Posts

PIMA Heart Team Sees 177; Nine Require Cardiac Surgery

Our intrepid heart team has returned home after seeing 177 patients in a week’s time on isolated Christmas Island in the central Pacific, where they identified nine needing life-saving surgery.

Nine heart patients heading for surgery. Plans are underway now to bring the nine patients to Baylor Scott White Heart Hospital in Plano, Texas for surgery, says team leader cardiothoracic surgeon Dr. David Moore, M.D.

Team members on the island were divided into small units for their one-week stay and were able to perform 176 heart echoes on adult patients and 975 rheumatic heart disease-screening echoes for children at local schools on the island.

In addition, team members offered educational talks to teachers and students about rheumatic heart disease, its causes and cures… where many islanders suffer as a result of undiagnosed and untreated rheumatic fever in children that results in heart disease later in life.

Counseling Patient: Volunteer cardiothoracic surgeon Dr. David Moore, M.D., counsels patient on Christmas Island after tests show the patient needs heart surgery to correct the effects of his rheumatic heart disease. In just one week, the PIMA Heart Team saw 177 patients with 176 echos and 9 patients identified for surgery back in the U.S.

Counseling Patient: Volunteer cardiothoracic surgeon Dr. David Moore, M.D., counsels patient on Christmas Island after tests show the patient needs heart surgery to correct the effects of his rheumatic heart disease. In just one week, the PIMA Heart Team saw 177 patients with 176 echos and 9 patients identified for surgery back in the U.S.

“We are really proud of our professional team members who volunteered time and expertise in helping the good people of Kiribati, where the need it great,” said Carlton Smith, president of Pacific Islands Medical Aid.

The physician and medical officer in charge for the Kiribati Ministry of Health on Christmas Island, Dr. Teraira Bangao, says ‘the team worked very hard when they were here… they did a great job… starting out each day at 8:30 a.m. and working straight through to 6 p.m.”

“We are so thankful to the team members and everyone at Pacific Islands Medical Aid and look forward to their next visit,” he said.

In this humanitarian outreach, Dr. Moore and his team of heart surgeons at Cardiac Specialists in Plano, Texas and Baylor Scott White Heart Hospital in Plano will provide surgeries and hospitalization for the patients, while Pacific Islands Medical Aid provides all housing, meals and local transportation in the Dallas area for the patients and their chaperones, and the Kiribati Ministry of Health provides round trip airfare.

Please help support this life-saving program with your donation. Here is Dr. Moore’s report.

By Dr. David Moore, M.D.

Rheumatic heart disease remains a major global health concern primarily affecting young adults in the developing world.

This is particularly true in many of the islands of the central and western Pacific.

Our team from Baylor Scott White Heart Hospital in Plano, Texas recently returned to Kiritimati (Christmas Island) in the Republic of Kiribati with the support and coordination of Pacific Islands Medical Aid.

 

Team members included Dr. David Moore, CV surgery; Dr. Steve Mottl, cardiology; Michael Rampoldi, echo cardiographer, Candice Rampoldi, echo assistant and echo data collection; Amy Moore, trip coordinator and data management; Sherry Swanson, Baylor Heart Hospital social services; and Tom Roma, school education program.

Little Ones Included: All islanders, young and old, showing signs of possible heart disease were checked out by our volunteer heart team on their most recent visit to Christmas Island in Kiribati, where nine were identified for life-saving heart surgery back in the U.S.

Little Ones Included: All islanders, young and old, showing signs of possible heart disease were checked out by our volunteer heart team on their most recent visit to Christmas Island in Kiribati, where nine were identified for life-saving heart surgery back in the U.S.

In the course of our week on the island, we functioned as two teams; one evaluating patients in the clinic at Ronton Hospital and the other focusing on education regarding prevention of rheumatic heart disease (RHD) as well as echo screening in the primary schools.

