For 15 years, a team led by Dr. John D. "Jack" Rose, a cardiologist and professor in the Department of Cardiovascular Sciences at the Brody School of Medicine at East Carolina University, has been healing hearts and more in Nicaragua.
Rose, Dr. Harry Adams, an infectious disease specialist; Dr. Theodore C. Koutlas, a heart surgeon; Dr. David Hannon, a pediatric cardiologist; and others have worked to establish a partnership with the medical school in the bustling city of León. This relationship enables them to offer specialized medical care in Nicaragua that would be unavailable otherwise, as well as frequent mission opportunities for medical students and residents.
The team usually makes two trips a year, each about two weeks long. The first is in September and involves evaluating patients with valve and congenital heart disease and bringing down a surgical team to perform open-heart surgery. The second trip is in February. It involves general clinics as well as cardiology.
In addition, students round in the local hospital. The teams attend a weekly HIV clinic operated by the infectious diseases specialist there. They also spend time in community clinics in León or neighboring towns.
In September a team of ECU physicians traveled to Nicaragua where they performed cardiac surgeries and helped train the local physicians in medical procedures.
Koutlas is typically accompanied byDr. Curtis Anderson, a cardiothoracic surgeon and ECU associate professor; perfusionist Bill Hodges, and other surgical team members from ECU and Vidant Medical Center. All who go on the trips do so at their own expense.
Koutlas is leaving ECU at the end of the year butplans to continue this project along with Anderson and the Vidant surgical team.
Brody faculty members who work out of León are members of Project Health for León, an effort organized by Dr. John Paar, a Raleigh cardiologist who established the cardiology program in León years ago. The organization aims to train Nicaraguan medical professionals, provide specialized medical care to Nicaragua and offer educational experiences in Nicaragua to American medical students and other medical professionals.The project also organizes several cardiac surgeries donated by Vidant Medical Center and local physicians for Nicaraguans who require the more extensive resources available here.
This past Sept. 14-18, the team saw 350 adults and children, most with serious valvular and congenital heart disease. The surgical team performed 11 operations in five days, mostly valve replacements. Over the years, they have completed 105 open-heart procedures with a success rate of more than 98 percent.
Nicaragua is the second-poorest nation in the Western Hemisphere. With a population of 6 million, 48 percent live below the poverty line, and 80 percent subsist on less than $2 dollars a day, Rose said. The government provides universal medical care, but funds and resources are meager.
For example, the university hospital in Leon has no CT scanner and provides only basic laboratory services, Rose said. Rheumatic fever and rheumatic heart disease, now rare in the United States, are common afflictions there, and rheumatic heart disease is the most common heart-related cause of death in young people in developing nations.
Nicaraguan physicians are intelligent and capable, but lack facilities for advanced training, Rose said. No cardiology or pediatric cardiology training programs exist in the country, and physicians who seek this education must travel abroad.
"Each journey reinforces just how fortunate we are," Rose said. "Sometimes, friends and colleagues ask, 'Why do you travel all the way to Nicaragua when the medical needs in eastern North Carolina are so great?' We hope that we help to satisfy these needs in our daily work and in our volunteer activities here. But Nicaragua is a special case. There, the medical problems are so great and the resources so limited that it is difficult for Americans to comprehend."
In addition to providing a service, the trips are educational. ECU medical students receive elective course credit for participating. ECU nursing students also travel to Leon, and Dr. Donna Lake and Debra Kosko of the College of Nursing have started a teaching and research program with the Universidad Nacional Autónoma de Nicaragua-Leon School of Nursing. Next year the ECU School of Dental Medicine might participate on the project.
In addition, twoNicaraguan medical students come to ECU each year for a six-week rotation in medicine or surgery; a total of seven have done so to date.
For 10 years, ECU nurse Donna Lou Edwards has worked on Project Health for Leon. She travels to the country for two weeks each year, paying her own way, organizing a surgical clinic that helps people with heart valve disease who otherwise would most likely not receive medical care. "My first experiences there changed my life and have made me a better person and nurse," she said recently.