1: What are you trying to accomplish?
2: What's your evidence that you can accomplish it?
3: How is it possible that you can provide an open heart surgery in Iraq for less than $1,000? Is that the full cost?
4: So is that the same thing as saying that my donation doesn't really make a difference? That the "up to 85%" funded locally by those inside Iraq is all that is really necessary to make this work?
5: Any other costs?
6: What is the bottleneck to more surgeries: money or skilled labor?
7: I'm skeptical of non-profits and charities because they always seem to be asking for more money. How can I be sure that Preemptive Love Coalition has "room for more funding" and that I'm not paying into a huge savings account, "Rainy Day Fund", or something similar?
8: Do you have enough volunteer surgeons available for unfunded Remedy Missions? (i.e., are there trips that you could fund if you had more money, or is there a labor bottleneck?)
9: Many heart surgeries require follow-up treatment (including additional surgeries). Do you have a way of providing these to patients?
10: How do you assess whether surgeries are completed competently and appropriately?
11: What is the rate of complications during and following surgery?
12: How do you assess whether surgeons are performing additional surgeries that they would have not had the funding or motivation to perform otherwise?
13: How do you assess whether surgeons are charging their patients for the surgeries you fund?
14: Do you follow up with the surgeons you've trained to assess whether they are correctly applying their training?
15: What information is available on the activities - and competence - of the surgeons you've trained?
16: Where do surgeons work after completing training? Do they serve poor patients?
17: How much do you spend each year on "program" expenses and how much on "overhead?"


----------

 Q: What are you trying to accomplish?

A: Train Iraqi heart surgeons and nurses so they can eradicate the backlog of tens of thousands of Iraqi children waiting in line for lifesaving heart surgery. [Back to Top]

 Q: What's your evidence that you can accomplish it?

A: Each year we continue to increase Iraq's total number of pediatric cardiac surgeries with new surgeries in Iraqi centers that would not - indeed could not - have been accomplished otherwise. Ministry of Health (MOH) officials speculate 500 surgeries were accomplished in 2009 (of which we provided 23 - 4.6% - outside the country). The addition of our 82 surgeries in FY 2010 - to the 500 baseline - for a total of 582 approximated surgeries, represents an increase created by PLC of 14% over 2009. In FY 2011 we anticipate increasing Iraq's total number of pediatric cardiac surgeries to at least 719 (or another 19% over FY 2010 directly attributable to our surgeons and our training).

Each year the local teams with which we work will become more proficient, and each year they will independently take on a larger case load than they could have the year before. None of these figures yet account for that additional output.

In March 2010 the Iraqi Ministry of Health asked us to expand our work to three additional sites. In May 2010 we began additional discussions about establishing a fellowship program in which international surgeons and nurses would take up residence in the Iraqi system to train locally for 40 weeks out of the year.

Our model does not rely strictly on volunteers because the level of need in Iraq outstrips what we could reasonably supply through volunteer labor alone. Accordingly, we set our budgets so as to actually contract the international surgical and nursing staff we need to accomplish our mission.

Sure, this increases the cost-per-mission (and thereby, cost-per-child) over early "mission" models in which volunteerism was idealized and training was not necessarily prioritized. But our contract labor + volunteerism model is inarguably the only way to create a nationwide quarterly training program and fellowships inside Iraq with international experts across approximately 6-8 surgical sites. Moreover, our model does not face the same sluggishness of learning that other surgery organizations suffer because we do not have the same rates of turnover; we have incredible consistency across our programs and missions. [Back to Top]

 Q: How is it possible that you can provide an open heart surgery in Iraq for less than $1,000? Is that the full cost?

A: The "less than $1k" numbers we routinely publish represent the amount in "program costs" we spend from our international donor money. The figure does not necessarily account for every single management, overhead, or fundraising expense.