Echo screening of asymptomatic children allows for early detection of RHD with the identification of subtle abnormalities in the heart valves. Children with these findings can then be started on prophylactic penicillin injections preventing subsequent episodes of Strep Throat and thus avoiding further immune response and valve damage.

A total of 950 children were screened by our team over a period of four days. At the same time, children, teachers and some parents received education on the prevention of RHD, emphasizing hand washing, appropriate coverage for cough, and the need to see a physician or nurse for treatment of sore throats.

At the clinic, our team evaluated and obtained an echo on 175 patients. Two children with congenital heart disease were identified, three adults with probable coronary artery disease and eight patients with rheumatic heart disease were diagnosed.  The adult patients will be brought to Baylor Scott White Heart Hospital in Plano, Texas for additional testing and surgery. The children with congenital heart disease will be referred to an appropriate facility for surgical correction.

Our team appreciates the opportunity to continue this good work made possible by Baylor Scott White Health Care System, the Republic of Kiribati Ministry of Health and Pacific Islands Medical Aid.

We are grateful to the people of Kiritimati (Christmas Island) for their warm hospitality and support.

Children from Tarawa Get Heart Surgery

For the parents of 2 year old Iotua Nenetaake and Bwabwane Meeia, 10, it’s a dream come true that their children have been saved, thanks to the efforts of Pacific Islands Medical Aid, the leader of HeartGift Texas and heart surgeon Dr. Camile Hancock Friesen at Dell Childrens’ Medical Center of Central Texas in Austin.

Ready to Go Home - Children from Tarawa in Kiribati are ready to go home after successful heart surgery in Austin, Texas. Sitting between children is their heart surgeon, Dr. Camile Hancock Friesen of Dell Childrens Medical Center of Central Texas. Second from right is Sonya Keeling, International Director of HeartGift of Texas, who arranged help for the children. Others include parents of the children and Kiribati Ministry of Health nurse/translator.

Ready to Go Home – Children from Tarawa in Kiribati are ready to go home after successful heart surgery in Austin, Texas. Sitting between children is their heart surgeon, Dr. Camile Hancock Friesen of Dell Childrens Medical Center of Central Texas. Second from right is Sonya Keeling, International Director of HeartGift of Texas, who arranged help for the children. Others include parents of the children and Kiribati Ministry of Health nurse/translator.

The children, their mothers and Kiribati Ministry of Health nurse have now all returned to their home island of Tarawa in the Central Pacific following successful heart repair surgery for both children.

Congenital heart problems for each child were first discovered by our volunteer heart team leader, cardiothoracic surgeon Dr. David Moore of Baylor Heart Hospital in Plano, Texas and his team, traveling to far-away Tarawa last year.

Surgery was made possible with the help and leadership of Ms. Sonya Keeling, national patient coordinator for HeartGift Texas, who’s efforts made it possible for the children to come to Dell Childrens’ Medical Center.

Ms. Keeling said both children “were amazing in their recovery from surgery. Having them here has been such a great experience for all of us involved,” she said.

Heart Team: More Than 40 Saved

More than 40 lives have been saved to date by our Pacific Islands Medical Aid heart surgery program, thanks our donors, the leadership of cardiothoracic surgeon Dr. David Moore of Baylor Scott White Heart Hospital in Plano, Texas and dozens and dozens of great volunteers.

What began as an outreach to Christmas Island in the isolated nation of Kiribati several years ago has grown to encompass the wider island nation of 33 islands in the Central Pacific where many young patients suffer with heart valve disease, brought about by untreated rheumatic fever when they were very young.

“Among all of the medical programs we have undertaken,” I think we are most proud of the heart surgery initiative,” said Carlton Smith, PIMA president.

With the help and support of the Kiribati Ministry of Health, our team has visited the islands with diagnostic tools to identify the most urgent cases and arrange for them to be brought to the U.S. for open heart surgery, Carlton said. Team members, led by Dr. Moore, include cardiac sonographer Michael Rampoldi of Baylor Scott White and nurse Amy W. Moore.

