and the tearful hugs of thanks as we leave make the team want to continue helping.
Please help us open the door to a new life for these children.