Health City Cayman Islands Chief Pediatric Cardiologist Dr. Sripadh Upadhya has performed thousands of heart surgeries during his career with the India-based Naryana health system, but he has seen only a handful of patients with problems like the one found in year-old Miloury Jeudy of Haiti.
The child is one of three heart patients who were picked up at Port-au-Prince airport on Aug. 6 via a cooperative program managed by Health City hospital, nonprofit Have a Heart Cayman and the Haiti Cardiac Alliance.
Since December 2014, private planes have been shuttling patients back and forth between Cayman and Haiti for surgeries funded partly by donations to Have a Heart and partly by what amounts to nonprofit work for Health City Cayman Islands.
It’s unlikely a child with Miloury’s condition would have lived to see her 16th birthday without undergoing the complex surgical procedure that is, at least at the moment, impossible to perform in Haiti.
“There’s a hole in her heart, but it’s in a very unusual location,” Dr. Upadhya said. “It’s in between two arteries. We use a device to close [the hole] … it’s very rarely done. This defect is very rare … it’s maybe the third or fourth one I’ve done.”
Miloury came out of the operation healthy and happy, according to reports from the hospital, and will be headed back to Haiti – as of this writing – as soon as travel arrangements can be made.
The three children on this latest trip, Miloury, 15-year-old Benjamin Baptiste and year-old Mchaendel Gilot, all had surgeries at Health City on Aug. 18-22, about two weeks after a private aircraft owned by the Dart group dropped them off at Owen Roberts Airport.
Dr. Upadhya said the other two surgeries he performed were not nearly as complex as Miloury’s, but they did present their own challenges – in particular, Benjamin’s surgery. The teen has lived with what Dr. Upadhya termed a “restricted” pulmonary valve which has limited blood flood to his body and brain and limited his development.
The procedure Benjamin underwent, called a balloon pulmonary valvotomy, is trickier to perform the older a patient gets. Dr. Upadhya said the same valvotomy procedure was used on year-old Mchaendel, but would be much more difficult for someone of Benjamin’s age.
Benjamin’s mom said she hoped her son would be able to speak words following the surgery at Health City, which he has never been able to do, but Dr. Upadhya said, unfortunately, that would not be a result of the surgical procedure.
“He has Down syndrome, which is independent of the cardiac issues,” the doctor said. “His mental development difficulties are permanent. He has to go to speech therapy.”
While they stay in Cayman, the Haitian children and their guardians – some of them parents, some close relatives – stay in two rooms of a hospital ward at Health City Cayman Islands on Grand Cayman’s eastern district. An interpreter from Port-au-Prince travels with the group and stays with them to translate the French-derivative patois spoken by the Haitians.
“They are very much comfortable and they are quite happy to spend the time here in the hospital,” Dr. Upadhya said. “They don’t feel like their families are away from them … with the interpreter here. They like going out and enjoying the beach.”
Haiti heart patients
To send young patients to Grand Cayman, a Haitian social worker, Kessy Acceme, and his employer, the Haiti Cardiac Alliance, contacts Health City doctors and Jennifer McCarthy, the director of Have a Heart Cayman.
McCarthy, former executive director of HospiceCare Cayman, now works from an office in Health City on fundraising and logistical efforts for the heart surgeries. The medical professionals make an annual trip to Haiti to pre-screen potential patients. On the most recent trip to Haiti, McCarthy said she went along with Dr. Upadhya to screen about 150 potential patients for surgery in Cayman.
McCarthy said it was heartbreaking to watch. Some of the children attending these screenings have such severe conditions, mostly requiring heart replacement surgery, that Health City is unable to assist. Other children aren’t chosen because they are too young; doctors hope they will “grow out of” their heart ailment.
Among the 150 potential patients, about 60 were chosen. They are the ones who will hope to attend Grand Cayman for medical procedures within the next several months, if they can make it in time.
“Once they’re prioritized, then it’s down to who can get a passport and [which cases] are most urgent,” McCarthy said.
Watching Dr. Upadhya’s skill and professionalism as he handled some 40-50 screenings per day [typically U.S. or Canadian heart specialists would not handle more than a dozen or so in a day] was exceptional, McCarthy said.
“He’s used to seeing that many patients from practicing in India,” she said.
Not all patients will get to go, and even some heart patients who are “on the list” to receive surgeries at Health City or elsewhere do not survive long enough to arrive for the life-saving procedure.
Speaking to the Cayman Compass at the Port-au-Prince airport on Aug. 6, Acceme was well aware that a few of those kids – some just toddlers or babies – had already missed their chance.
“In the past few months, we’ve had five kids die waiting for surgery,” Acceme said. “But it’s just beautiful when kids go to the Cayman Islands for surgery and they come back healed and happy. They can do anything they want in life.”
Saturday’s visit to Port-au-Prince brought the happier version of this story.
Ultimately, Acceme said, the Haiti Cardiac Alliance wants to open its own “center of excellence” for these types of surgeries in the home country.
The bureaucratic and logistical problems in the impoverished Caribbean nation make getting children out in time to receive life-saving treatment a monumentally difficult task.
Acceme said almost all of these families have never left Haiti, some have never even left their ancestral villages, and acquiring a passport through the current processes may take more time than the young patients have left.
Nonetheless, the Haiti Cardiac Alliance has managed successful medical procedures for about 200 children around the world, with about one-third of those (64 surgeries) having been performed at Health City Cayman Islands since late 2014.