Cohen A J, Tamir A, Houri S, Abegaz B, Gilad E, Omohkdion S, Zabeeda D, Khazin V, Ciubotaru A, Schachner A
Department of Cardiothoracic Surgery, E Wolfson Medical Center, Holon, Israel.
Ann Thorac Surg. 2001 Feb;71(2):462-8. doi: 10.1016/s0003-4975(00)02243-8.
Congenital heart disease (CHD) causes the death of thousands of children in developing countries. At the Wolfson Medical Center (WMC), a prototype program has been developed to address this issue.
Since 1996, indigent children have been referred to the program, with the cooperation of partners in developing countries. The project's aims are to (a) train their medical personnel at WMC, (b) travel to participating countries to teach, evaluate patients, operate, and promote the development of local centers, and (c) treat children with CHD, at WMC, who lack a local option for care either due to prohibitive costs or unavailability. The project's personnel are state employees who volunteer to treat additional patients within the framework of their salaries, and community volunteers.
The program has seven partner sites in six countries, including two provinces in China (Hebei and Gansu), Ethiopia, Moldova, Nigeria, the Palestinian Authority, and Tanzania. Five physicians and 10 nurses have been trained from five participating countries. Over the past 4 years, 11 teaching trips have been made abroad, and operations have been performed at four partner sites. A total of 386 patients have been operated on-360 at WMC and 26 at other sites. There have been 17 (4.3%) acute deaths. Follow-up is 92% complete with 3 late deaths reported.
Hospital-based regional centers can be created to promote the care of children with CHD in developing countries. Good results and follow-up care can be provided with appropriate planning.
先天性心脏病(CHD)在发展中国家导致数千名儿童死亡。在沃尔夫森医疗中心(WMC),已开发出一个原型项目来解决这一问题。
自1996年以来,在发展中国家合作伙伴的协助下,贫困儿童被转介到该项目。该项目的目标是:(a)在WMC培训其医务人员;(b)前往参与国进行教学、评估患者、开展手术并促进当地中心的发展;(c)在WMC治疗因费用过高或无法获得当地治疗选择而患有CHD的儿童。该项目的人员包括自愿在其薪资范围内治疗额外患者的国家雇员以及社区志愿者。
该项目在六个国家有七个合作站点,包括中国的两个省份(河北和甘肃)、埃塞俄比亚、摩尔多瓦、尼日利亚、巴勒斯坦权力机构和坦桑尼亚。已对来自五个参与国的五名医生和十名护士进行了培训。在过去四年中,已进行了11次国外教学访问,并在四个合作站点开展了手术。总共为386名患者进行了手术——360例在WMC,26例在其他站点。有17例(4.3%)急性死亡病例。随访完成率为92%,报告有3例晚期死亡病例。
可以建立以医院为基础的区域中心,以促进发展中国家对患有CHD儿童的治疗。通过适当规划可提供良好的治疗效果和后续护理。