Our total expenditures for FY 2010 were $188,919. We performed 82 surgeries during the same period for a per child total of $2,304 (though this data is a bit moot moving into 2010-11 as we abandon our very expensive "surgery exports" program(s) in Turkey, etc. and focus henceforth on more cost-effective in-country surgeries alone).

When all of our Remedy Mission partners are taken into consideration - including the Iraqi Government, medical companies that donate medicines and supplies, and local organizations - the real Remedy Mission cost to all donors is in the range of $5,400 - $7,000. Put another way, up to 85% of the total cost of a single surgical/training mission is now subsidized by local, Iraqi constituent institutions. [Back to Top]

 Q: So is that the same thing as saying that my donation doesn't really make a difference? That the "up to 85%" funded locally by those inside Iraq is all that is really necessary to make this work?

A: There is not a single site across Iraq for which our Remedy Missions are fully funded. If we fail to provide our 15-19% of the overall budget, Remedy Missions fail, surgeons and nurses do not get trained regularly, on-site audits from our international team do not happen, up to 20 children are delayed from receiving surgery, and a few may even die or become inoperable. Your role in funding the remaining 15-19% is as critical in the short term as any other entity. A single Remedy Mission is binary - it either happens or it doesn't. Your money makes it happen. But our goal is to continue to graduate all our programs so they are 100% funded locally in the next 5-10 years. [Back to Top]

 Q: Any other costs?

A: Our numbers per Remedy Mission do not account for "indirect costs," such as the cost (or value) of our volunteer medical staff from around the world, costs to local healthcare systems, the cost of a family to travel to the surgery site, the opportunity costs of lost income for families as they wait for surgery, etc. The reason we think it's important to note this here is because lifesaving is actually quite difficult. Building a pediatric cardiac surgery system for the entire country of Iraq is laborious and full of complexities. [Back to Top]

 Q: What is the bottleneck to more surgeries: money or skilled labor?

A: People often assume that the biggest need is more Iraqi heart surgeons. We could use a few more, but the real bottleneck is skilled nurses, technicians, and non-surgical physicians. A surgeon is only as good as his support staff. One of our biggest challenges is training pediatric cardiac intensive care nurses. To date, we haven't found a better model than our Remedy Missions through which we bring quarterly hands-on training to local nurses (and surgeons) in Iraq. Rather than exporting the nurses to Europe or the USA for training (whose medical systems barely resemble the Iraqi system), we train them with what they have on hand in their local environment. [Back to Top]

 Q: I'm skeptical of non-profits and charities because they always seem to be asking for more money. How can I be sure that Preemptive Love Coalition has "room for more funding" and that I'm not paying into a huge savings account, "Rainy Day Fund", or something similar?

A: For the record, we are skeptical of non-profits as well! In 2012 PLC needs $350,000 on hand at any given time to cover our cash flow needs for up to three Remedy Missions per quarter. We are still 30% under-funded against that goal. In addition to cash flow needs, we still require 15-19% funding on most of our missions after local sources contribute their portion; we have un-funded pilot programs in new cities where local doctors have been requesting our help (but where weve yet to woo local philanthropists or health directors); and we have research and social service initiatives through our Followthrough program that require funding at present because we have not yet sought local funding for those initiatives (seeing as how they relate mostly to our Monitoring & Impact Evaluation objectives). Please see our "Funding Gap" page to look deeper into our anticipated program costs, the sources of funding we are counting on, and the funding gap between the two for the next few years. [Back to Top]

 Q: Do you have enough volunteer surgeons available for unfunded Remedy Missions? (i.e., are there trips that you could fund if you had more money, or is there a labor bottleneck?)

A: Great question! We use a hybrid volunteer/staff model. Roughly 25-30% of any one of our Remedy Mission teams is employed by the International Children's Heart Foundation (typically the surgeon, scrub nurse, anesthesiologist, ICU doctor, and often a part-time ICU nurse). The remainder of the team typically comprises volunteer physicians, technicians, and nurses from across the world. Because the hardest-to-come-by positions are contract labor for us and NOT volunteers, we have never failed to run a mission for lack of personnel. We have only cancelled or turned down a request for a future mission due to lack of funding. [Back to Top]

 Q: Many heart surgeries require follow-up treatment (including additional surgeries). Do you have a way of providing these to patients?

