By Alice Reid
Friday, December 28, 2007
Three-year-old Caroline wanted nothing to do with her cardiologist.
"Wanna listen to my heart?" he asked, offering his stethoscope. She snuggled into her mother's lap, giving him a sideways glance as if to say, "I've had enough of your tricks."
Caroline Mwahulhwa had come a long way -- from Uganda, in fact -- to see Craig Sable at Children's Hospital. And Sable, along with Richard Jonas, a cardiac surgeon at Children's, probably saved her life with a fairly straightforward operation.
Sable is part of the hospital's global reach. Every year, he and a team of heart specialists from Florida and North Carolina go to Uganda, where the group performs surgeries and helps African doctors identify and treat children with congenital heart defects.
As director of telemedicine at Children's, Sable also consults and lectures, usually via video teleconference, with doctors from Africa to Iraq -- and as close as St. Mary's County.
Surgery for a whole raft of heart problems in children is all but routine in this country. Not so in the developing world, where many children die of cardiac complications. Sable wants to change that.
"Our goal is to identify treatable and curable heart defects in children that without repair will usually kill them," Sable said before he examined Caroline recently. "There are probably 5 million such children worldwide, and probably 1,000 in Uganda.
"My goal is to find those children and try to fix them."
Under the auspices of the Children's Heart Project, a privately funded foundation, the team has also brought dozens of Ugandan children to the United States and Europe for heart surgery. The only requirement: that the case be simple enough for the child to return home without needing complicated follow-up care.
Caroline was such a child.
"We met Caroline in March and found that she had an abnormal blood vessel leading from her coronary artery to the right side of her heart, sending a lot more blood to the heart than normal and making it pump harder," Sable said.
Typical of youngsters with heart defects, she'd suffered recurrent illnesses and hadn't grown normally.
By late October, Caroline and her mother, Rebecca, had arrived here and were staying with a Fairfax County family while preparations were made for Caroline's surgery. The operation, performed a few weeks ago, went smoothly, and she recovered quickly.
According to Sable, she should face no more operations.
"I think she'll get fewer infections, and she'll have more energy," Sable said as a bright-eyed Caroline skittered around her mother's chair, engaged with a talking plastic toy.
Sable looks forward to returning to Kampala -- a journey that requires two eight-hour flights ("None of us goes business class") -- to continue training doctors there in pediatric cardiology. On a recent visit, the American team guided Ugandan doctors as they performed two operations. Then the African surgeons observed the Americans.
"Children's has been incredibly supportive making physicians' time available, and surgeon's time," Sable said.
The hospital plays a major role not just in this Ugandan effort but in other corners of the world via video and computer technology that allows doctors in the District to interpret medical tests or beam medical lectures across the globe.
One lecture that Sable beamed to Baghdad required its audience of Iraqi doctors to spend the night at their hospital. Because of the eight-hour time difference, the lecture ended after the 5 p.m. curfew, and no one could leave.
"Those physicians still crave collegiality. They want to maintain practice standards, and they want to keep things going as best they can," Sable said.
Meanwhile, Sable will continue his work in Uganda, hoping that one day the Carolines in that country won't have to travel 7,200 miles to have their little hearts repaired.
How to Help
Most patients at Children's don't have to travel thousands of miles to get the help they need. They live right in the Washington area, and, under Children's open-door policy, none is turned away because a family lacks insurance or the means to fully pay the bill. Last year, the hospital absorbed $50 million in uncovered expenses delivering world-class medicine to every child who needed it.
That's what this campaign is all about: raising money to help defray costs like those.
So far, our readers have been very generous, contributing $115,950.31. But we still have a way to go to meet our goal of $500,000 by Jan. 18.
Please help by mailing a check or money order to Washington Post Campaign, P.O. Box 17390, Baltimore, Md. 21297-1390. Make it payable to Children's Hospital.
To donate online with a credit card, go to http://www.washingtonpost.com/childrenshospital.
To contribute by phone using Visa or MasterCard, call 202-334-5100 and follow the instructions.
All gifts are tax-deductible, as allowed by law.
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