Abstract
In low and mid-income countries, there has been a 50% global decrease in the incidence of preventable deaths of children since 1990. However, the mortality from non-communicable diseases (NCD) such as congenital heart disease (CHD) has not changed. Of the estimated 1.3 million children born with CHD annually, over 90% do not have access to cardiac care. With the increasing fertility rates in sub-Saharan Africa, the health burden of CHD will increase as well. Over the last 30 years much has been achieved with short term cardiac medical missions. However, much remains to be done to provide long term solutions needed to achieve the sustainable development goal of reducing deaths of children <5 years of age. This review discusses the present status and the need for a paradigm shift to achieve long term sustainability.
Highlights
The global population is approaching 8 billion
Of the estimated 1.3 million children born with congenital heart disease (CHD) annually, over 90% do not have access to cardiac care
Over 70% of the facilities reach
Summary
The global population is approaching 8 billion. Over the last few decades progress has been made in reducing maternal and child mortality as well as diseases such as malaria, tuberculosis, and HIV. They identified several key areas needing attention for a successful medical mission They include: (1) Background study of the host country, (2) Identifying a dedicated host team with definable leader, (3) A Memorandum of Understanding (MOU) which stresses the exit plan, (4) Government help must be included, (5) Consider reliable NGOs for low cost items as well as locally available disposables and devices, (6) Successful programs depend on vision, appropriate skill sets, accessibility, availability, awareness, affordability, and action plan. They conclude that humanitarian, medical, and surgical outreach activities should focus on education and sustainability reserving “surgical tourism” for those countries that will likely never have the capability to have free standing cardiothoracic programs (9).
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