A: Yes, we do. Our model dictates quarterly visits to each program site (a hospital inside a regional hub). Our reliance on local cardiologists ensures that the local team prioritizes and almost entirely sets the agenda for patient selection (within a development curricula) - after all, Iraqi doctors are the ones who are most intimately connected to the patients and their daily progress! When a local cardiologist sees a child who has either (1) deteriorated and requires another intervention or (2) advanced as expected to the next step of a complex, staged intervention, the child is prioritized for follow-up treatment. [Back to Top]

 Q: How do you assess whether surgeries are completed competently and appropriately?

A: Because we are a broker and play a combination administrative and financier role in the coalition of partners working in Iraq to develop pediatric cardiac care, we are able to stand in-between the local surgical team and the international surgical team (whom we contract as a third-party to train and perform surgeries in Iraq). If the local team or health directorate suspects a lack of competence in the international team, a cavalier attitude, or a single poor judgement call, our role is to be the go-between - to be the advocate for the local healthcare providers vis-a-vis the international surgical team.

Similarly, if the international surgical team feels pushed by the local surgical team to perform procedures with which they are uncomfortable or for which they think the local system is ill-prepared, they are able to refuse children for surgery and/or use us (PLC) as a go-between.

The checks-and-balance between the two teams helps us ensure surgeries are performed in a competent, appropriate manner. [Back to Top]

 Q: What is the rate of complications during and following surgery?

A: We report our in-hospital and 60-day mortality after each Remedy Mission. You can finds those numbers here. We also produce reports after each Remedy Mission detailing the trip, including data on intraoperative complications, post-operative complications, and mortality. You can find those reports here. We are also deliberately raising the funds necessary to help us bring our various heart hospitals into compliance with the International Quality Improvement Collaborative for Congenital Heart Surgery in Developing Countries. If this kind of quality improvement and reporting initiative interests you, we are currently looking for financial partners for our Followthrough program. [Back to Top]

 Q: How do you assess whether surgeons are performing additional surgeries that they would have not had the funding or motivation to perform otherwise?

A: Pediatric heart surgery in Iraq is almost nonexistent without our work. There are two active programs for relatively simple surgeries (one in Erbil and one in Baghdad). Local surgeons claim that combined they perform no more than a few hundred pediatric surgeries a year. In every location where we work, pediatric heart surgery is effectively nonexistent. Therefore, every surgery performed at our program sites (both when we are present and when we are not) are "additional surgeries" that they would not have had the SKILL to perform without the FUNDING we employed to train them in their local environment. [Back to Top]

 Q: How do you assess whether surgeons are charging their patients for the surgeries you fund?

A: Because we work in public (government) hospitals - and because healthcare in Iraq is provided almost entirely free of charge - it is widely known that any cardiologist, surgeon, or administrator seeking compensation for services is acting outside of Iraqi law. [Back to Top]

 Q: Do you follow up with the surgeons you've trained to assess whether they are correctly applying their training?

A: We see them quarterly in their local environment and perform real-time audits of their skills, recollection of past training, application of new techniques, etc. Additionally, our international surgeon remains on call at any time via phone, Skype, or email for consultation. [Back to Top]

 Q: What information is available on the activities - and competence - of the surgeons you've trained?

A: Because our Remedy Mission training program only began in late 2010 - and pediatric heart surgery at our sites across Iraq is the same age - there is still relatively little independent practice to report, and therefore little data on the activities and competence of our surgeons and their teams. But as they begin performing more surgeries independently, we are trying to align each site/surgical team with the International Quality Improvement Collaborative for Congenital Heart Surgery in Developing Countries (a data collection and tracking initiative of Children's Hospital Boston and Harvard University). [Back to Top]

 Q: Where do surgeons work after completing training? Do they serve poor patients?

