STS Surgeons Improve Cardiac Surgical Care Around the World
By Emily A. Farkas, MD, FACS

October 26, 2016



It might not surprise you that during my career as a physician I’ve caused a few tolerant patients and families to think, “Where in the world is my surgeon?” But you may be surprised to learn that many heart surgeons really do travel all over the world to provide free cardiovascular care to those patients who have no other options.

 “Where in the world is my surgeon?”

If you’re reading this, you or a loved one may have a heart problem that requires surgical treatment. Let’s imagine that it’s your daughter, around 5 years old, who seems to get winded and tired a little easier while playing. She isn’t eating much or gaining weight. Your pediatrician hears a murmur and tests confirm a hole in her heart. Your doctor writes down the recommended treatment: an operation to close the defect. You immediately start to research different surgeons, hospitals, locations, and insurance coverage to choose the best option for you and your daughter.

STS Member Dr. Emily Farkas (USA) with a patient in Nigeria on the first postoperative day. Photo courtesy of Scott Sharick for the VOOM Foundation.

Now imagine that you live in a part of Africa where there is no heart surgeon in the entire country. In fact, there’s no heart surgeon in the surrounding border countries. Perhaps you could fly with your daughter to another part of the world, but it would cost more than a year’s salary to do so, and you would surely lose your job while being away. This means that you couldn’t provide for the rest of your family due to the cost of her operation. So your doctor writes down his recommendation for the only treatment available to you and your daughter: prayer.

Children left homeless after an earthquake struck the South Asian nation of Nepal

This is a real scenario in many developing countries and something that’s hard for many of us to even imagine. To put this problem in perspective, in Germany there is one heart surgeon for every 80,000 people. In China, there is one heart surgeon for every 208,000 people. In West Africa, there is one heart surgeon for every 26.5 million people.

There are members of The Society of Thoracic Surgeons who take this to heart and donate their time and skills in the places where the need is the greatest. Some spend a few weeks a year providing free heart surgery in developing countries; others split their time between charitable mission work overseas and a practice in their native country. There are still others who have made it their career focus by spending all of their professional time in a country where they can serve those less fortunate with their skills and altruism.

STS Member Dr. Kathleen Fenton (Nicaragua) assists a surgeon in Libya who is performing open heart surgery. Photo courtesy of the Novick Cardiac Alliance.

Regardless of how much time is donated, the mission is the same: first, to treat the countless children and adults who have no options for heart surgery where they live. Second, and equally important, is to assist the local staff in training a team that can provide this care independently to serve their community. Many nonprofit organizations commit several years of recurrent visits to a location to develop it toward this self-sustaining goal. After all, as the proverb goes: Give a man a fish, and you feed him for a day. Teach a man to fish, and you feed him for a lifetime.

STS Member Dr. Ralph Bolman (USA) with a patient who previously had double valve surgery and is now a medical student in Rwanda. Photo courtesy of Team Heart.

Give a man a fish, and you feed him for a day. Teach a man to fish, and you feed him for a lifetime.

We all become frustrated at times when navigating our health care system proves challenging or when the options available to us seem limited. It always helps me to remember that there are some places in this world where there are no options. I respect and admire all of those who come together to improve surgical care for that 5-year-old girl and her family, whether she is here or around the world.

A boy from a remote part of the Amazon region a few days after cardiac surgery. Photo courtesy of CardioStart International.

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The opinions expressed in this article are those of the author and do not necessarily reflect the views of The Society of Thoracic Surgeons.

The Society of Thoracic Surgeons

The STS mission is to advance cardiothoracic surgeons’ delivery of the highest quality patient care through collaboration, education, research, and advocacy.