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?"


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 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)

Why Father’s Day Means So Much to Hafez And His Son

June 15, 2011 by Jeremy · 1 Comment 

At exactly this time last year, Hafez (pictured above) was facing down the worst Father’s Day of his life as he desperately worked against the clock to save his son’s life.

At exactly this time last year, we asked for your help… and you came through in a huge way, raising more than $30,000 in just a few weeks so we could launch our first-of-its-kind Remedy Mission inside Iraq.

At exactly this time last year, you made this father’s day and helped secure for him a happier life than the one he was facing without you.

Meet Abdul Kareem – the son of my friend, Hafez. When I met them, they did not have the money to pursue surgery outside of Iraq like all the rich people, people with political clout, or the lottery winners.

I’ll never forget Hafez’s plea to me – certainly the same plea I would make on behalf of my son – “Just do something for him. He’s just a little boy.” He got so emotional that he excused himself from my office. This father, having done all he could for his son, walked away from the office crying. Abdul Kareem needed heart surgery before his first birthday or he was likely to become entirely inoperable – “a lost cause.”

But you weren’t about to let that happen!

The day our surgical team arrived from all over the world for Remedy Mission I, Hafez must have seen us on the news because he called me ten times: “Is my boy going to surgery? Mr. Jeremy, just do something to help my little boy!”

His boy was going to surgery, thanks to those of you who gave in response to our request last year’s for Father’s Day and our Remedy Mission launch!

There is another moment with my friend Hafez that I won’t forget – the day his son Abdul Kareem had surgery. I remember it so distinctly because after the surgery Hafez grabbed me, kissed me, and gave me an tearful “thank you” for keeping our word; for saving his son’s life.

Once Abdul Kareem was discharged to return home, Hafez sent me a message from the road. The message said something like, “Thank you so much for your organization and for helping my little boy. We will not forget you.“ With tears running down his face, he wanted to thank you each by name. You made a father’s dream come true. And you prevented his big brother, Abbas, from growing up without a soccer-buddy.

Dad, I love all the great memories we’ve made together. This year, I wanted to add, “saving a child’s life in Iraq” to the list, so that another child and his father can make great memories together too.

We want to make it easy for you to honor your dad this Father’s Day and help save the life of baby Ghazel. A simple $10 donation will help us save her life and cover the cost of two hours of hands-on training with local Iraqi surgeons! A $25 donation will accomplish that and add hours of training in Iraq for an additional three Iraqi doctors and nurses! If you like, we’ll even provide you with a free downloadable card that you can print and give to your dad this Father’s Day!

Jeremy Courtney lives and loves in Iraq as a co-founder and Executive Director of the Preemptive Love Coalition. He's also the father of two spectacular children, and married to the lovely Jessica Courtney. When not absorbed in PLC work he can be found writing songs and singing about hope and future. Follow Jeremy on Twitter: @JCourt.

Parzheen is doing great, and we’re stuffed!

April 25, 2011 by Cody · 1 Comment 

If you’d have been in Iraq this week, you would have been invited to this feast.

It was a feast celebrating another healthy heart from our most recent Remedy Mission in northern Iraq.

Parzheen and her family invited us to come for a medical checkup and to see the rest of the family, including Parzheen’s grandparents and to spend a day with them in their village. All of this was to thank YOU for saving the life of their daughter!

It was a perfect day. Together with Parzheen and her family we filled the village with laughter as we filled ourselves with the most delicious Kurdish food.

Everything around their home was in full bloom. The turkey’s were gobbling. The chickens were out searching for worms. The garden was beginning to show signs of life. Parzheen was outside playing and keeping up with all of her brothers and sisters, things she couldn’t do before her heart surgery.

It was all perfect and we left Parzheen with a check up that was just as perfect. She’s doing great!

Our Followthrough Program is gaining momentum as we continue to see children each week that were served during our last Remedy. Stay tuned to see more of the stories you’ve forever changed!

On behalf of Parzheen, her family and all of us at PLC, thank you for saving her life!

Cody Fisher is the co-founder and Development Director of the Preemptive Love Coalition. He moved to Iraq in 2007 where he met his wife and since then they've been waging peace and mending hearts across Iraq. His passions are photography, peacemaking, and food that doesn't come out of a can. You can follow him on Twitter: @candmfisher.

