A chance for young hearts to beat

Twelve-year-old Yamin Sheikh was born with a heart defect that has only worsened over time. His father Md Motiar Rahman Sheikh, a landless day labourer from Bagerhat, could not afford proper treatment for his little one.

However, five months ago, following an echocardiogram after years without treatment, the doctor recommended immediate surgery due to the significant enlargement of the atrial septal defect in Yamin's heart, which had reached 15mm.

At Bangabandhu Sheikh Mujib Medical University, the cost for open heart surgery is Tk 1.20 lakh, significantly lower than the Tk 3 to 4 lakh charged in private facilities. But for Yamin's poor parents, that was still too much.

His father had to sell his cattle just for the money needed to travel and stay in Dhaka for treatment.

The family was at their wits' end.

But hope arrived from a government programme offering a lifeline -- free surgery at BSMMU, a chance for Yamin's heart to finally beat strong and free.

Yamin underwent surgery by an Indian pediatric cardiac surgeon at the hospital on January 27 and is now receiving post-operative care there.

The expense was entirely covered by the project providing free open-heart surgeries and interventional cardiology procedures for children from financially struggling families.

This project, initiated in 2018, has completed over 1,000 interventional cardiology procedures and conducted 360 open-heart surgeries from 2021 to 2023.

Another 600 patients are awaiting their turn for these life-saving surgeries.

"We were fortunate to receive financial support as we couldn't afford his surgery," said Motiar. "If the hospital could cover the costs for tests and medicines not included in the package, it would be a huge help," he added.

A couple from Feni said their daughter had heart surgery on January 24 and is now in the ICU.

"Our daughter has had a heart defect since birth. We hoped it would get better, but it worsened, and she became too weak even to walk," said Abdul Hannan, the father. "We've been here for 19 days. Thankfully, the surgery went well," he added,

Three-month-old Deepto, with a heart defect and coronary artery disease, was seen with his mother in the pre-operative room.

"We've been here for a month. Deepto needs to weigh four kilogrammes for the open-heart surgery, but he only weighs 2.5 kilos," his mother said.

Chairman of BSMMU's paediatric cardiology Dr Md Tariqul Islam said they started the to address financial barriers preventing parents from seeking medical care for their children.

"In 2018, a Tk 8 crore budget was issued to cover interventions, doctor training, and seminars. Later, we required additional funds for complex surgical cases," he said.

"In March 2021, we filled the shortage of pediatric cardiac surgeons and ICU doctors by appointing an Indian team for surgeries and post-surgery care," he added.

"We've recently appointed local experts -- a pediatric cardiac surgeon, an anaesthetist, four nurses, and a perfusionist. If everything goes well, we won't need to rely solely on the foreign team," he said.

HOW TO REGISTER

Parents must submit a five-page form along with certificates from UP chairmen or ward commissioners, guardians' NIDs, photos, and the child's birth certificate.

Only six beds are allocated for paediatric cardiac surgery, and three ICU beds are shared with adult patients, causing significant backlogs for the project's over 600 listed patients, with wait times of up to six months.

"We aim to transition to a complete paediatric cardiology and cardiac surgery unit by June this year. There will be 40 beds each for interventions and cardiac surgery, two separate operation theatres for children, and 10 dedicated ICU beds," Dr Tariqul said.

DEVELOPING SKILLED WORKFORCE

While progress has been made in developing manpower for paediatric cardiology, with 19 individuals completing their training and working across various regions, paediatric cardiac surgery remains challenging due to its complex nature and a lack of willing professionals.

"Currently, the country has only 5 paediatric cardiac surgeons and not all of them are equipped to handle complex cases," Dr Tariqul said.

"To fill this void, the project is leveraging foreign surgeons' expertise to train BSMMU's assistant professors, yet challenges persist in post-surgical care, as skilled intensivists are lacking, leading to regular anaesthetists overseeing the ICU," he added.

In 2022, a BSMMU study across eight divisions involving 6,400 cases showed a congenital heart defect prevalence of 18 per 1,000.

The Bangladesh Journal of Cardiac and Thoracic Anaesthesiology reported in 2023 that the country sees over 30,000 annual births with congenital heart defects, but only 3,000 receive surgical treatment.