A dream fulfilled: Building a self-sustaining cardiac surgery service in Ghana

cardiac surgery clinic in GhanaThere were many skeptics who said we couldn’t create a self-sustaining pediatric cardiac surgery program in West Africa. But after eight missions to Kumasi, Ghana, our team’s goal was fulfilled.

Along the way, we faced numerous challenges.

For starters, when our initiative — called Hearts and Minds of Ghana — launched back in 2008, clinicians in Ghana had never seen open-heart surgery in children. (We were the first team to successfully conduct pediatric open-heart surgery in West Africa). In the beginning, Ghanaians asked what was going on and questioned the promises we made. They wondered, were we actually going to help? Would we come back?

When we first saw the facility, it had bare concrete walls and no screens on the windows; you couldn’t open them or flies would come in. There were also intermittent power outages. How do you create an operating suite and care for these children when the power might go out at any moment?

In 2014, we had to delay our mission a year due to the Ebola epidemic.

But while we were gone, a surgeon we had helped train, Isaac Okyere, MD, returned to the clinic and began performing simple heart surgeries! Another doctor also returned and opened a six-bed Pediatric Intensive Care Unit (PICU). We are excited with the progress and commitment of these local community members, who will maintain and grow the program over time.

In November 2015, Hearts and Minds of Ghana performed surgery on our 100th child, and to date we have operated on 112 children. In addition to the surgeries, we have evaluated over 1,000 children, giving diagnoses and answers to families who didn’t quite know what was wrong with their child.

On our last trip, we left much of our equipment at the center, so the local care team can continue with surgery and running the PICU. A computer was also donated to the PICU for the nurses to view Open Pediatrics and other medical education resources.

Looking ahead

In April 2016, a group of medical personal will return to Kumasi to continue teaching and working in the PICU, the NICU, Pediatric Emergency Medicine and Pediatric Oncology. We will focus on patient safety, low-tech simulator training and nursing empowerment. We’ll also be building a six-seat swing set for the hospital daycare center.

Now, instead of asking whether we’ll keep our promises, people in Ghana ask the team, “When will you be back?,” “How can I get my child on your list?” and  “Can you promise to operate on her next year?”

Francis Fynn Thompson, MD, Hearts and Minds’s lead cardiac surgeon, is from Ghana and still has family there. He believes in giving back to the people of his home country and wanted to train local doctors and nurses with the clinical and technical skills necessary to continue caring for the children after each mission.

Fynn-Thompson loves soccer, and on the first mission he started a tradition of giving each child he treated a soccer ball at the end of the trip.

This year, instead of presenting the gifts himself, he gave the first ball to Okyere, signifying that the program really was his now.

That was the first moment when we said as a team, “We did it! We’ve made this program and made it sustainable, and now we’re turning it over to the local team.”

a cardiac surgery patient with stethoscope

About the blogger:  Beverly Small, RN, is a staff nurse in the cardiac intensive care unit (CICU) at Boston Children’s Hospital.

Learn more about Hearts and Minds of Ghana and check out the project’s blog.

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