Leah’s Story Exemplefies The Need For Followthrough

April 22, 2011 by Cayla · 1 Comment 

As a new member of the PLC team, there’s always something to learn. One of the first things on the to-learn list was how to answer the question, “What’s your job?” in Kurdish. I usually use the term ‘social worker’ to describe what I do, so I asked my language tutor how to say that in Kurdish and she explained that there isn’t a word for it because there isn’t really a job like that in our city.

Because women tend to stay home, the need for a family advocate/social worker to come to them is huge. Unfortunately the need isn’t widely seen, and in many homes even basic healthcare knowledge is lacking.

Last week I went with our family services director, Jessica Courtney, to visit Leah, one of the children who received surgery in March. Jessica was there in the ICU to help Leah’s mom understand the importance of a feeding tube and, for the second time, I got to see her comfort and inform this worried mother about medicines, dosages and how to help her child recover.

Hospital trips and caring for a sick child can be fearful times, and mothers need someone they can rely on. We hope to be that for them.

Leah’s mother wouldn’t have understood the urgency of a feeding tube or her baby’s need for consistent medication if Jessica hadn’t been there.

This is why we Followthrough.

Cayla Willingham is a Family Advocate in PLC's Followthrough program. When she isn't spending time with families, she enjoys cooking up amazing food, hosting friends, haggling at the bazaar, and learning Kurdish.

Parzheen Receives Total Correction; For Discharge from ICU Tomorrow

March 7, 2011 by Jeremy · Leave a Comment 

Parzheen went in yesterday for a total correction of four different heart problems and came through with spectacular results! She had her breathing tube removed within a few hours and her chest tube removed just shortly after that. She will likely be sent out of the critical care unit tomorrow where we will have a few more days in the ward to enjoy her amazing smile thanks to you!

Parzheen’s lifesaving surgery was made possible because of so many of you who have partnered with us through our Monthly Lifesaver program. We love our campaigns and fundraising pushes, but we benefit tremendously from those of you who quietly and faithfully invest every month into children like Parzheen.

We cannot always pre-select children in time to run massive fundraising campaigns in their names. We do not always have the capacity to create videos in advance of surgery. And not every child is your typical “poster child” mold.

Our community of Monthly Lifesavers gives us a steady budget each month that we can rely on to plan for future training and surgery Iraq.

Will you join our community of Monthly Lifesavers? Every bit helps. It’s the faithfulness of your monthly gift that makes this such a high-impact act of love for the children of Iraq.
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MONTHLY SPONSORSHIP Choose this option to give life to children every month for the amount of your choice (entered below). Your credit card will be billed each month without any additional work on your part.

If you’re on Twitter this week be sure to use the #RemedyMission hashtag to describe all the good news coming out of Iraq this week via @preemptivelove.



With help from our friends:

Jeremy Courtney lives and loves in Iraq as a co-founder and Executive Director of the Preemptive Love Coalition. He's also the father of two spectacular children, and married to the lovely Jessica Courtney. When not absorbed in PLC work he can be found writing songs and singing about hope and future. Follow Jeremy on Twitter: @JCourt.

Death Will Never Conquer

March 4, 2011 by Jeremy · 5 Comments 

Yahya passed away early this morning after an all-night surgery. It was a surprise to everyone. When he was admitted to the ICU there seemed to be plenty of confidence that he would be just fine. But within just 30 minutes of admission his heart gave out and all efforts to revive him failed.

I still remember the first time I was introduced to Yahya. It was over a year ago. His uncle called my cell phone and said, “I’m at your office, I need to talk to you about a sick kid.”

It was after hours and I was already at home. But I could hear the urgency in his voice so I invited him to my home for tea. He arrived and made an impassioned plea for Yahya – his brother’s son. I was leery of helping Yahya after reading his reports – we had seen some children with complex heart defects like him die abroad and I couldn’t stand to put a family through that drama again. I did my best to avoid commitment and send Yahya’s uncle into the night without any solid hope for his nephew.

The following weeks were filled with phone calls and followup from the family, “Please help our boy!”

