Cardiac Surgery Plans a Mission to Rwanda

International nursing efforts are important to the BWH Department of Nursing. In partnership with the Center for Nursing Excellence and the Division of Social Medicine and Health Inequalities, the development of a global nursing program is in progress. This program is aimed at furthering the principles of access to care in resource-limited settings; supporting health care and health education for the poor; enhancing community partnerships internationally as well as locally; addressing basic social and economic needs; and bringing back to BWH the wealth of experiences.

-Patrice Nicholas, DNSc, MPH, APRN-BC, director of Global Health and Academic Partnerships in the Center for Nursing Excellence

Compelled by a startling need for cardiovascular care in Rwanda, a team from BWH Cardiac Surgery is planning a long-term mission to help a hospital in Rwanda establish a cardiac surgery program. In April, BWH’s Team Heart - Rwanda 2008 will officially begin the mission by performing surgery on Rwandan patients suffering from one of the most common medical problems in Africa: rheumatic heart disease.

“Rheumatic heart disease is just as serious a health problem in Rwanda as HIV/AIDS,” said Leslie Sabatino, BSN, RN, of Tower 8CD, one of the leaders of Team Heart - Rwanda, along with Cardiac Surgery Chief R. Morton “Chip” Bolman, III, MD, his wife Ceeya Patton-Bolman, MSN, RN, Zane Khalpey, MD, Prem Shekar, MD, and Partners In Health’s Gene Bukhman, MD.

Heart disease in sub-Saharan Africa is a consequence of a generation of?health care neglect. Rwanda lacks the resources to deliver chronic interventions, such as penicillin, and to perform the life-saving operations to help the most critical patients.

During the inaugural visit, the BWH cardiac surgeons, anesthesiologists, nurses, perfusionists and other clinicians who make up Team Heart - Rwanda will operate on about 10 of these most critical patients at King Faisal Hospital in collaboration with Partners In Health.

Over the next seven to 10 years, Team Rwanda Heart will work closely with King Faisal Hospital and the Rwandan Ministry of Health to help establish a comprehensive program to treat rheumatic heart disease. The team will work with community health workers on prevention efforts, like educating the public about strep throat, obtaining antibiotics, getting diagnosed early and when it’s necessary to get a cardiology consult.

“We hope that the model of care we establish can be used throughout sub-Saharan Africa,” Patton-Bolman said.

Team Rwanda also plans to build a support model for Rwandan nurses. Suellen Breakey, PhD, RN, of Cardiac Surgery, is leading this effort to create a certificate program that will equip Rwandan nurses with the skills and knowledge they need to care for patients with heart conditions. “We want to walk away and leave nursing in a better place,” Patton-Bolman said.

Bolman and Sabatino, along with cardiac perfusionist Mike McAdams and Susan Hall, RN, of the Cardiac Surgery ICU, traveled to Rwanda in October to visit King Faisal Hospital and determine what equipment and resources Team Heart - Rwanda will need in April.

“We are excited to begin this long-term relationship,” Sabatino said. “It will be incredibly rewarding to help Rwanda set up a cardiac surgery program that will benefit countless Rwandan people in need in the years to come.”

Stay tuned to www.brighamandwomens.org/cardiacsurgery/rwanda.aspx for updates on Team Heart - Rwanda, including fund-raising events and ways to help.

Mission to Rwanda

• In Rwanda, there are fewer than 4,000 nurses to care for a population of 9.9 million. For comparison sake, BWH has about 3,000 nurses.

• Team Rwanda officially begins its mission on April 6, the anniversary of the beginning of the genocide that occurred in 1994. Rwandans requested this date because they see it as a way to move forward.

• BWH’s Cardiac Surgery Division performed the world’s first rheumatic valve surgery in 1923.