Wednesday, April 9, 2008

From Paul Farmer, MD, co-founder of Partners In Health

Paul Farmer surprised Team Heart with a visit to King Faisal Hospital this week. Above, he and Ceeya Patton-Bolman greet Alice, who underwent mitral valve replacement the day before.

“Blog” from the mountains of Northern Rwanda

It was awesome—not a word I use lightly—to stand in the anesthesiologist’s spot (“behind the blood-brain barrier,” they used to say at the Brigham) and to watch Chip Bolman and an ace team from BWH cannulate the aorta of a 26-year-old man about to undergo mitral valve replacement (Prem Shekar has already done a big case that morning, so this was the second one of the day).

I’d had the good fortune to transport Jean-Claude Muhozi from rural southern Rwanda, where he lives in a refugee camp, to King Faisal Hospital, where “Team Heart” is repairing the valves and lives of many young Rwandans this week. It was awesome medically, as it always is when the pericardium is opened; it was awesome personally, as someone who has fought alongside many others to make sure that quality medical care be made available to the poorest; and it was awesome spiritually to see, on the exact anniversary of the 1994 genocide, that the power to heal continues to trump the power to maim, sicken, or kill.

Who knows what Jean-Claude, who lives in a tattered refugee camp with his brothers, has gone through even prior to falling ill with valvular heart disease that has made him cough and gasp for breath for years?

It was of course great to see nurses and doctors and techs and PAs from the Brigham, some of whom I’ve known for almost 20 years, here in Rwanda; indeed, a couple of them had been to our site in Haiti too. The members of this team are not only saving the lives they touch here—for who could imagine that a young man like Jean-Claude would have a chance without a team like this, providing its services free of charge to the patient?—but are also serving as living links between Boston and Rwanda. The members of this team are reminding people here in central Africa and in my native country that to be poor and sick should not mean a death sentence. The members of this team have done nothing less than lift a death sentence from those served, all of them symptomatic and facing grim prospects, at the same time that they have lifted the spirits of the patients, families, staff, and students here in Rwanda.

Two nights previously, we had a small dinner with the senior surgeons of Team Heart, some friends from the Ministry of Health, and members of the Partners In Health team based here in Rwanda. We had a nice meal and some toasts. The most moving one, for me, was from Dr. Innocent Nyaruhirira, who as a young orthopedic surgeon finishing his training in Belgium decided to return to his native Rwanda in 1994 while this continent’s worst mass violence was in full swing. Although his teachers counseled him to remain in Belgium, he returned to care for trauma victims of all sorts (landmines were then a huge problem here). He recently served in the Rwandan cabinet at the level of Minister and has been, since prior to PIH began working here in 2005, one of our best friends here; he’s now the Executive Director of KFH. He raised his glass to the team from the Brigham and reflected on the mass violence that had interrupted his training, noting only that, as a physician, he could think of nothing more important than seeing that efforts like those launched this week continue to flourish.

There: this is my very first blog entry, and I hope I’ve done a decent job. I’m now up at one of our rural sites high in the mountains of northern Rwanda. I’m so grateful to Ceeya Bolman, Leslie Sabatino, our own Gene Bukhman and all the others, including the staff at KFH, who made this miraculous week come to pass. Those of us who are “implementers” in the field understand, I think, some of the complexities around logistics and procurement that you’ve had to address and overcome. We join the patients served, and their families and caregivers, to say Murakoze cyane—thank you so much!
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