Finally, I met Yahya’s mom and dad and the little cutie himself. As they sat in my office they pled with humble urgency. They weren’t forceful. They weren’t rude. But they applied enough pressure on me that I couldn’t say “no” any longer. They made it abundantly clear that they understood the risk of his surgery and that they wanted it badly enough to endure whatever might come.

One of our core values as an organization is that we give “hope to the hopeless.” What that means is that we try to balance our impulse to be “last chance” people with our instinct to be “long-term” people. We held back on Yahya, wondering if it would give him long-term viability. But we ultimately dove in with Yahya’s family because we were their last chance. No one else would take on the risk.

We solidified this core value in November 2009 when we asked you what to do about a little boy named Ramyar. We asked you if you wanted us to apply your money in a high risk surgery or save it for a “sure thing.” You overwhelming said, “We want this Coalition to be about hope for the hopeless.”

We haven’t looked back since. We are the Last Chancers.

Still, committing to Yahya was full of complications. His surgery in Turkey was canceled due to an unavailability of an expensive assistant device. In fact, there was even discussion as to whether or not he should be included in our current Remedy Mission. Ultimately, we let the family themselves decide.

Our local cardiologist, along with our American surgeon, explained the risks of surgery, the option of waiting, etc. etc. Yahya’s dad was given a 50/50 chance of survival for little Yahya. Understandably, they wanted to give it a try. They couldn’t stand the risk of feeling like they had an opportunity to try and let it slip through their hands.

What would you have done? I have two kids – 5 and 3 years old. I have no idea what I would have done.

During Yahya’s surgery our Family Services Director, Jessica, sat down in the ward with all the parents whose kids were either in surgery or in critical condition in the ICU – those families whose kids were not “out of the woods” yet. As they asked questions about our organization and how long we’ve been working here, she recounted for them our past of taking children outside the country to significantly nicer hospitals than this Iraqi version in which we currently work. She told them about excellent American-trained Turkish doctors and fancy, pristine protocols abroad. Without fail, every family was so grateful for the chance to receive surgery at home. Let the Turks have their pristine hospital. “What if our child were to die abroad?” That would be a burden far too great to bear.

You gave Yahya’s family a chance that no one else would have. He had been rejected by every other opportunity out there. They are grateful to you. They will rest knowing they gave it their all for their only child.

And this is what we find almost universally – parents who just want a chance. And that’s what Remedy Missions are all about. We could continue to export kids to world class facilities, but who would invest in the future? We could continue to select the easiest children that almost never die, but does that make us any less culpable for the kids we pretend aren’t knocking on our door?

Was this a wasted opportunity? Did we waste the $670 that it cost us to provide Yahya surgery?

I used to feel that way when a child died in Turkey or Jordan or Jordan. I don’t feel that way anymore. Yahya’s death – though a terrible loss – was still an opportunity for local doctors to learn an innovative technique that they will be able to apply in future situations. His death was almost certainly unrelated to the particular tactic used in attempting to heal his heart. Educational gains always have significant costs. Before we only had the “we gave this child a chance” platitude. It’s not untrue. But local learning is an equally deep reason why your gift for Yahya made a difference.

Thank you for your willingness to stick with us through life and death. The gains that are needed here will not be made without significant risk and vision. We deeply appreciate your demand that we be the people of the last chance. I think it’s easier to sleep knowing we tried, than knowing we played it safe just so we could publish numbers and blog posts that seem more palatable.

With you,

Jeremy Courtney

Executive Director

email: http://scr.im/jcourt

+1 (806) 853-9131

Jeremy Courtney lives and loves in Iraq as a co-founder and Executive Director of the Preemptive Love Coalition. He's also the father of two spectacular children, and married to the lovely Jessica Courtney. When not absorbed in PLC work he can be found writing songs and singing about hope and future. Follow Jeremy on Twitter: @JCourt.

Stepping Back And Looking Forward

December 13, 2010 by Cody · Leave a Comment 

It’s not everyday you go to a place where they say it all began.

A place where they say the Garden of Eden might have been, where Abraham lived, where civilization sprung up along with architecture and the invention of the wheel.

We spent the day outside of the hospital, canoeing through the marshes on the Tigris River and meeting with local sheikh’s, eating lamb, drinking tea, and standing on the roof of the site that Abraham called home.

It was a complicated picture though, with military on every corner, and an AK-47 jammed in between the driver’s seat and mine.

