Cardiologists without borders

11-year-old Mazen from Gaza and Sagi Assa

“When I was one year old, my father died in the war between Israel and Egypt and I was left with a broken heart, which has no good treatment in the cath lab or the operating room,” says Sagi Assa (Wolfson Medical Center, Holon, Israel) telling Cardiovascular News the driving force behind his career in paediatric interventional cardiology.

This early trauma is perhaps one motivating factor that led Assa to become one of around 140 physicians working with the Israel-based humanitarian organisation Save a Child’s Heart, which, over its 25-year existence, has helped to deliver more than 6,000 interventional and surgical cardiac procedures to children from 63 countries, including some of the most impoverished and politically challenging regions of the world.

Through Save a Child’s Heart, children suffering with congenital heart disease—who would otherwise struggle to access treatment—are offered cutting-edge care, with costs including travel, accommodation and treatment, funded entirely by the charity. Much of this work extends to Africa, where Save a Child’s Heart has treated children from 28  countries to date. But, it is the organisation’s work with children closer to home, in Gaza and the West Bank—making up around 50% of the overall intake—that has garnered the most attention.

“Every Tuesday we have a Palestinian clinic running, no matter what the political situation,” Assa tells Cardiovascular News. These sessions typically involve screening between 20 and 25 children who are assessed for potential care. Assa and his colleagues work with doctors on the ground in Gaza, where there are no centres for interventional cardiac treatment, to identify possible urgent cases.

“Even if a child is born and needs urgent intervention they can be referred to us. The local physicians in Gaza have my phone number and they can call me even in the middle of the night to refer the child. In a few hours they can be in our hospital and treated just like any Israeli child,” Assa explains.

Despite the volatile situation in the region, Assa says that the important work that he and colleagues are carrying out helps to build bridges between populations that would otherwise be separated across the political divide. “The first meeting can be a very intense meeting,” he says, reflecting on the initial interaction with young patients—and their parents—who may be travelling into unfamiliar, and what they may perceive as hostile territory for the first time. “They can be afraid to meet us. I think it is very natural if you come to an Israeli hospital as a Palestinian, with the intense atmosphere between Israelis and Palestinians.”

However, Assa is a firm believer that projects like Save a Child’s Heart are furthering the cause of peace in the region. “Once they leave, they hug you, they smile, they laugh with you. It is like becoming a family. They feel very close,” he says. “This is a privilege we have as doctors. Despite all that is going on here around us, we really get attached to each other, and I think that this is the beautiful thing about Save a Child’s Heart. We all become ambassadors of peace, and these are seeds that I really believe in the future are going to help these two countries get closer to each other.”

For 11-year-old Mazen, Save a Child’s Heart’s 6,000th patient, the strong ties between Gazan doctors and Assa’s team has proven to be life-changing. During the first few weeks of his life, doctors in Gaza diagnosed Mazan with a congenital heart condition which required surgery. As he grew older, Mazan’s defect made it more difficult for him to breathe, and in late 2021 it was decided he needed emergency intervention—something that is not available to him in his home territory. Gazan doctors Abdalraheem Said and Hany Al Faleet referred Mazan to the Save a Child’s Heart programme in the hope that he could receive the care needed.

Swiftly transferred to the Israeli team, Mazen was treated at the Save a Child’s Heart International Pediatric Cardiac Care Center at the Sylvan Adams Children’s Hospital at the Wolfson Medical Center in Holon. First he was screened by Alona Raucher Sternfeld, the centre’s director of paediatric cardiology, before he was treated in the hospital’s new hybrid cath lab, in a procedure performed by Assa.

“When he was referred to us there was a question if it was possible to treat him in the cath lab, or if he would need a second surgery. We have to remember that reoperating on a child who has already had open chest surgery means a much more complicated operation,” says Assa. “The defect Mazan had was very near to his aortic valve, and I am happy that due to very advanced technology in the new cath lab we were able to offer him better treatment. Instead of being operated on he was catheterised.”

Speaking to Cardiovascular News in early 2022, Assa says he has been encouraged by Mazan’s swift recovery from the procedure. “The beautiful thing about cath labs is that the children can enter very sick, and half an hour after [the procedure] they have no scar, they are back to their normal life and feel much better. Mazan had really big problems before with breathing, with exercising, and the day after he was fine,” Assa explains.

Some of the African children being treated by SACH (PRNewsfoto/Save a Child’s Heart)

Now marking its 25th year in existence, Save a Child’s Heart has its sights on expanding its reach to offer care further afield. “We have to remember that eight of every 1,000 children are born with a congenital heart defect,” says Assa. “Half of them will need some intervention. It means there are so many children here in Israel, in the West Bank, in Gaza, and of course in Africa, who without getting this intervention are dying. Our aim was always to grow, and to save more children.”

One branch that the organisation looks set to expand is its training offering, which has already contributed to training several physicians in Tanzania, Zambia and more recently Ethiopia to deliver care for paediatric congenital heart patients. Save a Child’s Heart has also recently announced a new partnership between with Israel’s Ministry of Foreign Affairs (MFA), through its Africa Division and Agency for International Development Cooperation (MASHAV), which will bring 25 children from 25 African countries to Israel for care. The partnership will expand the geographical reach of the charity to help children from an additional 11 African nations—South Sudan, Democratic Republic of Congo, Chad, Sierra Leone, Liberia, Cameroon, South Africa, Angola and Mozambique—in receiving care.

Reflecting on his affiliation with Save a Child’s Heart, which has lasted for 20 of the organisation’s 25 years, Assa sees a personal humanitarian mission running in step with that of the charity. “It was probably destiny for me to become a cardiologist and to heal and save children with heart problems. I am very proud and very happy for every child that we are able to save. I go back home very satisfied,” he reflects. “I have friends and colleagues in the USA and in Europe, and some of them cannot treat patients because they do not have the right insurance, or because there is not the right facilities to treat them. So, being able to help children, not only Israelis but from other countries, it is a big privilege.”


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