Bringing Erneste Home

Kayla Quinn, RN, writes:

As the road to Erneste’s home began to narrow, our anticipation grew. Ceeya, George, Suellen and I escorted Erneste to his home near Nyagihunika. As we bounced around in the Range Rover bracing ourselves for each bump, we were quietly taking in the spectacular views. Erneste handed each of us thank you notes that he wrote proudly in English. We all knew that this experience was going to be touching beyond explanation, and we are thankful for being by his side for his return.

Erneste sat in the rear of the Rover with Ceeya by his side. As he was gazing out the window, he would point out to us some of the homes that belonged to his relatives and friends prior to the genocide. Turning a corner as we neared his home, Erneste noticed his brother standing in the road with his friends. He began to chase us down the road with all of his friends in tow. Erneste’s father was eagerly anticipating his arrival as well, standing in the road surrounded by friends and family. Read the full post.

Back in Rwanda

Team Heart members Ceeya Patton-Bolman, Suellen Breakey and Kayla Quinn (above) are back in Rwanda this week, working alongside and learning from Australia's Operation Open Heart Team, which is performing life-saving heart surgery on Rwandan children at King Faisal Hospital.

Ceeya writes:

Our small team of three arrived in Kigali last week to join Operation Open Heart. It is a wonderful opportunity for us to evaluate our educational goals for next April and synchronize with the Australian team. The supplies we left here are intact, and the unit looks great with Brigham-donated monitors. Many thanks to Kumar and his Kigali-based team of bio-meds.

We are having a wonderful time meeting up with old friends and colleagues, and we were delighted to see two of our patients doing well. A highlight was seeing Erneste reunite with his dad for the first time in six months upon our arrival at the airport. He was VERY happy, as he says! I visited a potential boarding school with him and was pleased with the emphasis on academics and good physical facilities. Both will be good for him. Read the full post.

Erneste's Story

At top left, Sue Gabriel, RN, cares for Erneste post-surgery; second from left, Ray Tye gives Erneste a Red Sox cap during their meeting in August; at bottom left, Jim Rawn, MD, lets Erneste listen to his own heart as he recovers from surgery at Brigham and Women's Hospital.

Team Heart is back at it, except this time our patient has come to Boston. 18-year-old Erneste Simpunga's heart failure was so bad that surgery was too much of a risk for him in Rwanda last April.

The Ray Tye Medical Aid Foundation, based in Braintree, generously offered to fund the cost of the surgery at BWH, and Simpunga was flown to Boston. Several weeks later, Chip Bolman and his team performed a successful double valve replacement. During the next few months, Simpunga recovered remarkably, gaining weight and exercising as he stayed with the Bolmans and enjoyed weekend visits with other Team Heart members.

The 18-year-old was much healthier—with a regular heart rate and an additional 20 pounds of muscle—when he returned to Rwanda in November. Simpunga is now back in school pursuing his dreams. “I want to be a doctor,” he said. “I want to help others the way I was helped.” Read more in the BWH Bulletin.

Thank You from the Bottom of Our Hearts!

Our first mission was a huge success, and we could not have done it without many, many supporters to whom we extend our sincere gratitude. From the vendors who donated the medical equipment necessary to care for patients and perform open heart surgery to the many individuals and groups who supported Team Heart volunteers to the elementary school students in Mission Hill who colored pictures for our patients, each and every contribution was important. Because of your selflessness, 11 Rwandans have healthy hearts and new hope for the future. Who knows how many lives they each will touch?

We thank you and hope that you will remain part of our team as we continue this long-term mission.

From Jose Zeballos, MD

Today the last three of our patients are leaving King Faisal Hospital in good health. Vedaste and Samuson will be heading home here in Kigali, while Jean will be taken by Dr. Schulze, cardiologist, to Butare Hospital closer to his home town. Read the full post.

From Leslie Sabatino, RN, clinical coordinator

I am here this morning after a long night's sleep and shower and I am wondering what to do. I have been in a constant 'frantic' rush for the last 9 months to get things together and packed, make sure everyone is comfortable, and this morning I feel quite lost and confused. I have no where to run to or calls to make today. It is an odd feeling. Read the full post.

From Our Hearts to Theirs

Eight of Team Heart's patients are still receiving care as they recover at King Faisal Hospital. At right, seven of the patients flash the thumbs up sign as they say good bye to Leslie, Ceeya, Rhonda and Jim, who left Rwanda today.

