Success of paediatric surgeries dependent on post-operative care – Dr. Soto

Apr 02, 2017 News

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– local paediatricians being trained to take up slack
By Sharmain Grainger

Without follow-up care a patient’s recovery could hang in the balance. It is for this reason

that deliberate efforts are being made to train paediatric doctors attached to the Georgetown Public Hospital Corporation (GPHC) to be suitably qualified to render follow-up care to paediatric cardiac patients. This move will essentially complement measures that have already been implemented to advance paediatric cardiac care at the premier public health institution.
The Government of Guyana, through the Ministry of Public Health and the GPHC, has for the past two years been collaborating with the International Children’s Heart Foundation, better known as the Baby Heart Foundation, which has been offering its expertise here. In fact, the Foundation has been offering similar support to a number of countries across the globe.
The Foundation, which is driven by donor and volunteer support, has to date conducted more than 7,000 paediatric surgeries globally. Scores of these surgeries have been conducted at the GPHC as a result of the strategic collaboration.
According to the Foundation’s Chief Executive Officer of Clinical Operations, Dr. Rodrigo Soto, since commencing surgeries in Guyana, there has been a two percent mortality rate.
“In general terms it is important for the community to know this programme has a mortality of only two percent in two years,” said Dr. Soto. He continued by making reference to the fact that even in a developed country like the United States with a similar patient cohort, the mortality rate is three percent. Over in Europe, he informed that the mortality rate is some five percent. “So at the moment we have had even better results…so we are extremely happy about this. People need to know if they bring their children here [GPHC] they are in good hands and we will really take care of them,” said Dr. Soto.
For some time, measures have been implemented at the GPHC to help advance its paediatric cardiac care. But according to Dr. Soto, the success of such cases is dependent on post-operative care. But although this aspect of paediatric care is viewed as especially important, Dr. Soto, during an interview with this publication, took into consideration that there currently does not exist a formal programme in Guyana to train intensivists.
An intensivist, also known as a critical care physician, is a medical doctor with special training and experience in treating critically ill patients. An intensivist completes a fellowship in critical care medicine after finishing a residency in internal medicine, pulmonary medicine, anaesthesia or surgery.
In order to ensure that local capacity is built to cater to the paediatric cardiac care, Dr. Soto disclosed that the Baby Heart Foundation is currently working with five paediatricians.
“We are training them in order to take care of the intensive care,”said Dr. Soto as he added, “the post-op care with cardiac patients is probably one of the most complex in intensive care, so if we teach the physicians and nurses [too] to take care of their patients, you are sure that they will be able to take care of any other sick kid coming to the hospital.”
Moreover, he noted that with the advanced capacity, the GPHC will have personnel who not only have the ability to care for paediatric heart patients, but any paediatric patient for that matter. Dr. Soto observed that at the moment, there is not an exclusive paediatric intensive care unit [ICU] in the country, since the intensive care at the hospital caters to both adults and children, which is not good.
“So I think one of the main challenges is to train people capable of taking care of intensive care – nurses and physicians. You can do a beautiful surgery, but if the patient is not well looked after [following] surgery, you may lose the patient,” said Dr. Soto, as he reiterated the importance of post-operative care.
The Baby Heart Foundation has over the years catered to children with congenital heart disease, which is regarded as the most common global birth defect.
According to information shared by the Foundation, “one percent of the world’s population is born with heart disease…many congenital heart defects can be repaired with just one surgical intervention, while others require staged repairs”.
The Foundation has been lending its support to countries with limited to no capacity to address congenital heart defects. In many of these countries these heart defects go undetected or are diagnosed too late. In its quest to address this “unfortunate situation,” the Foundation has embraced a three-fold approach: providing direct care to as many children as possible in the short term; sending medications, surgical supplies and diagnostic equipment to medical facilities in developing countries, and training surgeons and medical staff so they can ultimately provide care for their own people.

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