OUR MISSION HAS BEGUN

On Saturday, February 5, 2005, the Jamaican Children’s Heart Fund Inc. (JCHF) embarked on their first official journey, as JCHF, to Kingston, Jamaica. The goal of this and following trips is to attend to the needs of infants and children with congenital and acquired heart disease in Jamaica. Providing open-heart surgeries for children of families in need is our mission. JCHF is a not-for-profit 501c3 charitable organization, consisting of both lay people and medical professionals who volunteer their time and services to achieve this goal. Over the past nine years this team has provided this life saving surgery for over 90 children in Jamaica.

Through the efforts of JCHF, Bustamante Children's Hospital, local cardiologists, surgeons, and nursing staff, eight pediatric cardiac surgeries were successfully performed in a four-day period.

In preparation for the week, work began early Sunday morning with the unloading of many boxes. Donated supplies and equipment were shipped from the United States and included intravenous infusion pumps, medications, instruments, disposables, and other needed items that are necessary to set up a functioning operating room and intensive care unit. By about four in the evening preparations had been completed. Surgeries were scheduled to begin the next morning. Our greatest need, cardiac monitors and ventilators had to be borrowed from the hospital Intensive Care Unit. Our most important expectation is that the children do not need prolonged mechanical ventilation or invasive monitoring. Having the luxury of several mechanical ventilators, invasive monitoring equipment, and infusion pumps was not an option; there were just not enough. We therefore modified our true needs to the environment.

Two surgeries were performed per day on children who ranged in age three months to five years.

Our first case on Monday, February 7th was a very special five-year-old boy named Jemar Silvera. Although our goal is for the children to have surgery and require only one to two days of intensive care, Jemar was the last to leave the hands of the JCHF team. Although his surgery was successful, we thought Jemar would be left needing a permanent pacemaker, his heart was not beating properly on it’s own. After two weeks of healing, Jemar’s heart rhythm returned. The JCHF team had left him under the close supervision of the Bustamante Children’s Hospital nurses. With his contagious smile a nurse could always be found within arm’s distance.

Our second case, Tiandra Bailey was out of our care on postoperative day two. This little girl, attached to her mother’s embrace, could not wait to be discharged.

 Both these children had closure of their Ventricular Septal Defect.

On our second surgical day we began with Sheldon Gordon, our special angel with Trisomy 21, Downs Syndrome. Sheldon was born with AV Canal. This repair usually accompanies extra support after surgery in the Intensive care setting. After 24 hours of maintaining Sheldon’s airway, he was taken off the breathing machine. We then began to wean the medications that help his heart function. This was done over a period of 3 days.

Baby Brady at only three months of age underwent major cardiac surgery. Baby Brady was born with Double Outlet Right Ventricle/VSD. This baby was transported to us from the University Hospital very ill and in desperate need of heart surgery. This was our sickest case, and although the baby’s surgery was successful, the intensive after surgery care continued at Bustamante Children’s Hospital once the JCHF team had left.

Kimani Edwards VSD repair, Ojara Bailey Tetralogy of Fallot Repair, and Ashley Wilson Tetralogy of Fallot repair all did exceptionally well after their heart surgery.

Many of the children chosen have been awaiting surgery for years. Living with congestive heart failure, some far away from even primary care, these children and their families only hope they will get their needed surgery. Symptomatology that is now rarely seen in the United States is common among this population. Severe clubbing (curvature of the finger and toe nails related to lack of oxygen), squatting, blue spells, and failure to thrive are complications seen from unrepaired congenital heart disease, a common occurrence in the daily life of these children

A prime example of these children is Britney Warlock who has Tetralogy of Fallot (TOF). She holds a special place in many of the team member’s hearts. In 2003 during a previous Cardiac trip, we placed a Blalock-Taussig Shunt into Britney to allow her time to grow and to prepare her for her needed surgery, complete repair of TOF. During this year’s trip we were able to do just that for Britney. She received a complete repair of her cardiac defect and actually went home two days after surgery! Her mother is a true inspiration!

Although the medical professionals volunteer their time and efforts, the experience from relations established with the children, their families, and the Jamaican team is priceless. There is knowledge gained in transitioning from the United States, where the latest technology is at our disposal, to an environment where there is minimal equipment and supplies available. This creates an increased awareness and requires the clinician to utilize astute assessment and critical thinking skills and provide the same level of care in two different environments.

Though these children have severe and unrepaired cardiac lesions, their resilience was demonstrated during and after surgery. There was minimal use of blood products and drugs that help the heart function. Their tolerance for activity and recovery was rapid. The children could be found playing and laughing even two days after intensive surgery.

A medical professional leaves an environment of such, returning to their practice, re-evaluating the care and management of their patients. Although our goal was to provide care and education, we departed more enriched and with a better appreciation for who we are and what we do.

We deeply appreciate continued community support, donations, sponsorship and missions partnership. The sponsorship for this mission trip also provided funding for JCHF to refurbish Ward 8 at Bustamante Hospital for Children to provide desperately needed space for infants and children being admitted for and recovering from pediatric open heart surgery.