تقرير مندوب المؤسسة العالمية لقلب الأطفال الذي عملنا على أن يحقق من أجله مساعدة وتطويرجراحة القلب لأطفال اليمن من خلال تعاوننا مع مركز القلب بالمستشفى العسكري بصنعاء التابع لوزارة الدفاع المينية

هذا هو تقري مندوب المؤسسة العالمية لقلب الأطفال أنزله كما هو وبكل أمانة لما جاء فيه وأترك الأمر لكم جميعا

Fact about Yemen:

Location:

This entry identifies the country's regional location, neighboring countries, and adjacent bodies of water

Population: 23,822,783 (July 2009 est)

Age Structure:

0-14 years: 46.2% (male 5,602,590/female 5,398,103)

15-64 years: 51.3% (male 6,212,378/female 6,009,401)

65 years and over: 2.5% (male 288,501/female 311,810) (2009 est.)

Population growth rate: 3.453% (2009 est.)

Estimated Congenital heart disease: 8000/ year.

Prevalence of rheumatic heart disease in the population: 3.6 / 1000.

Birth Rate: 42.14 births/1,000 population (2009 est.) number 12 in the world.

Mortality rate: total: 54.7 deaths/1,000 live births

Unemployment: 35% (2003 est.), maybe > 40 % now.

Population under poverty line: 45.2% (2003)

Heart Surgery in Yemen:

1. No specific center for this surgery

2. Patient with good income mostly travel abroad.

3. No fully trained pediatric cardiologist in Yemen, there is only tow doctors, trained mainly by experience.

4. Recently team from Saudia Arabia performed few surgery at thowra hospital.

5. There is hug waiting list waiting for team to come from abroad, most of them die before the help arrival. Most of those dead have reasonably easy corrected heart disease.

6. Patients with Heart disease such as hypoplastic heart die before even coming to the waiting list.

Major hospital in Sana’a with capability to perform heart surgery:

1. Main Military hospital: public: No ped. Cardiac surgery at this time.

2. Geram-saudie Hospital: Private hospital and very expensive above the ability of most family. Some surgery being performed at this hospital by local staff.

3. Thowra Hospital: Public: some surgery also performed at this hospital by visiting Saudi team.

This visit was contacted with the help of Dr. Ahmed Nouman who arranged every thing in this visit and was great resource for trouble shooting.

I visited only Military hospital and German-Saudi hospital.

Thowra hospital was excluded due some technical and administrative issues and Dr. Ahmed nouman could not make the arrangement for that.

Some Detail about each hospital:

1. Military hospital:

I visited this hospital with Dr. Ahmed Nouman:

This hospital has great new cardiac center, recently build by King of Saudia Arabia as gift to Yemeni people. The hospital manager is very enthusiastic and he showed over the 2 days visit great desire of working with ICHF, he expressed interest on having the ICHF sponsor the hospital for full one year. He promised he will do every thing in his power to make this project work. He does have good connection at the high rank defense ministry.

Positive points:

1. It is state of the art cardiac center with excellent equipment.

2. Never open and all equipments are new.

3. 2 surgical rooms with 4 heart lung machines. Each room has 2 movable surgical beds, so while you are working on one patient you can make the other patient ready as well, and place all line you need in separate room.

4. State of the art anesthesia machines as well.

5. Stat of the art Cath lab built by German company with Biplane cameras and great monitoring system.

6. 2 Intensive care unites with 10 beds in the first one and similar in the third floor, fully equipped with monitoring system.

7. State of the art CT 64, and MRI cardiac in nearby building

8. New echo machine with both adult and pediatric TEE probes

9. In short story this hospital is equal to any hospital I have seen in the USA in the equipment or maybe better.

Negative points:

1. This hospital is completely adult oriented with no pediatric unite; however they get referred patients from all over the country including pediatrics.

2. They told me adult heart surgery will start by November this year.

3. There is only one pediatrician and his involvement in pediatric cardiology is not clear.

4. All the staff they suggested as part of the team is mostly in adult cardiology, however it is not difficult to recruit pediatric staff as long as there is training for them, since there is a lot of pediatrician in the city and most of them will excited to join.