A: As of Q2 2011 there was only one private hospital in Iraq (to our knowledge) providing pediatric heart surgery (and those surgeries were on the lower end of the complexity scale). Our work does not necessarily mean to exclude private hospitals as they continue to come online and become viable options, but at present the government system has a better equipped foundation for training local surgical teams. As we look to fully graduate our local surgical teams in the next 5-10 years, we imagine that most of them will stay in the public sector for all of the stability, pensions, and benefits of loyalty provided to those who stick with it. But, undoubtedly, some will seek positions at private hospitals (assuming private hospitals are willing to invest in the requisite capital purchases necessary to establish a credible program). In the public sector, rich and poor are served alike. In the private sector, poorer patients would be at an obvious disadvantage. [Back to Top]

 Q: How much do you spend each year on "program" expenses and how much on "overhead?"

A: As a rule, we do not adhere to the model that claims that "overhead" is somehow bad and "program" is somehow good. There are very bad program expenses. There are overhead expenses that are excellent investments. We agree with Paul Brest, President of the Hewlett Foundation, when he said, "Achieving a low overhead ratio drives many charities to behaviors that make them less effective and means more, not less, wasted dollars." Therefore, we spend as much on overhead as we need to accomplish our mission. The mission itself is our North Star - not arbitrary (even harmful) standards about overhead-vs-program expenditures. For the record, however, you can find a current pie chart of our expenditures here (and if you're into that sort of thing, you'll probably be impressed!). [Back to Top]

Jeremy Courtney Founder, Executive Director Twitter: @Jeremy_Courtney

“I'd love to hear any critique or questions you might have!”

DROP A NOTE OR DONATION BY MAIL: Preemptive Love Coalition 1300 Darbyton Dr. Hewitt, TX 76643 GIVE BY PHONE: To make a gift over the phone, using your credit card (Visa, MasterCard, American Express, or Discover), please call +1 (806) 853-9131 during normal business hours. IRAQ OFFICE: +964 770-355-6298 (local)

The Surgery Was A Success! After Much Difficulty, Mohammed & His Mother Are Going Home!

July 10, 2011 by Alex · 1 Comment 

Mohammed – quite possibly one of the cutest kids in southern Iraq – is currently resting after his successful surgery!

On our last day at the hospital we found out that Mohammed has suffered through much more than a failing heart; just before he was born his father left their family, and his mother was left to raise him alone.

That’s a big deal in a region like southern Iraq. It’s not easy for a woman to take on that kind of responsibility alone, which is why I feel such respect for Mohammed’s mother.

Like so many single mothers, she worked hard to raise an amazing kid, and she helped get him to the place where his life could be saved.

So, as we near the end of Remedy Mission VI, we’re celebrating Mohammed’s successful surgery, but we can’t really celebrate his life without acknowledging the hero who has always stood behind him.

We’re excited that Mohammed’s heart is healing, and he can now grow into a man capable of caring for the woman who sacrificed so much for him.

So from Mohammed, his mother, and all of us – thanks for saving his life!

Our Partners:

Alex Phillips, a two-time PLC summer intern ('10 & '11), has invested his heart into the surgical and medicinal aid available to the children of Iraq, hoping to better understand the complicated ties between poverty and health. On his off days, Alex spends his time reading up on his field, listening to punk rock, riding his bike, and updating his Twitter: @_alexphillips.

After Nearly Two Weeks of Waiting, Mohammed Is In Surgery!

July 8, 2011 by Alex · 1 Comment 

After nearly two weeks of waiting, Mohammed is now in surgery!

He’s brightened our days here in southern Iraq, and now our Iraqi and international surgical team is working to repair his heart so he can continue brightening days for many years to come!

