Healing Hearts in Iran

October 13, 2015 | Pulitzer Center

Farzana Shah

Ava, 2, had the holes in her heart mended during the first week of the medical mission. She was discharged from the ICU one day after surgery. Image by Farzana Shah. Iran, 2015.

Zahra, 9, had surgery that completed her single ventricle physiology. Her smile here was captured two days after her repair. Image by Farzana Shah. Iran, 2015.

Sri Rao, a cardiologist with the William Novick Cardiac Alliance (NCA), is screening children for cardiac surgery. Changes to the operating schedule are made if a child with urgent need is identified. Image by Farzana Shah. Iran, 2015.

Abolfazl, just two months shy of his fourth birthday, required two open heart surgeries during the medical mission: one to correct two leaky valves in his heart, and a second to fix his heart rhythm by the placement of a pacemaker. Image by Farzana Shah. Iran, 2015.

One-year-old Mohammad was content as long as he had a bottle of milk in his hand. He had Glenn shunt surgery which routed a portion of his blood to go straight to his lungs rather than coming back to the heart. Image by Farzana Shah. Iran, 2015.

Karen Bowtell, a ICU Nurse Educator with the William Novick Cardiac Alliance (NCA), is captured while reviewing ICU topics with one of the local nurses. The main goals of NCA are to collaborate and train local colleagues so that they can provide cardiac care for children independently. Image by Farzana Shah. Iran, 2015.

To hold a child in times of fear, discomfort or sadness is a focal point of nursing children. The healing touch of Fahima, an Iranian ICU nurse, with little Mohammad, 5, is captured here. Image by Farzana Shah. Iran, 2015.

Jack, a respiratory therapist with the William Novick Cardiac Alliance (NCA), reviews ventilator management with Iranian ICU nurses. The nurses took the opportunity to have a one on session with a respiratory expert. Image by Farzana Shah. Iran, 2015.

Baby Misq and his mother after surgery. Misq and his parents traveled from Baghdad, Iraq, to Tehran when they heard that William Novick Cardiac Alliance (NCA) was making a trip to Iran. Image by Farzana Shah. Iran, 2015.

Ali-Reza, 14 months, loves his photo to be taken. He was discharged from the ICU two days after surgery. Image by Farzana Shah. Iran, 2015.

Partnership is a key during a medical mission. Here Dr. Novick (red hat) mentors Iranian surgeons through a cardiac surgical case. Image by Farzana Shah. Iran, 2015.

A group photo of ICU and surgical staff is taken after the final case came back from the ICU. Image by Farzana Shah. Iran, 2015.

With nine operating days, a total of 23 children received opened heart surgery and 17 other children underwent catherizations at Children’s Medical Center in Tehran. Children were screened daily in the clinic and added to the list with the most critical cases put at the highest priority.

The ability to have so many surgeries in such little time was due to the close partnership between the William Novick Cardiac Alliance, an American-based non-profit, and the local staff at the Children’s Medical Center. An existing cardiac program in the hospital allowed for the greater concentration of the cases to be of a higher complexity. One-on-one training of these cases could occur in both the operating theater as well as the ICU.

While industrialized countries have benefited from the advancement in pediatric cardiac surgery over the last 50 years, there are still major gaps in access to this service worldwide. According to the World Society for Pediatric and Congenital Heart Surgery, the mortality rate of children jumps from between 3 and 7 percent to 20 percent in developing countries. This quota may be higher in third world countries due to the lack of resources in diagnosing cardiac anomalies.

The Children’s Medical Center in Tehran is unique in distinguishing between its pediatric cardiac intensive care unit and its neonatal cardiac intensive care unit. The division of these two populations earlier this year permitted for both of the nurse-led ICUs to specialize their training. As a result, they had a significant decrease in the mortality rate of their neonatal population. This leading center brings great promise to this region by providing accessibility to adequate cardiac care.