Imagine trying to close your eyes and picture the Garden of Eden when police sirens and car horns continually bring every thought into submission.

It was a good change, to be out of the hospital and instead of talking about the future and trying to cast a vision for healthcare, to instead listen and hear about the history of the land we’ve stepped into.

I found out that the man who directs our security once lived in the marshes we were canoeing through. His family fled there, like so many, to hide from Saddam Hussein and the Iraqi military. To save their lives they left their homes and cars for reed huts and canoes.

I also found out that some of the doctors and politicians we spent the day with were once revolutionaries who rallied local tribes and cities to resist the regime.

From the time Abraham left it seems like the people here have been in one epic struggle for tomorrow.

But since the fall of Saddam they’ve been able to devote their resources towards development rather than just survival. Now these sheikhs and revolutionaries are the leading voices in developing health care, strengthening the school systems, and building stronger ties within their local communities.

The Middle East is a complex culture built on honor and with each day that we’re here, we see how they continue to honor those who have gone before them and also those who are following close behind. They’ve sacrificed so much to have today and they continue to sacrifice for tomorrow.

As hard as it was to try to imagine the past today, we got glimpses here and there. Sometimes it’s just as difficult to try to imagine the future but with each surgery and with each story we hear, we get small glimpses that let us know this is all going to be worth it.

Cody Fisher is the co-founder and Development Director of the Preemptive Love Coalition. He moved to Iraq in 2007 where he met his wife and since then they've been waging peace and mending hearts across Iraq. His passions are photography, peacemaking, and food that doesn't come out of a can. You can follow him on Twitter: @candmfisher.

You Just Helped More Kids in 12 Days Than Any 12 Month Period in Our History… for Less!

September 13, 2010 by Jeremy · Leave a Comment 

Deeya is alive and doing well at home today because of the surgery you provided for her in Iraq!

Wow! What a phenomenal trip it has been these last few weeks as you have brought a new remedy to the children of Iraq through the surgical and nursing team of Dr. William Novick. It’s high time we update your impact to help Iraqis make a better future for themselves and their children.

The total expense for our first Remedy Mission was approximately $90,000. This amount was further subsidized by the Director of Health in our city and the Kurdish Regional Government in Washington D.C., and the International Children’s Heart Foundation. The balance was underwritten by you!

This family was not yet chosen for surgery… they are still waiting for our next Remedy Mission.

Locally, Remedy Mission was a great success. We ended the week at dinner with the governor and the health director where they invited us to start our next Remedy Mission as quickly as possible. When we suggested May 2010 as a next date, all the surgeons and the health director rallied together to urge us to begin again in February instead.

Our current proposal is a five year plan comprising four trips per year to make the Sulaymaniyah Cardiac Center a premier facility in the region that is able to perform 12-14 surgeries per week without foreign assistance. We estimate that this will cost $1.5m and we are currently talking with the local authorities in hopes that they will choose to shoulder the majority of that expense.

During Remedy Mission ICHF and local surgeons performed 25 corrective cardiac procedures. Put differently, we helped more kids in 12 days than we have in any 12 month period to date… at a massive savings compared to our work in Iraq… with hands-on training for Iraqi doctors and nurses! A typical all-inclusive surgery in Istanbul costs us $10,000 (after subsidies). That expense is usually shared among the family of the child, local and international donors. The typical PLC international donor portion of a surgery in Turkey is $3-5k.

Cody Fisher reviews the list of kids who received surgery and kids still in line for February 2011.

The numbers for Remedy Mission look much different. Not only are we able to work in partnership with others more during Remedy Missions, but every surgery represents a local development and training opportunity. The all-inclusive price for all partners was approximately $3,600 per child (compared to $10k in Istanbul and much more in the States or Europe).

Remedy Mission has taught us a lot about being fiscally and developmentally responsible. Therefore, in an effort to redouble our commitment to long-term local solutions, we will be increasing our Remedy Mission funding in hopes of facilitating four Remedy Missions in our current city in 2011.

The following families are still waiting in line for our help…. Will you be the remedy? Donate the amount of your choice below to get our next Remedy Mission off to a strong start!