The patients are in good hands. Team Heart's Jose Zeballos, MD, arrived in Kigali on Thursday to work with King Faisal staff in ensuring these patients receive top-notch care and make a full recovery over the next week.

From Ceeya Patton-Bolman, RN, program coordinator

I sit in an empty ICU and reflect on what the past 10 days have been not only for us, the 36 members of Team Heart, but for those patients who do not share a common language and yet entrusted us to provide their care. It was an eerie feeling to transfer the patients out to the surgical ward, and I had forgotten in the past few years the incredible emotional connection physicians and nurses develop with patients in that critical period. Read the full post.

From Chip Bolman, MD, chief of Cardiac Surgery

I got back yesterday p.m. The trip was an unbelievable experience, probably the most intense and powerful of my life. We operated on 11 Rwandan patients, who came from the four corners of the country. Fortunately, despite extremely challenging conditions and various equipment shortages and breakdowns, they all survived and are doing well. Read the full post.

From Prem Shekar, MD, cardiac surgeon

Team Hearters:
It has been a singular honor and pleasure to work alongside all of you during this mission. It is very clear that it has been a great success. Hats off to Ceeya, Leslie and Chip for this.

It has been my dream that I would try and return to this world (at least in part) what it has given to me in plenty. This dream is now beginning to be realized. And what a great group of people to start doing this extraordinary work with. Barry Shopnick maintains that it takes a special gene to do this kind of work and I believe we have that gene.

I had never imagined that I would be sad leaving this place. But, as I sit in the Departure Lounge of the Kigali Airport (all alone – thanks to my visa adventures), there is a mixed feeling of happiness and sadness. Happy that I have finally started my "payback" journey and sad as I have seen one more time (as I have again and again) that there are people on this planet who lack the very basic necessities that we so easily take for granted. Humility is one lesson that I have learnt from this trip.

It certainly is a beautiful country and with its humble, grateful, happy, traumatized yet determined people. From my end, I thank you all once again for all your efforts in making this possible and I hope all of you will return on the next mission as I surely will.

God bless (and for the atheists, may the force be with you).

From Paul Farmer, MD, PhD, of BWH and 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. Read his first ever blog entry below.

“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? Read Dr. Farmer's complete entry.

Visit with the Minister of Health

From left, Dr. Chip Bolman, Dr. Jean Damascene Ntawukuliryayo, Rwanda's Minister of Health, Ceeya Patton-Bolman, MSN, RN, Dr. Joseph Mucumbitsi, and Dr. Gene Bukhman.

Yesterday, Dr. Jean Damascene Ntawukuliryayo, Rwanda's Minister of Health, met with Team Heart's Chip Bolman, Ceeya Patton-Bolman and Partners In Health cardiologist Gene Bukhman to discuss health issues in Rwanda and the long-term work Team Heart is doing with King Faisal Hospital.

"You have come from such a long distance to visit us, to work with us," Dr. Ntawukuliryayo said. "We are so thankful to you."

We thank Dr. Ntawukuliryayo for hosting and supporting Team Heart during this mission.

Scenes from Surgery

This past week, the OR team has collaborated to perform nine open heart surgeries, including tricuspid, mitral and aortic valve replacements. On Thursday, the team will complete two more cases, operating on 11 Rwandan patients total on Team Heart's inaugural mission.

Clockwise from top left, after surgery, patient Velaste holds up the box that contained his new mitral biocor valve donated by St. Jude Medical; surgical technologist Jenn Loayza; Luigi Nascimben, MD, with patient Jean-Paul; Vlad Formanek, MD, (at right) and Radhika Dinavahi, MD; and John Connell, MD, (left) and Chip Bolman, MD.

Team Heart Nurses: Caring and Curing

The Team Heart nurses in the intensive care unit and step-down ward are making sure that patients get the very best and safest care. Simultaneously, our nurses are ensuring that King Faisal Hospital nurses are learning about care for patients after open heart surgery.

Team Heart nurses include, clockwise from top, Lisa Kelley, RN, admitting a patient to the ICU; Pavel Nelyubin, RN, nurse in-charge with patient Jean-Paul and King Faisal nurse Rosine Uwavutse; Kayla Quinn, RN, with Jean-Paul and his wife; Denise Ricci, RN, with Celestin; and Marie Caulfield, RN, with Djuma.

