For the past 27 years, volunteers from Lahey Hospital & Medical Center have headed to the Viedma Hospital in Cochabamba, Bolivia, where they spend a week caring for 400 to 500 patients with potentially fatal heart and vascular problems. Public radio and television announce their arrival in this poor South American country with limited medical resources, and sick people travel days to see them.
Thirty-two Countries Served
Since its inception in 1993, Lahey’s Global Outreach Program has provided travel expenses for staff volunteers — doctors, nurses, physical therapists, electrophysiologists and others representing 25 departments — to go on these and other medical relief missions to more than 32 countries around the world, as well as to Native American reservations in the United States. The program was originally funded through cookbook sales and golf tournaments, and it is now sustained through the generous gifts of individual donors.
“There’s a huge reservoir of enthusiasm for volunteering,” said David Martin, MD, a cardiologist and co-director of the program who has gone on many of the missions to Bolivia, and to India, Morocco and Kenya. “It connects us back to why we went into medicine in the first place and recharges our professional batteries.”
Community service is integral to the Lahey mission and is a required component of medical residency training. “I think the experience makes our residents better doctors,” said Martin, chair of the Lahey Hospital & Medical Center’s Division of Medicine. “It teaches them to understand other cultures, cultural differences in the understanding of illness, and dealing with patients who don’t speak our language.”
The trips expose the medical staff to pathologies and illnesses that are not typically found in Massachusetts. The recent spread of the Zika virus from South and Central America is a reminder that this is important, said Martin, noting that “we live in an interconnected world.”
Many of the patients they see in Bolivia have heart problems related to advanced Chagas disease, which is caused by insect-spread parasites that infect half the people in the region. They may have heart block— a kind of arrhythmia caused by damage to the heart’s electrical system— or heart failure. Treatment includes implanting a permanent pacemaker or defibrillator to keep the heart pumping regularly. The staff divide into teams, with some doing heart echocardiograms and diagnosis, one team implanting the donated devices, and another conducting a follow-up clinic to monitor those with pacemakers or defibrillators implanted on previous missions.
Sarju Ganatra, MD, went on the Bolivia mission as a resident and then to Uganda as a cardiology fellow. He found his experiences “eye-opening, humbling and inspiring.” One young girl he treated in Bolivia, though suffering with heart block due to Chagas, had travelled for almost three days to get there, including a full day and a half of walking.
Ganatra was also impressed with the local medical staff who worked alongside them. “They learn from us, but we also learn from them how to provide the best care possible with the extremely limited medicines and technologies they have available,” he said.
Chagas’ disease is not as uncommon in the United States as most physicians think, infecting more than 300,000 people. Ganatra and Martin published an article when Ganatra returned from Bolivia, presenting the case of a 37-year-old Bolivian woman with the permanent form of heart block caused by Chagas. “It is important for doctors here to recognize Chagas so they can treat it early and prevent spread of the disease,” Ganatra said.
The past two years, Lahey has celebrated “Global Health Week,” which features presentations like Ganatra’s on medical cases and global health care delivery so other medical staff can learn from their experiences.
“By supporting the Global Outreach Program, we’re able to help people in the world most in need, which is very gratifying,” Ganatra pointed out. “But we also learn many other things from the experience that we bring back to our patients here too.”