Our Recent, 2008 Trip to India... by Joanne Russo

     Gift of Life International sent a surgical team to Lifeline Hospital in Chennai, India, June 23 to June 30, 2007. Our surgical team consisted of a senior cardiac surgeon, Pierantonio Russo, MD; a perfusionist, Regye Cane, CCP; and two clinical nurse specialists, Margaret Deaver, RN and myself, Joanne Russo, RN, all from the University of Missouri. Three non medical representatives of GOLI accompanied the team.

     Chennai (formerly Madras), the first British post in India founded in 1600 is located on the Indian Ocean southeast coast. The focus of an urban area of about 7.5 million, Chennai is a manufacturing and administrative center, and an important leader in information technology (IT).

     A civilization that boasts a 7,000 year history - India is an emerging economic poser, where the contrasts between old and new are evident everywhere. Modern India faces formidable challenges caused by poverty, educational disparities, and in health care. Tuberculosis, HIV/AIDS and cardiovascular disease are the most common causes of death.

     The health care system is based on government hospitals and clinics and a rapidly growing private sector. Ayurveda, the religiously based traditional medicine and science is still practiced. Western medicine and surgery have advanced rapidly over the last twenty-five years. Currently, an estimated 6 million persons need cardiac surgery; approximately 1000 surgeons practicing at 175 centers perform seventy to eighty thousand cardiac operations per year. The number of surgeons and hospitals is insufficient to meet current and projected needs.

     Indian surgeons are generally well trained and need very little technical help from foreign consultants. They do need assistance for advanced treatments and there are quality improvement initiatives required to create more efficient delivery of the highest order of care.

     Selected private hospitals offer quite advanced care in areas such as stem cell therapy, tissue engineering, minimally invasive surgery and robotics surgery and report excellent results. Certain selected centers, accredited with the international branch of the JCAHO, treat international patients, including American citizens under the increasingly well known label, "medical tourism." Some health plans from the United States, such as United Health Care, are accepted at these centers

     Surgery for complex congenital disorders in children are performed with good results in ten hospitals nationwide, but the number of operations is far short of the need, estimated at about 1.5 million.

Dr. PA Russo and J Russo with a little patient a week after open heart surgery - Cluj, Romania, 2001.

Chennai, India.

Chennai, India: The IT corridor.

Chennai, India-Traditional Temple.

Joanne Russo, RN; Regye Cane CCP; Margaret Deaver, RN at the Lifeline Hospital, Chennai.

From left to right, Dr. Kumar, Dr. Kapadia, Dr. Russo.

Dr. Russo and the local team in the operating room.

The perfusionists working on the heart and lung machine during one of the open heart operations during our visit.

Read More... by Joanne Russo,   (Cont'd)

LIFELINE HOSPITAL: THE GOLI EXPERIENCE, JUNE 2007

     Our team visited the Cardiac Care Unit of Lifeline Hospital, a 225 bed facility that opened in October 2005. Located near the bustling IT corridor in Chennai, the hospital has established relations with many of the IT companies (notably CTS and Infosys) to provide care for their employees. Our team was invited to lend technical and logistical support to Lifeline's efforts to establish a pediatric cardiac surgical program there. It is estimated that 1000 new cases of congenital heart defects in Chennai require surgery every year, but there were facilities for only 350 to 500 cases

     Our team worked with the Lifeline Cardiac Unit to perform seven operations, June 23-30. Led by Nand Kishore Kapadia, MD, Lifeline has an excellent adult cardiac surgical program with a superb local reputation. Dr. Kapadia previously worked under Dr. Russo's supervision as a fellow at St. Christopher's Hospital for Children in Philadelphia. Working closely with Dr. Kapadia, Ravi Kumar, MD, is Chief of Cardiology. He is also director of the stem cell cardiac and paraplegia programs, which are financially sound and have an established reputation.

     The joint teams performed seven operations on patients aged six months to fifteen years. The patients had been previously evaluated at other centers, but had been turned down because of high risk associated with the severity of complications. Six of the patients survived the surgeries. One infant with complex anomaly of his pulmonary veins survived the operation without complications, but died the following day because of irreversible pulmonary hypertension.

     Lifeline Hospital offered a conference (CME) on congenital heart disease as part of the GOLI visit. The conference participants included staff and medical students of the hospital. They could watch the surgeries live on large screen closed circuit television. Dr. Kapadia and Dr. Russo interacted with the audience in real time during the operations.

     Nurse Margaret Deaver gave a lecture on mechanical support of the circulatory system and mentored the Lifeline Intensive Care Unit nurses with daily bedside interactions. I led the nursing operating room team and provided teaching in organization dynamics and in advanced sterile techniques. Regye Cane provided daily teaching concerning pediatric perfusion issues and participated in the conference.

     Our work in Chennai was facilitated by the advanced level of professional standards of the Lifeline team. All of them are fluent in English, because English is the language of medicine in India. (Most of the patients and there families did not speak English, but others of the twenty some languages of India.) Our visit was a successful professional, cultural and human experience. Through these kinds of experiences, progress is made toward the goal of improving the lives of the world's most precious resource: children.

The joint teams performed seven operations on patients aged six months to fifteen years. The patients had been previously evaluated at other centers, but had been turned down because of high risk associated with the severity of complications. Six of the patients survived the surgeries. One infant with complex anomaly of his pulmonary veins survived the operation without complications, but died the following day because of‘ irreversible pulmonary hypertension.