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31st March 2016

The price of life

A nine-year-old girl from Bangladesh needs a €5,000 heart operation but her family’s income is just €70 per month. Now a charity is stepping in to provide less-invasive surgery – for free

Fima has a hole in her heart. It causes palpitations and has stunted her growth. She is heading for her 10th birthday but looks small and frail. Her condition makes it difficult to play with other kids and she has spent more time in the hospital than in school.

‘When she was in pain, we were in pain,’ Fima’s father says.

Her family traveled the length of Bangladesh in the hope of getting open-heart surgery which could dramatically improve Fima’s life. The chance of success at the outset was severely limited, not just by the relatively high cost of healthcare for low-income families in Bangladesh but also by the chronic shortage of skilled surgeons.

The demand for surgery is high because around 25 babies in every 1,000 are born with congenital heart disease in Bangladesh. This is around three times the rate seen in Europe and the US.

But Fima was fortunate to be one of 250 children to benefit from projects such as ‘Little Hearts’, run by British charity Muntada Aid. The initiative is one of several UK charities that brings experts to Bangladesh to perform surgeries on children with congenital heart disease – and train local staff in the process.

The charity has raised more than $2 million dollars since 2013, enabling their teams to deliver surgical care to children in countries where the expertise is simply not there.

Training is a key part of their work. As the skills of local health professionals expand, the charity’s capacity to save lives increases. During its most recent visit, the Muntada Aid team carried out a record 94 operations instead of the 50 it had performed on its last visit.

Ultimately, empowering local surgeons to become experts in the procedure will dramatically increase access to surgery in Bangladesh.

New surgery

Of course, money and expertise are not the only solutions. Some doctors are rethinking the surgical procedures itself, in search of methods that are quicker, cheaper and more efficient.

‘Patients need expensive treatment but they can’t afford it by themselves and most of them die due to a lack of money and facilities,’ says Nurun Fatema, a cardiologist at Dhaka’s Combined Military Hospital (CMH). ‘Eighty percent of them are below the poverty line.’

In an effort to increase access to life-saving surgery, Dr. Fatema has been performing an operation which is less invasive than open-heart surgery – and she’s been doing it free of charge.

The procedure runs a catheter from the groin to the heart where a dye is injected. Using a large X-ray monitor, Dr. Fatema can see where blood is trapped or leaking – highlighting the problem area. From there, the cardiologist uses a combination of balloons and stents to fix the problem.

Hope for the future

Meanwhile, Fima is on the mend. Her surgery took several hours and left her with a large T-shaped bandage where surgeons opened her body to access the heart.

As her mother sat by her bedside just two days after the operation, she could already see a difference. Now that Fima has oxygen-rich blood flowing through her system, her complexion is taking on a healthier hue. ‘She’s a completely different colour,’ her mother says.

The change in Fima’s life – and that of her family – proved to be profound. Her parents used to keep her home from school, fearing she might take ill during class. She would routinely miss three or four days per week. Now she can join her class most days.

And the violent palpitations her parents witnessed in the years before surgery are a thing of the past. ‘I used to see her heart beating furiously, and now it’s calm,’ Fima’s mother says.

With a little help from charitable organisations, newly-skilled local surgeons and clever new approaches to surgery, thousands more children could get the help they need to put a little colour back in their cheeks.