Heart defect diagnosis on foetus

Ms Sikiyo Simanga attends to her grandson Robert Kelemo at Muhimbili National Hospital in Dar es Salaam recently. PHOTO | CITIZEN REPORTER 

By Syriacus Buguzi

In Summary

Cardiologists at Muhimbili National Hospital (MHN) can detect holes in the hearts of unborn babies using a newly introduced diagnostic tool, known as the 4D Echocardiogram, installed at the hospital’s cardiac centre.

Dar es Salaam. Doctors in Tanzania can now diagnose heart defects in babies when they are still in the womb by using ultra-modern technology. The new development will see children born with heart defects get early treatment and enjoy their childhood.

Cardiologists at Muhimbili National Hospital (MHN) can detect holes in the hearts of unborn babies using a newly introduced diagnostic tool, known as the 4D Echocardiogram, installed at the hospital’s cardiac centre.

If this technology was available before and was incorporated in routine programmes for pregnant women at many health facilities in the country, perhaps children such as 4-year-old Robert Kelemo from Manyara Region would have enjoyed their childhood--with early treatment. But Robert’s heart condition was only diagnosed recently.

Since birth, he was not growing normally. His grandmother, Ms Sikiyo Simanga, 50, recalls that in his growth process, her grandson was unable to achieve some developmental milestones on time. Compared to other children of his age in the family, he was unable to stand without support or walk on time.

“Robert was always very sick. He could not breathe like the rest of the children. At times, his fingers and mouth would turn blue,’’ says Ms Simanga, who recently accompanied young Robert to MNH, where cardiologists discovered a hole in his heart.

‘’For the past four years, we have been moving from hospital to hospital. Each time Robert was admitted, we were told he was suffering from pneumonia,’’ said Ms Simanga in an interview with The Citizen in Dar es Salaam.

As Ms Simanga narrated his grandson’s predicament recently at MNH, a sad reality that afflicts most parents with children like Robert also cropped up--It’s the expensive nature of heart diseases.

Before Robert was finally diagnosed with the condition at the referral hospital, his family members had almost exhausted their financial resources for his earlier treatment and admission at lower level health facilities. They had also tried all sorts of local herbs in Kiteto, Manyara, without relief.

‘’I sold almost all my goats to make sure this young boy got cured. My first born daughter [who is Robert’s mother] had wiped all her resources. Robert’s father too, was already overwhelmed,’’ narrates Ms Simanga, who is a livestock keeper.

For the past four years, Ms Simanga and the rest of Robert’s family members kept their fingers crossed, praying hard so that at some point, a cure for his disease would be known.

But, even when the cure was finally found, it still sounded like a distant dream to obtain—especially when the family was told that it would cost about Sh20million for Robert’s heart surgery in India through a government sponsorship that would probably be endorsed at the end of this year.

However, as one English saying goes, the unexpected always happens—and so, sometime last month, the saying made sense in Robert’s future life and his entire family.

At a moment Robert’s family was still bewildered by the cost of treatment in India, they were treated with the good news that a team of heart surgeons from Saudi Arabia would be arriving in the country in a few days to operate on children with heart defects at MNH.

That, to Robert’s grandma and the entire family meant that the long story was cut short. It sounded to them as a huge relief, as their quest for a cure abroad would have entailed waiting for the government to raise money and finally let them fly off to a foreign country.

It was then, that the Saudi surgeons, under the charity, Little Hearts, arrived and camped at MNH for one week and put broad smiles on the faces of mothers of 66 children, including Robert’s grandma, who had been put on a long waiting list to go to India if the government passed the 2015/2016 budget.

The foreign surgeons, in collaboration with local experts, used special single hand-guided devices, costing about Sh1.4 billion, to heal the children, free of charge.

According to the MNH Senior Public Relations Officer, Mr Aminiel Algaesha, the charity work helped the hospital to save about Sh1.3billion in expenses that the government would have incurred to send the children abroad.

However, that was not the only relief that the Saudi-based charity brought on the otherwise desperate Tanzanians. The mothers of the children who had lost hope could now see light at the end of the tunnel after some tough years of their endeavours to bring up their sick children.

According to the Head of the Cardiovascular Medicine Department at MNH, Professor Mohammed Janabi, most cases of children born with heart defects remain undiagnosed and even when they are diagnosed, it’s always too late to intervene.

‘’Few cases are detected and those we often see at Muhimbili, usually report at very late stages of the disease. This makes surgeries very complicated, ‘’ says Professor Janabi.

Tanzania, like most other developing countries, is facing stiff challenges in ensuring the access of heart surgery to children and adults due to its underdeveloped health infrastructure and human resource.

Such shortages have attracted several humanitarian projects that involve governments sending invitations to visiting surgical teams from foreign countries--but that has not helped create long term solutions.

According to Prof Janabi, this is also the reason behind the surge in the number of children with heart complications being sent abroad by the government or through some Non-Governmental Organisations.

‘’But majority remain on a non-ending waiting list, unsure of when they might get treatment,’’ he saysWorse still, the parents of these children usually experience psychosocial problems, much as their understanding of their children’s heart problems remains limited too,’’ adds the government’s senior cardiologist and head of presidential physicians.

Globally, it is estimated that approximately 8 to 10 out of every 1,000 live children are born with congenital heart defects every year.

These statistics have remained constant in different parts of the world but in Tanzania, there is no specific data on the extent of the problem.

MNH has embarked on a move to educate mothers and guardians, but also, according to Prof Janabi, plans are underway to carry out mass education campaigns through the Ministry of Health and Social Welfare.