title: Paediatric cardiac assistance in developing and transitional countries: the impact of a fourteen year effort.
abstract: BACKGROUND
  Paediatric cardiac services are poorly developed or totally absent in underdeveloped countries. Institutions, foundations and interested individuals in those nations in which sophisticated paediatric cardiac surgery is practised have the ability to alleviate this problem by sponsoring paediatric cardio-surgical missions to provide care, and train local caregivers in developing, transitional, and third world countries. The ultimate benefit of such a programme is to improve the surgical abilities of the host institution. The purpose of this report is to present the impact of our programme over a period of 14 years.
  
  
  METHODS
  We specifically reviewed our database of patients from our missions, our team lists, surgical results, and the number and type of personnel trained in the institutions that we have assisted. In order for the institution to be entered into the study, the foundation had to provide at least 2 months of training. In addition, the institution had to respond to a simple questionnaire concerning the number and types of surgery performed at their facility before and after intervention by the foundation.
  
  
  RESULTS
  We made 140 trips to 27 institutions in 19 countries, with 12 of the visited institutions qualifying for inclusion. Of these, 9 institutions reported an increase in the number and complexity of cases currently being performed in their facility since the team intervened. This goal had not been accomplished in 3 institutions. The reasons for failure included the economic situation of the country, hospital and national politics, personality conflicts, and continued lack of hardware and disposables.
  
  
  CONCLUSIONS
  Paediatric cardiac service assistance can improve local services. A significant commitment is required by all parties involved.
authors.affiliation: Department of Surgery, University of Tennessee Health Sciences Centre, Memphis, TN 38104, USA. ichfno@aol.com
authors.forename: William M
authors.initials: WM
authors.lastname: Novick
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Stidham
authors.forename: Tom R
authors.initials: TR
authors.lastname: Karl
authors.forename: Robert
authors.initials: R
authors.lastname: Arnold
authors.forename: Darko
authors.initials: D
authors.lastname: Anić
authors.forename: Sri O
authors.initials: SO
authors.lastname: Rao
authors.forename: Victor C
authors.initials: VC
authors.lastname: Baum
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Fenton
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Di Sessa
mesh_terms: D006348:Cardiac Surgical Procedures; D002309:Cardiology; D002648:Child; D003906:Developing Countries; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D007391:International Cooperation; D008493:Medical Missions / Q000458:organization & administration; D010372:Pediatrics