History of approaches to treatment

Cardiac surgery for beneficiaries with congenital and acquired heart disease has been available for many years in developing countries thanks to the hard work and creative adaptation of individuals who are able to stretch the limits of their abilities in spite of restricted resources. As K. Johnson stipulates, "While a very small number of organizations partner with each other, there remains considerable opportunity for improved communication among groups for the more efficient use of limited resources and improved services for client populations". (Johnson, 2007).

There are numerous international organizations that help combat this disease in low and middle income countries, as well as hospitals and institutions that work with facilities in these countries to provide cardiac services to local beneficiaries. Strategies to provide help to these countries come from the international community through these nonprofits.

As illustrated below, and taking children with heart disease as an example, these strategies tend to fit into one of the four models as published in a report by Children’s HeartLink entitled 'Second Global Report of Pediatric Heat Disease'. (Children's HeartLink, 2008).

INTERNATIONAL STRATEGIES FOR DELIVERY OF TREATMENT

  • Strategy 1 - Transporting children with heart disease to other countries for treatment
  • 
Strategy 2 - Sending surgical teams to developing countries

  • Strategy 3 - Training local doctors and staff

  • Strategy 4 - Creating regional centers for treatment of pediatric heart disease

Transporting children to advanced cardiac centers in developed countries is prohibitively expensive and only a few children can be treated in such a program. Sending cardiac specialist teams with their equipment to under-developed countries to treat children and perform cardiac operations is a one-off solution with little time to train local doctors in complicated surgical techniques. Also, the host hospital may lack the necessary equipment and money to maintain this type of program. According to Jacques Leblanc (Leblanc, 2009), the ”best way to reach and care for many children with CHD is to bring care to their local environment.” Sustained international support and strong partnerships are necessary to support these best practices strategies. A web based collaborative platform may help encourage such partnerships, including sharing best practices. Sir Magdi Yacoub, Founder and President of Chain of Hope UK states that establishing specialized pediatric cardiac centers is an achievable priority target. He stipulates "the success of these projects depends on collaborative efforts by all concerned". (Yacoub, 2007)