Dying For Lack of Medical Care

Bugando Medical Centre

A medical team from Israel’s Save a Child’s Heart, an international humanitarian non-governmental organisation, has successfully performed the first-ever paediatric open heart surgery on the youngest patient in Tanzania.

"She had a hole in her heart.  We had to stop her heart, go in and close this hole and then start the heart functioning again.  In places like Canada, you can do this operation any day. You don't let patients with the condition become six months old or even a year, without the operation.  But in Tanzania, this little girl was four years old and she could have died while being on a waiting list."

But that little girl is now healthy, and in school.  She is the child of farmers, living in a mud hut without running water or electricity.  And she had undergone what was historic surgery in Tanzania when a team of 13 doctors from Save a Child's Heart travelled to Tanzania from Israel to operate a cardiac clinic at the Bugando Medical Center in the city of Mwanza.

The Bugando Medical Center is an 850-bed hospital serving 15 million people, as best they can.  Lacking sufficient trained medical staff, pharmaceuticals, advanced technology.  Dr. Godwin Godfrey, son of a surgeon, born in a small town beneath Mount Kilimanjaro is a second-generation medical practitioner, intimately familiar with the heart-breaking difficulties of practising his profession in a developing country.

After he received his medical degree at Makerere University in Uganda he returned to Tanzania for his internship, choosing to do so at the Bugando Medical Centre.  "Most of our doctors are actually located in Dar es Salaam, the capital.  That is the biggest city and all the government offices are there.  But with me being interested in surgery, I thought if I went to work in one of the big hospitals I wouldn't get the hands-on experience that I wanted."

He did get that hands-on-experience in Mwanza, possibly more than he had anticipated, let alone wanted.  A lack of surgeons and specialists meant he was busy with pediatric cases, orthopedic, ophthalmology and neurosurgery, quite the introduction. He shifted to cardiac surgery, but there was little equipment, much less expertise.  He looked into possibly training in cardiac surgery close to home, discovering the only places in Africa were in South Africa, Egypt, Morocco or Tunisia.

But there, he was informed they had no interest in training foreign doctors.  A visiting German doctor representing a Christian charity recommended that he apply to study in Israel under a humanitarian project sponsored by the Save A Child's Heart group.  At the Wolfson Medical Centre in Holon, Israel outside of Tel Aviv, cardiac surgeons have treated over 2,800 children with congenital heart diseases, and adolescents suffering from heart-valve diseases.

As Dr. Godfrey discovered, patients come in to Israel from international destinations to undergo roughly 225 emergency operations annually.  Some 43% of the cases flown in come from Africa, 47% from Arab states, including the Palestinian Authority, Jordan and Iraq.  Dr. Godfrey was offered a full five-year scholarship by Save A Child's Heart to study pediatric cardiac surgery.  And the organization helped him to train a complete surgery team to work in Tanzania with him.

"Heart surgery is teamwork," said Dr. Godfrey as he toured Sick Children's Hospital in Toronto.  "It's not just the work of a surgeon.  You need a cardiologist, an anesthesiologist, an intensive care unit internist, people to operate the heart pumps and ventilators."  On his graduation next summer from the Wolfson Medical Centre he will represent the first and only pediatric heart surgeon in Tanzania to serve a country of 43-million people.

"A child on the waiting list with a serious heart condition may wait maybe three or four years and die of complications like heart failure.  Sometimes it can be very depressing being a doctor in a poor country like Tanzania.  Too many times you see children dying in front of your eyes.  You know that you are supposed to do something, like give them medicine, but you don't have it."

In Israel at the inception of his training at the Wolfson Medical Centre the situation was completely different.  "I always used to see a lot of death.  In our department in Tanzania (Bugando Medical Centre, Mwanza) you could have five or seven children die every day.  When I got to Israel to train I realized we weren't seeing any children die - even in a month."

"This was really an eye-opener.  Whatever we were doing; it was wrong.  It opened my eyes.  There is so much that we don't know.  There is so much equipment that we don't have.  There is so much medication that we don't have."  Tanzania's Ministry of Health has a waiting list of nearly 500,000 patients desperately requiring heart surgery.

"A child on the waiting list with a serious heart condition may wait maybe three or four years and die of complications like heart failure."