Stay tuned…

Our Partners:

Alex Phillips, a two-time PLC summer intern ('10 & '11), has invested his heart into the surgical and medicinal aid available to the children of Iraq, hoping to better understand the complicated ties between poverty and health. On his off days, Alex spends his time reading up on his field, listening to punk rock, riding his bike, and updating his Twitter: @_alexphillips.

Mohammed’s Still Smiling And Is One Day Closer To His Remedy!

July 3, 2011 by Alex · 2 Comments 

My friend Mohammed is back!

Mohammed made me feel so welcomed when we first arrived, and I’ve missed him as he’s been out of the hospital these last few days. But now he’s back and brightening everyone’s day with his contagious smile!

Besides seeing my new friend again, something else has me smiling all day: hearing that Mohammed is scheduled for surgery this week!

Each kid we meet here captures our hearts, but there’s something extra special about hearing how the remedy is coming to a little boy or girl you have a personal connection with. I can’t even imagine how special the feeling of hope and excitement must be for each of these kids, their parents, families, friends, and communities all over Iraq.

Thank you for bringing that feeling of hope to Iraq, and to my little friend Mohammed!

He’s one day closer to his remedy. Get ready!

Our Partners:

Alex Phillips, a two-time PLC summer intern ('10 & '11), has invested his heart into the surgical and medicinal aid available to the children of Iraq, hoping to better understand the complicated ties between poverty and health. On his off days, Alex spends his time reading up on his field, listening to punk rock, riding his bike, and updating his Twitter: @_alexphillips.

Mohammed Is Here For The Remedy

June 29, 2011 by Alex · Leave a Comment 

Today, I hesitated outside the entrance of the hospital ward in southern Iraq. Kids spend most of the day waiting for surgery in this room.

Mothers and their children filled the room, and I didn’t want to barge into a room that these families might have thought were off-limits to outsiders.

But as I stood there, recognizing that I was the outsider, looking confused and out-of-place, a 6-year-old boy named Mohammed walked up, smiled, and took my hand as if he knew exactly what I was going through.

He safely escorted me to the back of the room so I could meet the family I had come to see.

Mohammed never left my side, but just kept holding my hand and making me feel more at-ease until he felt that his duty had been completed.

We couldn’t speak to each other and even though we interacted for only a few minutes, I can’t help but to look forward to spending more time with Mohammed.

What makes me more excited is that Mohammed isn’t just here to help out this goofy foreigner; he’s here to have his failing heart restored.

He’s here for the Remedy.

The doctors are still unclear as to how complicated Mohammed’s heart condition is, but they’re beginning the tests that will help them know what needs to be done to reclaim his heart.

In the meantime, we’ll just keep waiting.

Stay tuned for more updates on Mohammed.

While you wait check out Rokya’s Mom documenting her daughter’s Remedy in Iraq on our Facebook page.

Our Partners:

Alex Phillips, a two-time PLC summer intern ('10 & '11), has invested his heart into the surgical and medicinal aid available to the children of Iraq, hoping to better understand the complicated ties between poverty and health. On his off days, Alex spends his time reading up on his field, listening to punk rock, riding his bike, and updating his Twitter: @_alexphillips.

At Long Last, Haydar is Finally Getting His Surgery!

May 29, 2011 by Alex · 1 Comment 

When I met Haydar he was kicking a soccer ball around the hospital hallway. We played there in the hallway for quite some time, kicking and throwing the ball back and forth between the three of us. I made my arms like a hoop in front of me and Haydar would shoot the ball through them—he’s a pretty good shot for a 6 year old!

Because there are so many children here in need of heart surgery, and because cuteness and playfulness are not criteria we get to use in determining the order for surgeries (unfortunately), Haydar ended up being further down on the surgery list.

But thankfully, after patiently waiting in the hospital and always trying to show us how brave and prepared he was, Haydar is finally getting his surgery! We couldn’t think of a better way to wind down as we near the end of our trip—thank you for helping us bring the Remedy to Haydar!

