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Posted June 25, 2014
A Long-Distance Mission to Save Lives

Mission Team
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For the ninth straight year, a team of 60 physicians, nurses and other healthcare professionals from All Children's Hospital and healthcare organizations throughout the United States and the world delivered life-saving care in the Caribbean. They participated in a special medical mission for one week in May to Kingston, Jamaica, treating children for a variety of cardiac related medical conditions.

By every measure, this mission was a success. The team performed 11 cardiac surgeries, provided cardiac catheterizations and interventional cardiology procedures for several other children and made sure dozens of others received medical management in an outpatient clinic.

The team partners with Kingston's Bustamante Hospital for Children. Built on an old army barracks, it's the only children's hospital in Jamaica and the only Jamaican hospital that does pediatric heart surgery. Many international charitable organizations have helped Bustamante Hospital for Children build a new cardiac ICU, set to open later this year. It will have 10 cardiac ICU beds and two cardiac operating rooms.

The trip was led by pediatric cardiovascular surgeon Dr. Jeff Jacobs, director of the Andrews/Daicoff Cardiovascular Program at the Johns Hopkins All Children's Heart Institute. Under Jacobs' leadership, the team has operated on more than 90 children since the first trip in 2006.

Jacobs became interested in the Jamaica mission project as a medical student at the University of Miami. It was years in the works, starting with bringing some children to the U.S. for heart surgery. "Our first organized trip to Jamaica was in 2006," he said.

"When we started doing this, there really wasn't a lot of pediatric heart surgery in Jamaica," he added.  "The local Jamaican team has grown from doing 1 or 2 pediatric cases a month to more than 100 per year."

The mission team consists of cardiac surgeons, cardiologists, anesthesiologists, intensive care doctors, operating room nurses, ICU nurses, and perfusionists (medical professionals that run the bypass machines). In addition, a variety of support personnel travels with the medical team to help with the overall logistics of moving equipment and organizing the intensive care unit. This year, Melodye Farrar, ACH director of continuing medical education, traveled with the team to help increase the scope of education and training opportunities for the Jamaican medical teams.

"In addition to doing surgery, we are also doing training," Jacobs stressed. "Education is a big part of our objective. While we want to operate on as many children as we can and save as many lives as we can, we also want to partner with the Jamaican team and empower them so they have the skill set to do more and more of this on their own."

Jacobs says it also takes specialized equipment to make this medical mission a success. "There's a large amount of equipment we've been able to get donated through a variety of charitable activities." He said.  "This includes ventilators, cardiac monitors, and the pumps that pump medication in the patient's veins. All Children's Hospital has donated bypass machines so each of the two cardiac operating rooms has a bypass machine." 

Money to fund the annual mission comes from the Cardiac Kids of Florida Foundation. In addition to equipment donated by All Children's Hospital, the mission has received support from Larry King Cardiac Foundation, St. Jude Medical, Edwards Life Sciences, Chain of hope, Gift of Life, and Rotary International. All the doctors and nurses who make the trip donate their time. It takes a year to raise the money needed to ship equipment, arrange for transportation, housing and food to feed the team. Dr. Jacobs credits Jennifer Carapellucci, RN, heart transplant coordinator at the Johns Hopkins All Children's Heart Institute, for devoting many hours every year to coordinate the logistics of each mission.

The trip is always an exercise in team building, adds Jacobs: "Many members of the team meet for the first time when they arrive in Jamaica and go right to work helping the kids. It's also tough going to an environment with limited resources. You work long hours with people you've not met before."

Jacobs feels this most recent mission was a success for several reasons, beyond the surgeries, catheterizations and interventional cardiology procedures performed and the outpatient clinic work.

"The first two-to-three years we went to Jamaica, nearly all of the surgeries were done by our visiting team members," he said. "This year, eight of the 11 cases were done by Dr. Sherard Little, the local Jamaican surgeon, with our help. The complexity of the cases has also changed. When we first went to Jamaica, we were doing less complex cases. Now the Jamaican surgeons are doing those cases independently. So, when we go down each year, we can concentrate on the more complex cases."

Jonathan Ellen, M.D., All Children's president and physician in chief and professor of pediatrics and vice dean, Johns Hopkins University School of Medicine, also made the trip this year to meet with the president and chairman of the board of Bustamante Hospital and the senior medical officer. He toured the facility and discussed future collaborative educational opportunities. Dr. Ellen is no stranger to the country's health system. He was previously invited by the Jamaican government to serve as a health advisor.

"By far, the most difficult part of the mission trip is deciding who to treat," says Jacobs. "During the week-long mission you can only operate on a certain number of children. We have a discussion about what we can do to help the most children and minimize risk. We operate on as many as we can but there are still more children who need our help."

"That's why we keep going back."