5. In short term if you decide to open pediatric heart center, it will be build from square zero up, and it means full commitment and great challenge for ICHF which has done many successful project, and I am sure it will do great in this one as well.

6. Financial issue still to be discussed further with hospital management, but they have promised housing, transportation, food, and security to the whole team while staying in Yemen.

1. German-Saudi hospital:

This is a private hospital and government has no control over it. Like all private hospital, it is main aim is profit as well as serving the patients.

We visit this site me and Dr. Ahmed Nouman and Dr. Tarek nouman.

Dr. Tarek nouman is adult cardiac surgeon who has a lot of interest in this project and expressed his support to get this project going via financial help via local charities.

Positive point:

1. The facility is few year old with total bed 76. It is probably the best private hospital in Yemen.

2. This is currently active pediatric cardiac surgery with surgeon name Abdulkareem Hajar, MD. he was trained in Jordan and then went to Saudi Arabia for short period of time. He has been doing heart surgery there for the last 6 months with good success rate (mostly simple surgery such as VSD and ASD, PDA, one Glenn, one DTG), no complex heart surgery at this time.

3. There is PICU with 6 bed capacity, could be extended to 11 bed. The unite is equipped with monitoring system.

4. Almost all nurses are from outside the country, with good credential.

5. NICU unite with 5 incubators.

6. There is 2 covering cardiologist from other hospital, and they do there own echoes, reading and they are involved in patients care. In my knowledge one of them was trained in Russia and the other one was trained locally. They also do basic intervention and diagnostic studies including PDA closure.

7. There is covering intensive care MD who is not trained as intensivist.

8. There is one surgery room with heart lung machine.

9. There is biplane cath lab reasonably new.

10. There is echo machine which reasonably new, but no TEE probe for pediatrics.

11. This hospital is ready to operate from day one and most of the needs are available.

12. The hospital has long list of patients with CHD who is waiting for surgery

13. The hospital has housing for visiting doctors in the same building, but I did not see it.

Negative point:

1. Very expensive

2. This project could be used to make this hospital more reach, however all surgery that will be done by ICHF team will be supported by charities and should be at no cost for the patients.

3. No ECMO machine or NO available. The same thing at the military hospital.

4. Financial challenge, since most of patients are unable to pay

How can patients pay?:

Dr. Tarek Nouman who is adult pediatric cardiologist has expressed desire to work on this issue with local charities and has told me that he has good contact with them.

If the issue of local charities works, we will be able to start working in this hospital very soon.

Final assessment:

This is great project and will definitely benefit the children who have no chance in live and there fate will be death unless some thing is done for them.

I am sure we need both hospitals to run in the same city, and there is very hug load of patients estimated in hundreds if not thousands to make both center function at the same time.

Having both center working at the same time:

Share the staff easily without having to travel to other cities and

Use the surgeon wisely when one hospital gets filled, and we have to wait for patients discharges.

Maximize the staff experience locally.

Probably the Military hospital could be the main center and the other hospital could be as back up surgery center.

We still need a lot of work to figure out financial support.

In the end I would like Dr. Ahmed Nouman who made this trip easy and well organized. Thank you to Dr. Tarek Nouman who helped us at the German Hospital and I am sure he will be great support for this project.

Thank you to Military hospital director who has great vision about this issue and he seems to be the man to get things done.

The most thank is to Dr. Novick who is the real driving force behind this and I know he will not get paid for this work but he will get the respect of so many needy children as well as there families.

Please feel free to comment in report after reading and send it back to Dr. Novick and me for further suggestion.

Finally, this project is huge and will need a lot of support and work from every one and should not have no politics attached to it.

Mohamed Sulaiman, MD.

Pediatric Cardiologist.

University of Chicago.

USA

001 347 804 7092.

This report will be followed by detail for contact, Yemeni teams who will be shadowing the ICHF team from both hospitals with short resume about each one, detailed map of military hospital cardiac center, equipment list at both hospital, administration contact at both hospitals with there email and phone number