Tefera Endale, Qureshi Shakeel A, Bermudez-Cañete Ramón
1Department of Pediatrics and Child Health,Cardiology Division,School of Medicine,Addis Ababa University,Addis Ababa,Ethiopia.
2Evelina London Children's Hospital,Guys and St Thomas' Foundation Trust,London,United Kingdom.
Cardiol Young. 2015 Jun;25(5):874-8. doi: 10.1017/S1047951114001000. Epub 2014 Jun 9.
Most children in the Third World do not have access to treatment for heart diseases, as the priorities of health care are different from the developed countries.
Since 2009, teams supported by the Chain of Hope and Spanish medical volunteers have travelled twice a year to help develop paediatric cardiac services in the Cardiac Center in Ethiopia, undertaking four missions each year. As of December 2012, 296 procedures were performed on 287 patients. The procedures included 128 duct occlusions, 55 pulmonary valve dilations, 25 atrial septal defect closures, 14 mitral valve dilations, and others. The local staff were trained to perform a majority of these cases.
Procedural success was achieved in 264 (89.2%). There were three deaths, five device embolisations, and three complications in mitral valve dilation. During the visits, the local staff were trained including one cardiologist, six nurses, and two technicians. The local team performed percutaneous interventions on its own after a couple of years. The goal is also to enable the local team to perform interventions independently.
Training of an interventional cardiology team in a sub-Saharan setting is challenging but achievable. It may be difficult for a single centre to commit to sending frequent missions to a developing country to make a meaningful contribution to the training of local teams. In our case, coordination between the teams from the two countries helped to achieve our goals.
由于医疗保健的重点与发达国家不同,第三世界的大多数儿童无法获得心脏病治疗。
自2009年以来,由希望之链和西班牙医学志愿者支持的团队每年两次前往埃塞俄比亚心脏中心帮助发展儿科心脏服务,每年执行四次任务。截至2012年12月,对287名患者进行了296例手术。这些手术包括128例动脉导管封堵术、55例肺动脉瓣扩张术、25例房间隔缺损封堵术、14例二尖瓣扩张术及其他手术。大部分病例由当地工作人员进行操作。
264例(89.2%)手术获得成功。有3例死亡、5例器械栓塞以及3例二尖瓣扩张术并发症。在访问期间,对当地工作人员进行了培训,包括1名心脏病专家、6名护士和2名技术人员。几年后当地团队能够独立进行经皮介入操作。目标是使当地团队能够独立开展介入操作。
在撒哈拉以南地区培训一支介入心脏病学团队具有挑战性,但可以实现。单个中心可能难以承诺频繁派遣任务到发展中国家,以便对当地团队的培训做出有意义的贡献。在我们的案例中,两国团队之间的协调有助于实现我们的目标。