From Jonnye Mastel, RN, of the OR

I feel like I have been practicing for this moment all my life…to be part of this extraordinary Boston team. I am profoundly grateful to the people of Rwanda who, in this week of remembrance, let us share with them such a celebration of life.

Jonnye Mastel is a nurse from Seattle who joined Team Heart to work as part of Chip Bolman’s surgical team. She and Chip worked together before he joined BWH.

Perfusionists Get Creative

Perfusionists Mike McAdams and Amy Patel operate the heart-lung machine during surgery.

Performing open heart surgery comes with its challenges. One of the greatest challenges came when the heater-cooler, a machine that controls the patient’s temperature during surgery, broke.

Perfusionists Mike McAdams and Amy Patel collaborated with Mike Gilfeather, a lead perfusionist back home at BWH, to come up with a solution. “His ideas, combined with ours, led us to the creation of a homemade heater-cooler,” McAdams said.

The solution works perfectly and ensures patients are safe as the team awaits delivery of a new heater-cooler from Kenya later today.

Patient and Nurse Education is Vital

Above, Suellen Breakey with patient Djuma and physiotherapist Emmanuel Muganwa.
Before patients go into the Operating Room, Suellen Breakey, PhD, RN, educates them about what will happen during surgery, what to expect in the intensive care unit and how they will feel afterward. The patients and their families exclaim in excitement when Suellen hands them a booklet of information translated into Kinyarwandan, their native language.

“The patients are surprised and excited to see that the books are in their language and translated perfectly,” Suellen said, adding that the books are helpful in teaching King Faisal’s nurses about heart surgery as well.

The books were translated by Egidia Rugwizangoga, RN, a BWH nurse and native of Rwanda. Although Egidia was not able to join us on this inaugural mission, she has been one of our greatest supporters. Her guidance and many insights are vital to the success of this mission, and words cannot express our gratitude to her.
Above, Egidia Rugwizangoga, center, with Leslie Sabatino and Ceeya Patton-Bolman at a February fundraiser for Team Heart in Boston.

From Leslie Sabatino, RN, clinical coordinator

Today is Tuesday, and the fifth patient just got his breathing tube out. His first words were “thank you.” Talk about bringing someone to tears! The patients are so appreciative.

I as well am so thankful to be able to work with such a wonderful group of professionals and friends. When we get home, the real impact of what we have all done will hit us like a ton of bricks. We have created a ripple effect in that saving the lives we have will help save families. Our patients are from various areas of Rwanda, so we can truly say we helped the people of this country.

I am so truly honored to be able to help the wonderful citizens of Rwanda with all the selfless people involved in Team Heart—from the kind woman who washed the floor between cases to the volunteer helpers in Boston to every member. You are all awesome!
Above, Leslie Sabatino with patient Alice.

From Rhonda Martin, RN, of the ICU

We’ve all been here about a week now and crammed in a month’s worth of activities.

I finished my first night shift at the hospital. Our patient did well and was so appreciative we came to Rwanda. I am constantly reminded of how much we have as I learn to save and reuse everything.

This week is also sobering because it is the 14th anniversary of the genocide. This next week is a week of remembrance for the Rwandan people. We visited the genocide museum and heard heart-wrenching stories of violence and loss. We stood next to local Rwandans who were crying over mass graves and touching photos of lost loved ones.

Yesterday we visited an orphanage and chatted with kids orphaned by the genocide and AIDS epidemic and gave them small gifts. We all look forward to a productive week at the hospital.

Above, Rhonda Martin with patient Joseph in the ICU.

Video: Mending Hearts

Celestin Gasamaza, a 25-year-old student and native of Kigali, never dreamed that the life-saving heart surgery he needed was a possibility. On Saturday, he was Team Heart's first surgical patient. Today, he moved from the intensive care unit to the step-down unit, where he is resting comfortably and feeling strong. In this video, Celestin shares his excitement about this "miracle."

"These people are good," he said of his care providers. "They did miracles. They performed wonders. We are asking God that he help them with all their work here. We appreciate it."

Mending Hearts

Today, Team Heart performed two more successful surgeries. At top left, Jean-Paul gets ready for his surgery, an aortic valve replacement, this morning.