Your donations have allowed us to provide housing, at Homewood Suites in Plano, meals and local transportation, while dozens of supportive surgeons working with Dr. Moore and medical professionals at Baylor Heart Hospital have pulled together to make this happen.

“It is our hope to be able to return early next year to Christmas Island and neighboring isolated… and seldom visited… outer islands of Tabuaeran and Teraina,” Carlton said.

HeartGift Austin to the Rescue

Two little children diagnosed with congenital heart defects by members of our PIMA Heart Team in Tarawa late last year will be literally saved by HeartGift Austin this month.

Under the direction of HeartGift’s national patient coordinator Ms. Sonya Skilling, the two patients, their mothers and Kiribati Ministry of Health nurse are scheduled to arrive in Austin Oct. 15 so that the children can have life-saving heart surgery there.

Two year old Iotua Nenetaake, a little boy from the isolated atoll in the Central Pacific called Nikunau, was diagnosed with a ventricular septal defect.

Bwabwane Meeia, 10, from the island of Tarawa, was also found to have a congenital heart defect.

“We are forever grateful to HeartGift Austin and Ms. Skilling for organizing and underwriting this life-saving effort”, said Carlton Smith, PIMA president.

Shriners Honolulu Helps Little Boy Who Walks On His Knees

Bandages Off - With surgeries on Iokabwa's hand and arm completed, bandages come off.

Bandages Off – With surgeries on Iokabwa’s hand and arm completed, bandages come off.

For years now, every time one of our Pacific Islands Medical Aid team would visit Christmas Island in Kiribati, we would encounter Iokabwa. a little boy who walks on his knees.

He would move about sometimes while sliding on the ground on pieces of cardboard, a task made much more difficult because his hands and wrists were turned inward, a condition he was born with.

Iokabwa’s mother has appealed to us over the years for help. We recorded his condition and consulted with many orthopedic surgeons and others… to no avail.

We encouraged members of Shriners Hospital for Children in Honolulu, and its leader, Dr. Craig Ono, to visit the island and examine patients who might be helped by them.

 

Iokabwa on Arrival - Iokabwa arrives at Shriners in Honolulu with his mother (at right). On left is PIMA hostess Nei Rerei Timon.

Iokabwa on Arrival – Iokabwa arrives at Shriners in Honolulu with his mother (at right). On left is PIMA hostess Nei Rerei Timon.

Dr. Ono believed then that Iokabwa could be helped and held out hope that with proper care, he could walk upright. Hand surgeries, too, could help.

Iokabwa has now been through several surgeries at Shriners Hospital, with emphasis first on his hands. Surgeries underway now are concentrating on his legs, where surgeons there believe he will be able to stand upright soon.

“It’s a miracle,” his mother says.

We are enormously grateful to the wonderful people at Shriners Hospital in Honolulu for Iokabwa and other children from the central Pacific island nation of Kiribati who they have helped, says Carlton Smith, PIMA president.

Under an agreement made three years ago, Shriners provides all medical care, the Kiribati Ministry of Health provides round trip airfare and we at Pacific Islands Medical Aid pay for local housing, meals and transportation when needed, provided by a wonderful couple in Hawaii, Rerei and Kaitibo Timon.

Please help us continue to support this great program, Carlton said.

All Successful, Heart Patients Head Home

Thanks to the efforts of dozens of hospital personnel and other volunteers, six more critically-ill heart patients from the central Pacific nation of Kiribati are now well and back home again.

Open-heart surgery at Baylor Heart Hospitals in Plano and Denton, Texas saved them all.

This third group of heart patients from Kiribati will now be followed by another group of five, scheduled to arrive in Plano later this month. Each group must remain in the U.S. for about a month to allow sufficient time for post surgery recovery. Most all will require heart valve repair or replacement.

All of this is made possible by the dozens of hospital physicians, nurses and others at Baylor Heart Hospitals, your donations to Pacific Islands Medical Aid (PIMA), and the Kiribati Ministry of Health.

