Heart Failure in Rwanda

Heart failure leaves thousands of young Rwandans literally gasping for breath and slowly suffocating for years on the brink of death with little access to the life-saving surgery they desperately need.

The heart failure patients Team Heart will operate on beginning this weekend were screened and identified by cardiologist Gene Buhkman, MD, of Partners In Health (PIH) and Brigham and Women’s Hospital, who works six months of the year in Rwanda treating patients.

PIH first became involved in Rwanda in 2005, working with the support of the government to improve the country’s rural health systems.

“We found that a huge portion of the patients we saw in the hospitals and clinics had heart failure,” Bukhman said. “The causes of the disease here are very different than in Boston and the rest of the U.S., where most heart failure patients are elderly.”

In Rwanda, the average age of a patient with heart failure is 35. The disease mainly results from cardiomyopathies not caused by heart attacks, and two causes virtually eradicated in the U.S. thanks to available treatments: malignant hypertension, or skyrocketing blood pressure, and rheumatic heart disease, caused by untreated strep throat.

“There is a lot we can do for these patients, even after they have been deprived of health care for so long,” Bukhman said. “We are working to prevent new cases from occurring by making medication available. For patients with advanced rheumatic heart disease, surgery is the best option.”

But few hospitals in sub-Saharan Africa have the capability to perform heart surgery.

Bukhman said that Joseph Mucumbitsi, MD, the only pediatric cardiologist in Rwanda, and the Rwandan Ministry of Health are steadfast in their commitment to get heart failure patients the care they need by sending them outside of the country for surgery when possible and opening King Faisal Hospital’s doors to groups like Team Heart and Operation Open Heart, an Australian cardiac surgical team.

“Cardiac surgery is not affordable for anyone in the country,” Bukhman said. “And there are many barriers to ensuring good outcomes after surgery. One of the great things about Team Heart is that it also is committed to helping remove other obstacles patients face that could prevent them from staying healthy after surgery.”

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