Team Heart members participating in the surgery include, at top right, Katie Morrison, RN; middle row, Radhika Dinavahi, MD; perfusionists Mike McAdams and Amy Patel; bottom from left, Barry Shopnick, PA-C, John Connell, MD, and Prem Shekar, MD.

The red Team Heart caps were made for us by our friend and colleague Nancy Carrigan, RN, of BWH Neurosurgery. Thank you Nancy!

From Chip Bolman, MD, Chief of Cardiac Surgery

We are off and running.

We did our first surgery Saturday, a 25 year-old with an ASD, a congenital defect in the septum between the upper chambers of the heart. He did very well- extubated very early, came out of the ICU on day 1, and was surrounded by his family.

Today, we performed two more surgeries: an aortic valve replacement for post-endocarditis aortic insufficiency, and a mitral commissurotomy for rheumatic mitral stenosis in an adolescent. Both went very well. Read the full post.

Pictured: Ceeya and Chip Bolman

Genocide Mourning Week Begins Tomorrow

During our time here, most team members have visited or plan to visit the Kigali Genocide Memorial Centre, which overlooks a mass grave of 250,000 victims of the genocide. The museum, filled with the photographs of victims and haunting images and descriptions of the genocide, serves as a permanent memorial to the victims and a place for survivors to grieve.

Tomorrow, the country begins its annual genocide mourning week April 7 to 13 in remembrance of the estimated one million people who lost their lives during the 1994 genocide.

Yesterday’s issue of The New Times, a daily newspaper in Rwanda, quoted U.N. Secretary General Ban Ki-moon: “May [the victims] rest in peace; my thoughts go to the survivors. May their courage and resilience serve as an inspiration to all of us.”

This year’s commemoration theme is “Let’s commemorate Genocide while fighting its ideology, rendering support to survivors and striving for development.”

First Patient Gives Thumbs Up After Surgery

Above, nurse Clementine Sezerano and patient Celestin smile for the camera.

The first patient came out of surgery earlier today and later flashed the thumbs up sign to his nurses. 25-year-old Celestin is doing well and resting comfortably after this morning’s atrial septal defect (ASD) repair.

ASD, a hole in the septum between the heart’s two upper chambers, is a congenital heart disorder, or one that is present at the time of birth. If ASD isn’t repaired, it can ultimately lead to heart failure.

Celestin was in good hands during surgery.

“ASD repair is one of the most common congenital heart procedures,” said Jim Rawn, MD, an intensivist at BWH. “And at the Brigham, it’s the most common congenital heart procedure we do.”

King Faisal nurses Clementine Sezerano and Etienne Nsereko and Team Heart’s ICU nurses are caring for Celestin this evening.

Above from left, nurses Etienne Nsereko, Kevin McWha, Clementine Sezerano and Sue Hall care for Celestin.

Surgery Begins

Final preparations are underway for the procedure Saturday morning.

At left, Respiratory Therapist Felix Gregorian helps prepare the ICU, where the first patient will receive care following surgery.

Meeting Our King Faisal Colleagues

Above from left: BWH's Prem Shekar, Leslie Sabatino and Jim Rawn meet King Faisal Chief Pharmacist Juliet Mbabaizi.

On the evening before the first surgery, the staff at King Faisal warmly welcomed Team Heart to the hospital at an informal reception.

“We are looking forward to having our people work side by side with you,” John Stevens, director general of King Faisal Hospital, said as physicians, nurses, respiratory therapists, surgical technologists and others from both hospitals mingled and became acquainted. “This is the first time. Let’s make it happen over and over again.”

Chip Bolman, MD, chief of Cardiac Surgery at BWH, told King Faisal staff how honored Team Heart is to be involved in this collaboration. “It’s a privilege for us to come here and help you to build a cardiac surgical program,” he said. “Thank you for allowing us to be here.”

Heart Failure in Rwanda

Heart failure leaves thousands of young Rwandans 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.” Read the complete article.

Above, Dr. Joseph Mucumbitsi, left, and Dr. Gene Bukhman at King Faisal Hospital

Team Heart

We're anxiously awaiting the arrival of Prem this afternoon to complete the team!
Update 2:28 p.m.: Prem has arrived safely! The team's all here.