Surgery Follow-Up - Team leader Dr. David Moore, MD, checks his patient immediately after surgery, along with Kiribati Ministry of Health chaperone Nurse Taabiti Anrake, who accompanied the patients from Tarawa.

Surgery Follow-Up – Team leader Dr. David Moore, MD, checks his patient immediately after surgery, along with Kiribati Ministry of Health chaperone Nurse Taabiti Anrake, who accompanied the patients from Tarawa.

Humanitarian team leader, cardiothoracic surgeon Dr. David Moore, MD of Cardiac Surgery Specialists in Plano, Texas, joined by cardiac sonographer Michael Rampoldi and nurse Amy Moore, together with PIMA president Carlton Smith, traveled to islands in Kiribati last October to locate and diagnose seriously-ill heart patients there.

More than 40 patients were identified, mostly suffering with heart valve disease, brought about by early and untreated rheumatic fever.

The trip to the U.S. for patients is an eye-opening one, considering most have never left their home village. Patients must get from their home island by boat or plane to the Kiribati capital of Tarawa, then fly from Tarawa to Nadi in Fiji. From NadI, they are bused four hours to Suva and interviewed the following day at the U.S. Embassy to get their U.S. visas.

From Suva, they go back to NadI and fly onward to Los Angeles and then to Dallas.

Going Home Celebration - Kiribati heart patients and friends join together for a going-home celebration hours before their departure from Dallas, sponsored by Ms. Sherry Shaw (at right), heart valve specialist with On-X Life Technologies, donors of the On-X heart valves. Also in back row is team leader and cardiothoracic surgeon Dr. David Moore, MD and PIMA president Carlton Smith.

Going Home Celebration – Kiribati heart patients and friends join together for a going-home celebration hours before their departure from Dallas, sponsored by Ms. Sherry Shaw (at right), heart valve specialist with On-X Life Technologies, donors of the On-X heart valves. Also in back row is team leader and cardiothoracic surgeon Dr. David Moore, MD and PIMA president Carlton Smith.

“We owe special thanks to personnel at the U.S. Embassy, and especially to vice consul Mr. Jeremias Dirk in Suva who has gone out of his way to expedite the visa process for these urgent heart cases,” said PIMA president Carlton Smith.

Invaluable help has also been provided by Ms. Sherry Swanson, LMSW, manager of Comprehensive Care Management for the Baylor Heart Hospitals in Plano and Denton, Texas, who has helped organize and coordinate surgery schedules, and patient care.

Heart Surgeries Save Islanders

Life-saving heart surgeries for islanders from the nation of Kiribati in the Central Pacific have now been completed at Baylor Heart Hospital in Plano, Texas and at Medical City Hospital for Children in Dallas.

Team Leaders: Our team leader,Dr. David O. Moore, MD, cardiothoracic surgeon with Cardiac Surgery Specialists, attached to Baylor Heart Hospital in Plano, Texas is shown with Kiribati Dr. Baranika Temariti, OB/GYN, who accompanied the eight heart patients to Texas from Christmas Island (Kiritimati).

Team Leaders: Our team leader,Dr. David O. Moore, MD, cardiothoracic surgeon with Cardiac Surgery Specialists, attached to Baylor Heart Hospital in Plano, Texas is shown with Kiribati Dr. Baranika Temariti, OB/GYN, who accompanied the eight heart patients to Texas from Christmas Island (Kiritimati).

By this writing on June 17, all surgeries have been completed successfully, mostly for heart valve replacements, according to Carlton Smith, PIMA president.

Dr. Baranika said, “this has been a remarkable undertaking, for which we and all the people of Kiribati are grateful.”

“Plans now call for all patients to continue their recovery in the Dallas area and return to their home island July 5,” Carlton said. “One patient, who received two artificial heart valves and began recovery, developed pancreatitis several days after surgery and will be required to remain behind for recovery and rehabilitation,” he said.