With you,

Remedy Missions are international pediatric heart surgery teams that we bring to Iraq to to perform lifesaving heart surgeries and develop the infrastructure for the future. If you’re on Twitter this week be sure to use the #Remedy or #RemedyMission hashtag to describe all the good news coming out of Iraq this week via @preemptivelove and @babyheart_org. If you’re on Facebook, “Share” this story with the button below.

Jeremy Courtney lives and loves in Iraq as a co-founder and Executive Director of the Preemptive Love Coalition. He's also the father of two spectacular children, and married to the lovely Jessica Courtney. When not absorbed in PLC work he can be found writing songs and singing about hope and future. Follow Jeremy on Twitter: @JCourt.

Abdulkareem Gets His Surgery After Months of Appeals from His Loving Father

August 26, 2010 by Jeremy · Leave a Comment 

Photos by Heber Vega; Lydia Bullock

It was around lunch time in the heat of June in Iraq when Abdulkareem’s father came into my office. He told me that his son was very sick, that he was very poor, and that he needed our help and was willing to do whatever he could to make it happen. We were preparing our July group for surgery in Turkey and one of the children had just withdrawn from the group. It looked like we might be able to squeeze Abdulkareem in at the last minute if all the right pieces fell into place quickly.

Abdulkareem’s father worked especially hard for his little boy. He traveled from his home in Diyala to Baghdad to get passports fro the family. He came to the office and called regularly to see what our status was with regards to funding for his son’s place on the Turkey surgery list.

There are two days in the duration of my journey with this family that I am unlikely to forget. The first was the day that Abdulkareem’s father – Hafez Bey – looked into my eyes and, with all the passion of a protective but powerless father, said, “Just help my little boy; just do something to save my little boy.“

Unfortunately, it did not work out to take Abdulkareem to Turkey with us for various reasons and we began the race against the clock to provide Abdulkareem surgery before his condition deteriorated any further. Our as-of-yet untested next option was our first Remedy Mission in August 2010. We gave Abdulkareem a priority spot on the Remedy Mission list.

The day our surgical team arrived Hafez Bey must have seen us on the news because he called me 10 times: “Is my boy going to surgery? Mr Jeremy, just do something to help my little boy!”

Photo by Heber Vega

There is one other day in the life of this family that I won’t forget – the day Abdulkareem had surgery earlier this week. I remember it so distinctly because after the surgery Hafez Bey grabbed me and kissed me and gave me an emotional “thank you” for making good on our commitment to his family.

One of the things we always try to explain to families is the presence of hundreds of people in the States and Europe – people like you – who work together to make every surgery possible. Of course, parents appreciate the ability to personalize their gratitude, but we talk about you frequently because we could not have saved Abdulkareem’s life without your many gifts to our Remedy Mission.

If you like what you’ve been able to be a part of this week with us (and there seem to be hundreds of you viewing the website and videos each day), please take two minutes to give toward the next Remedy Mission, the next Abdulkareem, and to the next father who is eagerly waiting for someone to help his little child. Please donate any amount of your choice below.

WIth You,

Remedy Missions are international pediatric heart surgery teams that we bring to Iraq to to perform lifesaving heart surgeries and develop the infrastructure for the future. If you’re on Twitter this week be sure to use the #Remedy or #RemedyMission hashtag to describe all the good news coming out of Iraq this week via @preemptivelove and @babyheart_org. If you’re on Facebook, “Share” this story with the button below.

Jeremy Courtney lives and loves in Iraq as a co-founder and Executive Director of the Preemptive Love Coalition. He's also the father of two spectacular children, and married to the lovely Jessica Courtney. When not absorbed in PLC work he can be found writing songs and singing about hope and future. Follow Jeremy on Twitter: @JCourt.

Jeen’s Surgery is a Total Correction After Doctors Work Until 4 a.m. on Failed Catheter Correction

August 3, 2010 by Jeremy · 6 Comments 

It has been a rough week for Jeen Mustafa. Her loving sister brought her outside of Iraq by donating her life-savings to PLC in hopes of procuring for her sister a non-invasive correction for her relatively simple heart defect. Simple does not mean unimportant, however; especially when it is your sister. Jeen would have never risen to the top of our charitable surgery list because her situation was neither urgent nor listed as complicated enough to warrant surgery outside of Iraq’s extremely new surgery industry. So, in an attempt to heal Jeen, her sister offered to pay the entire amount if we had the space and time to heal her sister without displacing another child. We were happy to help and grateful to all the staff and doctors at the Anadolu Medical Center for making this a reality.

