Watch Dr. Oakes' presentation on the rwanda trip below.


 

This short documentary on Team Heart was also shown in the presentation.

Bryan Health Team Mending Hearts; Saving Lives in Rwanda

Dr. Robert Oakes, cardiothoracic surgeon with Bryan Heart and a volunteer heart surgeon with Team Heart, returns to Rwanda on Feb. 1.

Joining Dr. Oakes on the trip are Bryan employees Vic Grdina, perfusionist, and Sheryl Sanders, RN, who will work with recovering patients.

Once again the team will perform heart surgery for Rwandan people who do not have such resources and who would otherwise die without our help. The first patient to receive care last year was a 14-year-old boy; this year the team expects to see a lot more teen-age patients.

In preparation for the trip, Vic contacted perfusionists from other Team Heart missions. Among the things he found out? There are often afternoon showers and when it rains it’s common to lose power. This means he will need to be ready to operate a hand-cranked machine to keep blood circulating until the generators restore power. This is just one of the many challenges to bringing life-saving care to the Rwandan people. Dr. Oakes marvels at how in a short time, basic rooms are transformed into complex operating and patient care areas by Team Heart, and doing so with materials and supplies that have been donated.

In addition to caring for new patients, each year provides the opportunity to see previous patients and enjoy a happy reunion. This is no easy task for previous patients, who live in rural areas and must travel several days to reach the clinic.

This year, Team Heart and Dr. Oakes will expand care to the region by introducing thoracic surgery. This will be a first, and it will require traveling to other hospitals to perform the surgeries and to train Rwandan surgeons.

We are proud to have Bryan Health professionals involved in this humanitarian effort. Vic, Sheryl and Dr. Oakes will be sending us photos and updates of their trip.

Day 1 (Sunday):

Hi All,

We left for the Lincoln Airport at 4:30.  We each had two suitcases, one of our own stuff and one filled with medical supplies for Rwanda.  

Vic, Sheryl, and I flew from Lincoln to Minneapolis, Minneapolis to Amsterdam, then Amsterdam to Kigali (The capital of Rwanda).

Our trip started at 6AM on Friday and didn't end until 7PM Sunday. We were exhausted!

Today we spent the first half of the day setting up the OR and the ICU. In the afternoon we went through our list of patients who need surgery. The ages ranged from 14 to 45, with the majority in their twenties.  

The list was 40 patients long - and everyone of them needed heart surgery. Regretfully, we only have enough supplies for 16.  

We spent the next 4 hours deciding as a full team which ones were the sickest and needed surgery the most. Some were too sick already, and didn't make the list.

After the meeting we were all emotionally exhausted. We defined the cases for the next day and met the patients. Then we all went out to a Rwandan art and dance presentation before turning in for the night.

Tomorrow's our first OR day. You are never really sure if everything is going to work OK and function properly until the first couple cases are done - so tomorrow is very important.

Thanks,
Robert Oakes 

Day 2 (Monday):

We are all are doing well.

First day in the OR, called" theatre" here. Dr Oakes performed the first surgery with Team Heart. It went very well. Looks like we will do 2, maybe 3 procedures each day.

Everyone is friendly to us; the area is beautiful. Very young and sick patients to work with.

– Vic Grdina

Day 3 (Tuesday):

Hello!  Everything is going really well here. Surgeries began yesterday and as of today four patients have been done. 

We will be opening the step-down unit tomorrow and will be able to move three patients out of the ICU. 

Things are progressing on schedule –16 total procedures will be done! 

I was able to go on a safari in Akagera National Park, which turned out to be an amazing experience. We were charged multiple times by two elephants. I was able to get some awesome photos!

– Sheryl Sanders

Day 4 (Wednesday): 

We are beginning day 3 of our surgeries. Our oldest so far is 38 years old. Today's patient is 15.

It seems that birthdays are not a big deal here. All of our patients have had Jan 1 as their birthday, but they usually know what year they were born.

All patients are all doing well in spite of being very ill.

Here is the front entrance of the hospital we are at, as well as the hallway that we transport our patients through from surgery to ICU. It is outside, so we use an umbrella if it rains.

