The Liner

This post is by Steve Woods, Rwanda Team Blogger.

Open Heart International is a significant logistical and practical challenge, with tons of gear, lots of staff (volunteers), negotiations with the Rwandan Ministry of Health and King Faisal Hospital, clinical decision making, team forging and generally being able to “go with the flow” to get the job done.

Amongst all of that, there’s a crucial piece of planning that takes place. The Surgical List. An evolving document that starts with selecting patients for presentation to the Open Heart International screening team (this year Beth Chidlow and Dr Phil Roberts) by Dr Joseph Mucumbitsi (King Faisal’s paediatric cardiologist) and Dr Emmanuel Rusingiza (from Kigali’s public hospital). The patients reviewed over the few days of screening are sorted into those for whom both an operation is needed and can be accomplished within the scope and time frame of this trip and those for whom an operation is either not possible or not warranted. From this “shortlist” the surgical candidates are chosen and arranged over the seven operating days to make the best use of resources, and fit with various requirements for theatre and post-operative care.

The list is adjusted daily (and sometimes more frequently) as events dictate, a task taken on by Dr Darren Wolfers in consultation with the local and visiting teams. A fact of life is that there is a limit on the number of surgeries that can be done in a week, and that there has to be a line in the sand where we start to pack up (and allow enough time in ICU for the last few patients).

Patrick was this trips “liner”. After waiting at the hospital for days, being ready for surgery (fasted all day) on Thursday, and still needing his mitral valve repaired, Patrick was sent home from the pre-operative ward late on Thursday afternoon, after a decision was reached that it would not be possible to perform his surgery this time around. He’s a great kid, loved being around the other patients (and the Australian volunteers) and loved the football game. We hope to see him on the list next year.