We remain committed to helping children who cannot get help inside Iraq, and we draw our cues from the governments with whom we work and from local cardiologists. If they tell us a surgery cannot be performed in country, then we consider that child for placement outside. Thankfully, local adult cardiac surgeons across the country are starting to make forays into pediatric surgery. To be precise, they are vastly different. But we are thrilled to see local surgeons eager for training and upgrading, such as that we are seeking to provide with our Remedy Mission in a few weeks.

Back to Jeen, it was very important to her sister that we pursue for her a non-invasive trans-catheter closure correction in which a catheter and umbrella-type closure device is inserted through the thigh, into the heart, and expanded and attached to the walls of the heart to close the hole that is currently causing her problems as she enters young-womanhood and anticipates marriage and children in the next decade. We ordered the closure device with her sister’s money, and the staff at Anadolu Medical worked overtime upon overtime until 4 a.m. to attach the device non-invasively by catheter. Unfortunately, it ultimately proved impossible and unsafe to settle for that correction and surgery was scheduled.

Surgery was not in the plan and not in the budget. But Dr. Sertaç Çiçek in his continued graciousness and kindness to the children of Iraq agreed for his team to perform surgery pro bono to compensate for the drama and disappointment. Surgery is exactly what they had been trying to avoid. The risk; the recovery; the scars – these were all the things they sought to avoid. But scared and heartbroken Jeen went into surgery to correct the TWO holes in her heart that were revealed during the diagnostic testing.

A few hours later Jeen emerged from surgery with a total correction. It was not the way we had anticipated. But a total correction is a total correction! She has a scar, but she no longer needs to fear marriage and child-birth as a death sentence. She can walk to school with her girlfriends without tiring. She can pay attention and pursue her education and her impressive English-learning without distraction.

And that scar? We think it will stand as a testament to the kindness of the Turkish team that worked for more than they had to and gave far more than was expected to serve a Kurdish child whose family risked it all at the hands of the Turks; the same Turks that some of their neighbors on the Iraq-Turkey border can only see as enemies are the very Turks who saved her life. And this is just the sort of kindness and compassion we’ve seen repeatedly by Dr. Sertaç Çiçek, his entire team, and those in charge of nursing and administration at the Anadolu Medical Center in Istanbul, Turkey.

Follow Jeen on Twitter: @JeenMustafa. Subscribe to Jeen’s updates via RSS HERE.

Jeremy Courtney lives and loves in Iraq as a co-founder and Executive Director of the Preemptive Love Coalition. He's also the father of two spectacular children, and married to the lovely Jessica Courtney. When not absorbed in PLC work he can be found writing songs and singing about hope and future. Follow Jeremy on Twitter: @JCourt.

VIDEO: Four Iraqi Children Arrive in Istanbul for Lifesaving Heart Surgery

July 20, 2010 by Jeremy · Leave a Comment 

On July 18th four Iraqi kids arriving in Istanbul, Turkey in need of lifesaving heart surgery. They have entered a country about which they have mostly heard negative stories.

This week will change their perspectives and change their lives forever…

Follow Chro on Twitter: @ChroArkan. Subscribe to Chro’s updates via RSS HERE. Follow Chro’s thread of longer stories (with pictures & video) on the PLC blog HERE.

Follow Leah on Twitter: @Leahibrahim. Subscribe to Leah’s updates via RSS HERE. Follow Leah’s thread of longer stories (with pictures & video) on the PLC blog HERE.

Follow Nivar on Twitter: @NivarMohammed. Subscribe to Nivar’s updates via RSS HERE. Follow Nivar’s thread of longer stories (with pictures & video) on the PLC blog HERE.

Follow Jeen on Twitter: @JeenMustafa. Subscribe to Jeen’s updates via RSS HERE.

Jeremy Courtney lives and loves in Iraq as a co-founder and Executive Director of the Preemptive Love Coalition. He's also the father of two spectacular children, and married to the lovely Jessica Courtney. When not absorbed in PLC work he can be found writing songs and singing about hope and future. Follow Jeremy on Twitter: @JCourt.

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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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