Surgery is called theatre as in theatre 1 which we do cardiac in. They have 5 "theatre" suites in their hospital, the largest in the country.

 
– Vic Grdina

Day 5 (Thursday): 

Greetings from the Land of a Thousand Hills.

Our Operating Room is up and running well.  We completed two operations each of the last three days. Our Cardiovascular ICU has been going for the past three days.  And our step-down unit opened this AM.

We are very busy finishing patient workups and defining the OR schedule for the rest our time here. It is critically important to make sure every patient is ready for their day of surgery.  It is a huge team effort.

We have been trying to find room to fit in extra patients on any day of the upcoming schedule - but it has been tough. Just our regular schedule took us from 6:30AM to past midnight yesterday. We are staying on track though.  

It is more of a marathon than a sprint; a fast but steady pace is important  to help the greatest number of people we can in the time we have here.

To all our friends, family and co-workers back home – we miss everyone. And thank you for all the support and kind words.

– Dr. Robert Oakes

Day 8 (Sunday):  

We are in the middle of our seventh straight day of cardiac surgery in King Faisal Hospital in Kigali, Rwanda. We do 2 surgeries each day in the same operating "theatre". There are 2 local perfusionists that we have been mentoring for the last few days.

Peter, a volunteer, had perfusion training in India and has now moved back to Rwanda to be closer to his family. Emmanuel works as an anesthesia administrator and does perfusion when volunteer group come to do cardiac surgery.

Besides our "team heart" based out of Boston, groups from Belgium and Spokane, WA also come to do cardiac surgery. It is difficult for Peter and Emmanuel to maintain their skills because there can be 4-6 months between teams operating.

They have sent a local doctor to train for cardiac surgery in South Africa. They are anxious for him to come back to operate in 4-5 years. They are good people and anxious to learn and use their medical skills.

Here is Peter, the volunteer perfusionist. He has come in 7 days in a row to participate in these cases.

– Vic Grdina 

Day 9 (Monday):  

Last day for surgery. Big tropical rainstorm coming in. Had to use the umbrella over the patient to transport to the ICU from the operating theatre. We lost oxygen pressure for the 4th time. The pressure goes low or the compressed air goes too high and reduces the oxygen to the patient. Just waiting for the power to go out with this storm.

Peter did a good job today running the heart-lung machine and noticed the drop in oxygen saturation. Tomorrow we will be taking inventory of our remaining supplies store the perfusion equipment.


– Sheryl Sanders

Surgeries have finished today. Everyone is doing really well for how sick their hearts are. It is so exciting seeing them progress to the step-down unit...they are welcomed and encouraged by the other patients who have made it there before them.

I have a new perspective of the fear these patients have.  I didn't understand why the African mothers seemed distant from their children. 50% of people die in this hospital i was told by a Rwandan nurse. So when you come in your family does not expect you to come home. Wow...can you imagine the fear?! Thank God everyone is doing so well!

Here is Vic in the OR during a triple valve replacement teaching the Rwandan perfusionist, and Dr Oakes and Dr. Bolman doing a triple valve surgery.

– Sheryl Sanders

We are happy to report that our 2013 Team Heart Mission in Rwanda was a great success!

We completed our goal of 16 cardiac surgery operations. Our Cardiac ICU was able to close last week and our step-down unit is now closed.  

The last of our team members are on their way home.

All of our patients are doing very well and have either returned home or will return home soon. Follow-up will continue through our Rwandan physicians throughout the year.

We will see them all again next February when we return...God willing. We hope to organize a slide show and video presentation here at Bryan in the next couple of weeks. There will be some Rwandan art and crafts for people to see, as well. Watch for more details on the Bryan Health Facebook – Hope you can all make it.

Thank you for your support!

Robert Oakes, MD
Bryan Heart Cardiothoracic Surgeon

 
Team Heart is a non-profit organization that includes volunteers in medicine, nursing, perfusion, respiratory therapy and a wide-range of non-clinical positions. For a time, the entire mission trip was in question due to instability in the area.