Video: Visit to Gisemba Orphanage

On Thursday, a few members of Team Heart had the opportunity to visit nearby Gisemba Orphanage in Kigali for the afternoon. Bill Garside had gifts of soccer balls, flip flops and water bottles for the children. He plans to go back later in the week for another visit. We are thankful for the chance to meet so many wonderful people in Kigali while we are here.

The Second Wave of Team Heart Arrives

The second group of Team Heart members arrived safely in Kigali this evening. The entire team will be here tomorrow afternoon when Dr. Shekar arrives. More to come!

Video: Let's Get Started!

Watch the action unfold as we prepare the ICU for our first patients this weekend.

Posted by Leslie Sabatino, RN, clinical coordinator of Team Heart

Hi Everyone,

The first wave of folks has done a tremendous job cleaning and organizing things - Hats off to them!! The rest of the gang is heading in tomorrow, and we will be fully prepped and ready for a mock run through by Friday afternoon. I am so excited!!!

Before we begin, I want all of you reading this to know what hard work and very generous individuals we have on our team. They are the ultimate volunteers. From washing down walls, unpacking bags, carrying emergency supplies through many countries, or making sure to remind each other to take our Malaria meds daily, everyone is in this together and I am so proud of each and every Team Heart Member. It takes everyone single person on the team to make this a success.

It is so touching and emotional for me to have this dream becoming a reality. Words can not even explain it without tears of appreciation rolling down my face. Wait until you see the appreciation on the patients' faces.

Stay tuned...........................

Unpacking...

The ten team members already here spent the day at King Faisal Hospital unpacking equipment and cleaning the intensive care unit where our patients will receive care after surgery.

We continue the preparations tomorrow in anticipation of the first surgery, which begins on Saturday.

We Have Arrived

The first wave of Team Heart arrived safely in beautiful Kigali last night. Leslie, Ceeya, Jonnye, Sue G., Sue H., Jess, Bill, Diane and Liz (at left with Gene Bukhman of Partners In Health) are excited to be here and begin our work. Today we head to King Faisal Hospital to begin unpacking and preparing for the surgeries, which begin on Saturday.

The other 22 members of Team Heart are scheduled to arrive tomorrow evening.

Team Heart in the Boston Herald!

Pick up a copy of today's Boston Herald for a wonderful article on Team Heart featuring Chip Bolman and Leslie Sabatino.

Read the article online here.

Packing...

Chief of Cardiac Surgery Ralph Morton "Chip" Bolman, III, MD, and Leslie Sabatino, RN, packed medical supplies on Friday. Team Heart has received over a half million dollars worth of donated medical supplies to perform heart surgery in Rwanda.

Posted by Ceeya Patton-Bolman, program coordinator for Team Heart

As I sit here, determined to complete the thank you notes before the "unpacking team" leaves on Monday, I cannot help reflecting on those whom have made this trip possible. Help has come not only from predictable sources, vendors we work with and respect and feel "we must have _____ to do this safely, hospital personnel have gone beyond our wildest hopes to make contacts for donations or broker great prices to provide what we need, but help has come in smaller donations, used cell phones (we continue to collect!!!) and more importantly from words of encouragement and the hope for success.

It has continued to amaze and warm my heart how the Brigham community has embraced this project. Chip and I came to the Brigham from the outside and the environment initially did not seem a welcoming one. A hard move, late in life, without children to introduce us to parents of their friends, at times we both despaired of ever being a part of the community. It has been incredible to me to see how the community of volunteers, nurses and physicians have supported each other and made a place for us too! Although we are not doing this trip for team building, it has been one of the most wonderful "side effects". Getting to know the team which embraces many more individuals than those traveling to Kigali has been wonderful.

Thank you to each of our supporters, we take a piece of you with us.

Welcome

Welcome to the official blog of Team Heart, a group of 32 volunteers from Brigham and Women's Hospital. In just two weeks, the team will head to Kigali, Rwanda, to begin a decade-long cardiac surgery mission to King Faisal Hospital.

During the inaugural visit this April, our team will perform life-saving heart surgery on Rwandan patients, most of whom suffer from rheumatic heart disease. Over the course of the next decade, we will work with staff at King Faisal Hospital and the Rwandan Ministry of Health to establish a self-sustained cardiac surgery program there.

It is an honor and a privilege for our team to be able to do this important work with our colleagues in Rwanda.

This blog will be updated frequently with photos, videos and posts during the first two weeks of April as Team Heart begins performing surgery in Rwanda. Stay tuned...