Mission accomplished by Chain of Hope

The recently completed joint mission by Chain of Hope UK and Chain of Hope Jamaica to facilitate six cardiac operations at the Bustamante Hospital for Children is being hailed a success.

This, despite the fact that four children slated for surgeries did not get their chance at the lifesaving intervention given the complexity of some operations which took longer than projected, as well as the situation of some of the patients falling ill.

Paediatric cardiothoracic surgeon Dr Sherard Little explained that with many respiratory viruses circulating, children presenting with coughs, colds and runny noses, is common in this season, and is not unique to Jamaica.

“If you have an upper respiratory tract infection, surgery usually has to be postponed because if you do any major surgery when a child has a cold, it increases the risk of the procedure. So what was happening was that a lot of the patients we had previously identified for surgery had to be cancelled because a lot of them came down with colds just before the surgery. And usually after you have a cold, you need to have recovered for about three weeks before we consider you for an operation, in general. So quite a few of our patients would have suffered that fate.”

One of the surgeries which was performed for the first time in Jamaica was the correction of a condition known as ALCAPA which is an acronym for Anomalous Left Coronary Artery from the Pulmonary Artery, a congenital heart defect in which the left coronary artery arises abnormally from the pulmonary artery. Left untreated, ALCAPA has a mortality rate of up to 90 per cent.

The operation was high risk, according to Dr Little but in this patient the heart function was well preserved and so the procedure went very well

“They went through the surgery without complication but generally speaking a lot of these children are very sick and if they don’t receive surgery in a timely fashion they are likely to die. This child was fortunate that we had the expertise in terms of the surgical and intensive care team to get the patient through the operation and now she is doing well, having been discharged and is at home.”

KNOWLEDGE TRANSFER

Dr Little who is also a director of Chain of Hope Jamaica explained that everyone benefits from these missions with the intense level of knowledge transfer between the local and visiting teams being a highpoint. “There is knowledge transfer between the nurses, perfusionists and between the different doctors - the surgeons, anaesthetists and the intensive care doctors. So that’s what it’s all about – persons learning from each other and by so doing we are building the local team so that we can do some of the more complex stuff outside of missions.”

Different types of blood in adequate volumes had to be identified and available at short notice, if needed – for the successful completion of the surgeries.

And with each patient needing about three to four units and 10 surgeries scheduled, between 30 and 40 units of the precious fluid had to be on hand for the mission. However, for each mission this creates a challenge since Bustamante Hospital does not have a blood bank and the National Blood Transfusion Service (still referred to as the Blood Bank) is located at 21 Slipe Road, in downtown Kingston, a little over three miles away.

“So if we need blood in a hurry, we can’t get it from the Blood Bank because of distance. So that is why we have to have the blood on-site, even though we don’t necessarily use it because a fair amount of the blood is returned. We have to have it available before starting surgery because you never know when you will need it and if you do need it, usually you need it in a hurry,” Dr Little pointed out. “But the Blood Bank has always facilitated us, they have been very cooperative in trying to make blood available to us.”

In a separate interview, Nola Phillpotts-Brown, general manager of Chain of Hope Jamaica, shared that sourcing adequate blood for patients is an ongoing challenge but the National Transfusion Service always assists the Bustamante Hospital for Children. She used the opportunity to make an appeal to Jamaicans.

“If you are able to, please donate blood. Just say you are donating to Bustamante Hospital for Children because on any given day, for any procedure, whether cardiac, orthopaedic or any other area, they will need blood and so we encourage you to give blood.”