Our Partners:

Alex Phillips, a two-time PLC summer intern ('10 & '11), has invested his heart into the surgical and medicinal aid available to the children of Iraq, hoping to better understand the complicated ties between poverty and health. On his off days, Alex spends his time reading up on his field, listening to punk rock, riding his bike, and updating his Twitter: @_alexphillips.

The Similarities Between Georgia, USA and Iraq: An Intern’s Perspective

May 27, 2011 by Alex · 2 Comments 

After arriving in southern Iraq about a week ago, I noticed a striking similarity to my first trip in northern Iraq last summer: being graciously welcomed by everyone we met. I can’t say that I was surprised by the Iraqi hospitality (it’s great everywhere we go) but I certainly enjoyed it.

One thing that did surprise me, however, was how similar some parts of southern Iraq are to my home in southeast Georgia. On our day off from working at the hospital, we traveled to the ziggurat at Ur, the city where Abraham started his sojourn, and to the marshes outside of the city. Okay, so maybe there aren’t any huge ziggurat pyramids in southeast Georgia, but there are definitely marshes. Our hosts arranged for us to be taken out onto the water in canoes- I could easily have forgotten where I was while looking out over the beautiful landscape. Of course, turning to the right and seeing a boatload (literally) of our Iraqi friends laughing and taking pictures reminded me I wasn’t in Kansas–I mean Georgia–anymore. Still, between being near my familiar marshes and the incredible hospitality, I keep feeling more and more at home here in southern Iraq.

Our Partners:

Alex Phillips, a two-time PLC summer intern ('10 & '11), has invested his heart into the surgical and medicinal aid available to the children of Iraq, hoping to better understand the complicated ties between poverty and health. On his off days, Alex spends his time reading up on his field, listening to punk rock, riding his bike, and updating his Twitter: @_alexphillips.

Meet Dr. Bob

May 26, 2011 by Alex · Leave a Comment 

He’s a retired pediatric cardiologist who spends some of his free time working with International Children’s Heart Foundation, helping kids in Iraq and training the future of Iraqi medical care—doctors and nurses who are eager to learn. Dr. Bob’s kind demeanor, patience, and medical expertise make him an incredible teacher and the kind of partner we love and need to have in Iraq. These qualities also made the brief conversations we’ve had very enjoyable.

Dr. Bob’s responsibilities here include performing echocardiograms (ultrasounds of the heart), repairing hearts through minimally invasive procedures, and training local staff to do the same. Between saving lives and equipping his Iraqi students with knowledge and skills for the future; Dr. Bob renewed my sense of awe in medical care and motivation for pursuing advances in treatment here in Iraq and beyond.

Want to know more about guys like Dr. Bob? Check out our medical partner, ICHF, on Facebook.

Our Partners:

Alex Phillips, a two-time PLC summer intern ('10 & '11), has invested his heart into the surgical and medicinal aid available to the children of Iraq, hoping to better understand the complicated ties between poverty and health. On his off days, Alex spends his time reading up on his field, listening to punk rock, riding his bike, and updating his Twitter: @_alexphillips.

Surgery, the “Neglected Stepchild” of Global Health

April 3, 2011 by Alex · 2 Comments 

In preparing for my 2nd internship with PLC this summer I came across an article written by two well-known global health advocates and physicians (a prof at Harvard and the current president of Dartmouth, if you’re into credentials) on the topic of surgery in the global health movement. [Paul E. Farmer and Jim Y. Kim. 2008. "Surgery and Global Health: a View from Beyond the OR." World Journal of Surgery 32:533-536].

After discussing this article with one of the directors at PLC and thinking about our current model for surgical aid in Iraq, a few points stood out:

The authors’ first argument is that surgery is the “neglected stepchild of global healthcare.” The fact is, although surgical diseases (CHD being one of the most prevalent) are a major cause of death and disability in much of the world, the vast majority of healthcare programs don’t address surgical needs.

