First Open Heart Surgical Procedures Done In Belize
posted (July 18, 2012)
Jules Vasquez Reporting
Dr. Bernard Bulwer - Echo-Cardiologist
"This huge undertaking of a cardiac surgery, which - in the words of CEO in the Ministry of Health, he said that he did not believe he would see the day in his lifetime, cardiac surgery in Belize at the KHMH. Now, it has happened."
And this is the team - or at least some of them that made it possible - participating in the first two open heart surgeries in Belize's history.
Dr. Francis Gary Longsworth - CEO, KHMH
"Certainly, it is cutting-edge surgery, and the surgery that was done here is no different or no less than the surgery that similar patients will get in the USA, Canada, Europe - anywhere in the world."
And anywhere in the world, it would cost about one hundred thousand US dollars - but for these first two patients, it was free.
But the real miracle is that it happened at all - the team was led by Mr. Adrian Coye:
Mr. Adrian Coye - Cardio-Thoracic Surgeon
"I trained both in Jaimaica and in the UK, and I qualified in both countries. I experienced both what it is to be pioneering already, and what it is to work with everything in place. What I did on Monday, is virtually impossible because I made these gentle folks work in 94 degree temperatures to do a case that we know had to be done, and anywhere else, they would have just cancelled the case."
But they soldiered on and pulled it off - the first surgery lasting about three hours, the second about four hours. Two history making procedures performed without a hitch by Coye with support from a team of international partners led by the legendary Dr. Francis Robicsek and assisted by Dr. Robert Stiegel, as well as a team of many others.
Open heart surgery is especially complex because - as the name implies - they have to open the heart which means stopping it - while this machine continues to feed oxygenated blood to the brain and the rest of the body:
Mr. Adrian Coye
"Open heart surgery involves making a generous incision - or in some cases, small incisions on the chest - to access the heart. The heart ailments may be variable. The valves may be tight, leaking, not working so well, or we may have blockages of blood flow to the heart muscle, of what's called the coronary vessels. We arrest the heart with a special agent, and in that light, it allows us to make incisions on the chambers, to see the valves, to take out the valves, and putting in new ones."
Dr. Bernard Bulwer
"Open-heart surgery is the only type of surgery that requires that your heart and your lungs go out of operations. That's why you have to have a heart-lung machine, and so that has been the thing that has bedeviled, or made heart surgery so challenging."
Mr. Adrian Coye
"But, to do it well, you have to have people who know what they're doing, and there is a team effort. This is what we were able to demonstrate, that by having the right people in place, the right team, then it is possible here, even at the KHMH."
And that is a theme they kept coming back to - that the high accomplishment of this surgery can be the impetus that lifts the much-battered institution out of the morass of public accusations and bad press:
Dr. Bernard Bulwer
"It is about the impact that it has on the entire institution, on the art of what is possible - on moral. The KHMH has strived - and in my recent tenure - it has strived because we said that the way to get an istitution that is beaten up, week after week in the media - the way to get an institution which has to operate on the same budget, how can we take that status quo, and take it to what we see now? It is because of the good will of the Belizean people, the good will of the international community, and the good will of everyone who has been involved. And we pray that the entire services of this institution, across the spectrum, will continue to grow, and the moral of all involved. We remember the KHMH, not for stuff which sounds juicy in the media, but for an indispensible institution, worthy of all the help and support."
Whether the surgery can transform the culture at the KHMH is left to be seen, but it can save lives:
Mr. Adrian Coye
"There are a lot of Belizeans with coronary artery disease, and you hear in the media sometimes that young professionals falling down from a massive heart attack. Now, that is treatable; that's what we're getting at, the fact is that they are treatable conditions."
But don't expect the next open heart procedure next week - we're not quite there yet:
Dr. Francis Robicsek - Chair Emeritus, Department of Cardiovascular and Thoracic Surgeries
"I want to say that we are extremely lucky on one end to have a high-level trained cardio-thoracic surgeon, but you will need to fill in the holes. You need some additional training for some of the personnel, and you need personnel - especially Belizean invasive cardiologists."
Mr. Adrian Coye
"The whole purpose is not for just 2 surgeries to be done. We're saying that we're building toward having our own local team, and to be independent in our own way. But, we have a beautiful partnership that will nurture us and help us with training and all of that. Everything is a process. This is the first part - the first step, as they say in the thousand-mile journey. But we have to be responsible in the steps that we take, and we don't want to embark on something that we cannot maintain. So, every step along the way, we have to build the foundation."
And that foundation finds its cornerstone in Mr. Adrian Coye - whose vision has been realized against all odds:
Dr. Bernard Bulwer
"Dr. Coye did, in my opinion, one of the craziest things. Less than 2 years ago, he came back to Belize to start cardiac surgery, when at that time, we did not even have a proper cardiology service. We did not have the type of echo-cardiograph support, which was reliable. We did not have a cardiac catheterization laboratory. So how can you even talk about doing cardiac surgery? We have seen - because of a dream and a desire - all of the different pieces come into place."
Mr. Adrian Coye
"Yes, we rose to the challenge, and what I had to do is what I was trained to do. It was fairly straight-forward, but what was difficult was to reach that point. And that was really where you literally were carrying mountains on your shoulders, just to reach that point. To make that step - I think - took, personally, great courage for me to just say, 'Let go ahead and do this case.' I am living the dream, and I'm very honored to be here to serve my people, and I hope that this is the beginning of greater things to come."
The 86 year old Dr. Robicsek was also the one who spearheaded the donation of the Cardio-Cath Lab in February.
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