Published August 1, 2023
National Heart Foundation Hospital and Research Institute (NHF) welcomed Children’s HeartLink medical volunteers to Dhaka, Bangladesh in May 2023. This training visit included a pediatric cardiologist and pediatric heart surgeon from Leeds Children’s Hospital in the U.K. During the four-day training visit, the teams had fruitful discussions on complex cases that the NHF team was handling and mentorship was offered in the Operating Room and Catheterization Lab.
NHF is partnering with Children’s HeartLink to establish itself as a regional training center that can educate more healthcare professionals in the country on how to provide care for children with congenital heart disease (CHD). According to estimates, Bangladesh witnesses the birth of around 49,000 infants every year who have congenital heart disease, and roughly 25% of them will require surgical intervention.
These pictures provided by Sam Flynn, our director of marketing and communications, give us an inside look at a Children’s HeartLink partnership training visit in Bangladesh.
Afsana welcomed the Children’s HeartLink team and volunteers upon arrival at the airport and with travel to the hotel. Pictured: Tom Okins with Don’t Blink Productions, Adriana Dobrzycka with Children’s HeartLink, Afsana with National Heart Foundation and Sam Flynn with Children’s HeartLink.
Prof. Dr. Jamie Bentham, one of the trip’s medical volunteers and a pediatric cardiologist with Leed’s Children’s Hospital, brought supplies for NHF’s catheterization lab which could no longer be used in the U.K. Together with the cardiologist team at NHF, interventions on children with heart disease had already been discussed and planned for this visit.
The first day of the training visit included a warm welcome from Prof. Dr. Mohammad Sharifuzzaman, senior pediatric cardiac surgeon with NHF. He is standing with Children’s HeartLink medical volunteers Dr. Osama Jaber, pediatric cardiac surgeon, and Prof. Dr. Jamie Bentham, pediatric cardiologist.
Many members of the pediatric cardiac care team and the medical volunteers gathered in a conference room for case discussions. A time to discuss the heart defect anatomy, care and next steps for several patients with congenital heart disease. These case discussions guide the training visit for the next couple of days while also enhancing the team’s decision-making and case prioritization skills. The NHF provides specialized care to approximately 2,000 children with heart disease in the country each year.
One of the many challenges for families is they must travel many miles and spend hours to reach the city of Dhaka for pediatric heart care. Here the teams from NHF and Leeds Children’s Hospital are looking at the child’s heart using an echocardiogram machine. This was an opportunity for the two teams to discuss the patient based on the information presented and then review the patient together to confirm diagnosis and treatment.
After discussing patients, Dr. Jaber headed to the operating room (OR) where he led the surgery on a baby with multiple congenital heart defects. NHF is the only hospital in Bangladesh able to perform this very complex surgery.
In the OR, or as Dr. Jaber calls it the “Theatre,” he could be heard explaining what he was doing, why he was asking for a specific tool and inviting questions. This was creating a learning environment and promoting a multidisciplinary team approach to care. A multidisciplinary team approach is when a team of clinicians work together to deliver coordinated care and support with the patient’s needs at the core, before, during and after treatment is delivered.
While Dr. Jaber was in the operating room, Children’s HeartLink Country Director Adriana Dobrzycka spent time in the pediatric intensive care unit (PICU). Pictured: Dr. Kamrun, an ICU registrar who is an intensivist in training, Adriana Dobrzycka, and Shilpi, one of the two charge nurses.
NHF has three pediatric intensive care units or PICU rooms. This room is where children stay immediately following their heart surgery. There are 8 to 12 beds with 1-on-1 care with one nurse to one child. Approximately 800 children a year will stay in this room, which is how many children NHF operates on each year.
Children fill the beds of the other two PICU rooms. Mothers can visit their child for only a couple of hours a day. When they are not visiting, the nurses keep the children comfortable and provide toys for them to play with. A child’s stay in this room can last several days to several weeks.
Prof. Dr. Abul Kalm Shamsuddin, senior pediatric cardiac surgeon and lead on the Children’s HeartLink partnership, meets with Adriana, in the PICU.
When he is not in the operating room, Prof. Dr. Abul Kalm Shamsuddin, pediatric cardiac surgeon, meets with families of children with congenital heart disease to advise them on next steps and talk through the options available. In Bangladesh, barriers to receiving care may include cost of care, travel to and from the hospital as well as patient waitlist.
Even during breakfast one morning, medical volunteers Dr. Osama Jaber and Prof. Dr. Jamie Bentham were discussing patients’ needs. Medical volunteers often use their vacation time or personal time-off to go on training trips like this one.
A health aid supports a mother in cradling her baby while she positions the baby to eat. After being sent home after corrective heart surgery, the baby struggled to eat. In the ward, the nurses supported the mother in feeding her son with an eyedropper. Within a couple of days, this baby was eating and able to go home.
Typically, after surgery children recover in the PICU, and move to the ward. In the ward, mothers can stay with their children 24/7. The hope is that when a child is in the ward, their next stop is going home.
Through the window, you will see cardiologists performing an intervention on a child with heart disease. A cardiac catheterization may be performed to diagnose heart problems, or an interventional catheterization can be performed to treat the heart condition without open heart surgery.
Inside the catheterization lab, the cardiologists are performing an interventional catheterization on a child with heart disease. Medical volunteer Prof. Dr. Jamie Bentham, pediatric cardiologist, shares his insights and provides coaching with the team but is intentional about not performing any part of the procedure. He shared that he’s there to build the team’s confidence because they are highly skilled and capable of performing these types of interventions.
After a successful day in the operating room and the Cath lab, the team members meet to share their wins and discuss complex cases.
The NHF administration, pediatric cardiac team, medical volunteers and Children’s HeartLink meet in person to discuss the partnership, progress and opportunities to advance the work being done.
The conference room was packed when the two teams got together for the morning rounds update. The handoff between the overnight shift and day shift resulted in healthy discussion and learning by all parties.
In Bangladesh, the native language is Bengali. Local nurse Shahjadi Loskar often acts as a translator between the two nursing teams from NHF and the U.K. She is also very generous and brought mangos, Jhalmuri (spicy crispy puffed rice) and homemade dried spicy mangos to share with Children’s HeartLink volunteers and staff.
The founder of the National Heart Foundation, Professor Brig. (Rtd.) Abdul Malik, graciously offered to talk with us while we were visiting. Pictured: Tom Okins, Don’t Blink Production; Afsana, NHF; Adriana and Sam, Children’s HeartLink; Shahjadi Loskar, translator; Dolly, NHF; National Professor Brig. (Rtd.) Abdul Malik.
Children’s HeartLink’s Marketing and Communications Director takes a selfie of the teams together during the last day of training.
Children’s HeartLink partnerships are designed to support local hospital teams in improving their pediatric cardiac teams and the care they provide for children with congenital heart disease. We lead multi-year training partnerships between medical teams from top teaching and research institutions and teams in Bangladesh, Brazil, China, India, Malaysia and Vietnam. Together, the teams build a program that aims to deliver high-quality, team-based care for children.
In December 2022, Children’s HeartLink announced their partnership with National Heart Foundation Hospital and Research Institute (NHF) and their medical volunteer team from Leed’s Children’s Hospital. NHF became Children’s HeartLink’s 20th partner hospital, and first in Bangladesh.
In person and virtual trainings are vitally important for Children’s HeartLink partnerships to be successful. This training visit was funded by the generosity of Omar Ishrak and his family. All of our work is 100% funded by you, foundations and organizations. It takes a community of supporters to make our work at Children’s HeartLink’s possible. Consider making a donation here to fund more trips to help us serve even more children with CHD.