Why? Because surgical interventions are usually complicated and require a larger investment than other kinds of health interventions, and treating surgical diseases requires a more advanced infrastructure and the involvement of more professionals than treating, for instance, malnutrition or malaria.

There is also the fact that surgical diseases have lacked the same kind of advocacy and exposure that have led to funding and programs for “high-profile” diseases like tuberculosis or AIDS.

The other major issue addressed by Farmer and Kim is that countries that actually have the surgical services often only have them in just a few locales, and the treatment is usually too expensive to be accessible by most of the population.

The question then arises: how do we make this treatment available in settings where infrastructure is poor, trained professionals are scarce, equipment is needed, and “the only thing not needed is disease, which exists abundantly.”

Remedy Missions are our answer to that question.

As you know, we recently moved from sending children abroad for surgery to a model that provides more surgeries at less cost while simultaneously training local professionals.

These Remedy Missions specifically address the impediments to surgery in global health described by Farmer and Kim.

They provide treatment of CHD for families that would never be able to afford traveling abroad for surgery. Our work also means we’re freeing surgeons up to focus on surgery, because, as Farmer and Kim write, “clearly we don’t want surgeons to be dragged out of the operating room to manage logistics, supply chains…and financing.”

Remedy Missions provide crucial training for all the different health professionals that are required for a surgery to be successful (surgeons, cardiologists, nurses, etc.).

This process of providing surgery and training is also an exercise in infrastructure building as we work toward the development of heart centers in northern and southern Iraq. The fact that we can count both regional and national governments as partners addresses the need for surgical care in the public sector in Iraq, and it bodes especially well for poor families who will need to receive treatment in the future.

Lastly, the partnership and advocacy of our supporters (that’s YOU) is helping to raise awareness of the burden of CHD and other surgical diseases in places like Iraq.

With well-planned, structured interventions that take into account the needs and problems associated with surgical disease globally, and the support and advocacy of a Coalition of concerned individuals and communities (that’d be you again), problems like CHD can cease to be a “neglected stepchild” of global health and instead serve as a model for building health systems and effecting powerful change in global contexts.

Alex Phillips, a two-time PLC summer intern ('10 & '11), has invested his heart into the surgical and medicinal aid available to the children of Iraq, hoping to better understand the complicated ties between poverty and health. On his off days, Alex spends his time reading up on his field, listening to punk rock, riding his bike, and updating his Twitter: @_alexphillips.

Soccer balls and Staircases Reflecting a Renewed Childhood

July 1, 2010 by Alex · Leave a Comment 

When I visted Ahmad earlier this week, I was struck by two objects that embodied the effect PLC has had on the life of a child who has undergone heart surgery.

The first was the metal staircase leading up to their home on the second level of the block. This old staircase was red, rickety, and full of holes — a lot like Ahmad’s heart was a year and a half ago. Ahmad had one of the most complex cases of heart disease PLC has seen. His combination of defects turned his lips, hands and feet blue from lack of oxygen and assured that he would not have a normal or lasting childhood. But thanks to your support, commitment from his family and the skill of medical professionals in Iraq and Turkey, Ahmad could greet us at the top of the stairs with a smile on his face.

Ahmad’s medical story is not finished. He still has some blue to his lips and will need more surgeries down the line; but a second powerful image — that of a tattered and beaten up soccer ball — made me realize how much of an impact his first surgery truly had.

Worn out soccer balls are certainly not uncommon in Iraq, and I probably wouldn’t have given Ahmad’s ball a second thought if his mother had not pointed out that this was the same ball that was given to him by PLC just a year ago. Ahmad, a boy who had not been able to run last year because of fatigue from a lack of oxygen, had beaten his new soccer ball to shreds playing with friends.

This is the impact Ahmad’s surgery has had. He may not have a totally corrected heart yet, but he does have a childhood — full of running, playing, laughing, falling, scraping knees and wearing out soccer balls.