Dr. Moore, with the help of cardiac sonographer Michael Rampoldi, diagnosed these eight heart patients on an earlier expedition to Christmas Island in the Line Island group of Kiribati and recommended urgent surgery to save their lives.

With help from officials at U.S. Customs and Border Protection, and with all documentation, special visas were granted the group on humanitarian grounds.

Most have suffered the effects of untreated rheumatic fever which attacks the heart valves years after initial infection, so that parents who don’t seek medical attention when their infant contracts rheumatic fever, or if antibiotics are not available… the disease lingers, sometimes for years before heart valve damage is discovered.

“For these fortunate islanders diagnosed by Dr. Moore and Michael, prospects for a long, normal life are now good,” Carlton said.

Here is Benateeta exiting surgery, and with cardiologist and Dr. Baranika three days after surgery. She should be released this Friday, after Coumadin levels are achieved.

Here is Benateeta exiting surgery, and with cardiologist and Dr. Baranika three days after surgery. She should be released this Friday, after Coumadin levels are achieved.

Among the patients is 13-year-old Benateeta Kamon, who received aortic and mitral valve replacements in a surgery at Medical City Hospital for Children in Dallas by pediatric cardiology surgeon Dr. Eric Mendeloff. The surgery lasted seven hours and required expansion in the heart to accommodate an adult size artificial heart valve. “She is out of the hospital and doing great,” Dr. Baranika said. “Hats off to Dr. Mendeloff, his team, and Medical City Hospital.”

Notia Remweru, 43, needed a new battery for her pacemaker, which she received at Baylor by Dr. Alistair Fyfe, MD. When told that her new battery will now last for about seven years, she said she was disappointed that the doctors didn’t put a new battery in that would last for only one year … so she could return to Texas once a year!

Baintaake Atanibeia is just 26, is married with two children and comes from a very remote island called Teraina… with no electric grid, no running water and seldom called on by a passing ship. Baintaake received an aortic valve replacement, bounced back from open-heart surgery, is feeling great and awaiting her trip home.

“Heart surgeons at Baylor Heart Hospital, including Dr. Moore in the lead, together with Dr. Katherine B. Harrington, M.D., Dr. Robert L. Smith, M.D., and Dr. William T. Brinkman, M.D., deserve our eternal gratitude for saving the lives of these wonderful young people,” Carlton said. “And that goes for all the nurses, staff members and Baylor Heart Hospital.”

Bwarereiti Bwatika, 29, received two artificial heart valves, but remains hospitalized with pancreatitis. His heart is now strong.

Team Leaders: Our team leader,Dr. David O. Moore, MD, cardiothoracic surgeon with Cardiac Surgery Specialists, attached to Baylor Heart Hospital in Plano, Texas is shown with Kiribati Dr. Baranika Temariti, OB/GYN, who accompanied the eight heart patients to Texas from Christmas Island (Kiritimati).

Team Leaders: Our team leader,Dr. David O. Moore, MD, cardiothoracic surgeon with Cardiac Surgery Specialists, attached to Baylor Heart Hospital in Plano, Texas is shown with Kiribati Dr. Baranika Temariti, OB/GYN, who accompanied the eight heart patients to Texas from Christmas Island (Kiritimati).

After several days in the hospital following open-heart surgery for two heart valves, Rawaa Tebeia, 46, is now bouncing back, despite her previous heavy smoking and damage to her lungs.

Young Mary Olivia Itaaka, 23 and the mother of two, is recovering fast after two new heart valves. School teacher Ueaata Tekaiti, 40, who now has a new aortic and mitral valve, is also doing great.

Patrick Rikaua, 28, was born with a hole in his heart, but with corrective open-heart surgery, can now look forward to a long, normal life.

“We are absolutely thrilled and grateful to those wonderful physicians, nurses, hospital staff members and the hospitals that made all of this possible,” Carlton said.