Alex Phillips, a two-time PLC summer intern ('10 & '11), has invested his heart into the surgical and medicinal aid available to the children of Iraq, hoping to better understand the complicated ties between poverty and health. On his off days, Alex spends his time reading up on his field, listening to punk rock, riding his bike, and updating his Twitter: @_alexphillips.

A Visit to A Local Doctor is Sobering but Encouraging to a PLC Summer Intern

June 15, 2010 by Alex · Leave a Comment 

The past few days of my internship have placed me in the offices of Dr. Aso Faeq. As a partner to the Preemptive Love and an invaluable member of this Coalition, Dr. Aso is the only pediatric cardiologist serving the northern region of Iraq. And what sets him apart even further is that as an intreventional cardiologist – a heart doctor certified to not only diagnose cardiac problems but also perform simple surgical procedures – Dr. Faeq is fullfilling a role that is even more rare throughout the country.

Given his position, Dr. Aso would already have an extensive patient list. But considering the high rate of congenital heart disease in Iraq, it was not surprising to find his waiting room overflowing with mothers and fathers holding and comforting their sick kids, whispering assurance and love into their ears.

Our visits to his office are heartbreaking, humbling, challenging and encouraging.

It is heartbreaking to realize how rampant congenital heart disease is in Iraq. The entire time Dr. Aso met with me and other interns he was seeing patient after patient and diagnosing congenital heart defects such as atrial septal defect, transposition of the great arteries, Tetrology of Fallot and others. It is heartbreaking to know that the best course Dr. Aso can pursue is often a procedure performed to extend a child’s life only a few years so that they can wait for an improbable surgery down the line.

It is humbling to see how Dr. Aso makes these diagnoses using very limited, mostly-donated equipment in a public hospital with little institutional support. It is humbling to see him treat more patients in a day than many doctors see in a week, without any extra compensation, with joy and a smile on his face.

It is challenging, as a student pursuing a career in medicine, to see such stark disparities in healthcare between western countries and that of the region where much of “western” medicine originated. It is challenging to hear this brilliant doctor humbly state that all he wants is the opportunity for more quality training in order to further treat his patients, while simultaneously seeing that desire denied. Because of geopolitical fears and misconceptions associated with Iraqis, Dr. Aso was recently refused a visa to attend a training meeting of the Association for European Pediatric Cardiology, of which he is a member.

And although I’ve left Dr. Aso’s office heartbroken, humbled or challenged, I always leave his office encouraged as well. It is encouraging to know that through his partnership with the Preemptive Love Coalition Dr. Aso can send out families from his office, giving their children a chance at surgery. It is encouraging to realize that even though Dr. Aso may be denied visas to travel and get more advanced training, we can bring the training to him and other local doctors with Remedy Missions. Most of all, it is encouraging to know that “long-term, local solutions” isn’t just a slogan. Long-term, local solutions are people – people like Dr. Aso.

Alex Phillips, a two-time PLC summer intern ('10 & '11), has invested his heart into the surgical and medicinal aid available to the children of Iraq, hoping to better understand the complicated ties between poverty and health. On his off days, Alex spends his time reading up on his field, listening to punk rock, riding his bike, and updating his Twitter: @_alexphillips.

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OUR BLOGGERS

	Matt Willingham is the PLC press secretary and writes primarily on politics, history, general updates and visual peacemaking through photography and film.
	Cody Fisher is a PLC cofounder and writes primarily on program development and peacemaking by giving us a lens into the lives of the real people we love.
	Jeremy Courtney is a PLC cofounder and writes primarily to emphasize our vision and values, including organizational and financial transparency.

Preemptive Love Coalition provides lifesaving heart surgeries for Iraqi kids in pursuit of peace between communities at odds. We offer the 30,000 Iraqi children suffering from life-threatening heart defects a chance at the surgery they need to save their lives. With our world-class international surgical partners we create long-term solutions by training local Iraqi doctors and nurses so they can sustainably save lives without our help.

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