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)

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.

How My Search For Healing Ended With A Laugh And A Half-Eaten Peach

June 20, 2011 by Ted · 1 Comment 

I walked into a pretty standard Iraqi home.

I sat down on a couch while the television informed us of an Iraqi political event.

I drank Mountain Dew from a glass bottle, thankful for the familiarity of a soda.

Then I met Hawlbast, a little boy who loves fruit, his family and giving kisses.

I found myself looking him over – looking for some sign that would indicate he had been healed. Something more than just the scar I knew was beneath his shirt. This was the little boy who in March of this year was laying on an operating room table undergoing open heart surgery. Surely I would be able to tell he had been through that.

But there was nothing.

He merely played with his brother, pretended to answer the phone and thoroughly enjoyed looking at pictures of himself.

He was behaving like any young boy his age would and it hit me: this is healing. Healing is being restored to what we were meant to be. In Hawlbast’s case, he wasn’t meant to have blue, poorly-oxygenated skin or shortness of breath- all of which he had to endure prior to his surgery.

I’m not naive enough to believe that there are zero complications lying beneath Hawlbast’s smile, but for now being restored in Hawlbast’s case means spending time with his family and brightening their day.

So when Hawlbast laughed and threw his half eaten peach at his smiling dad, I smiled too. I’m sure my father endured the same at my hands when I was Hawlbast’s age, and to me, that is a sign of healing.

Ted is making the magic happen as PLC's videography intern this summer ('11). He'll be the first to tell you: he shoots and edits to the glory of GOD and the benefit of Iraqi kids. When he isn't panning his camera, well... just go here to read just a few of Ted's lovable idiosyncrasies. He's also an avid Tweeter: @tedvid.

Finding Familiarity In An Unlikely Place | An Intern’s Perspective on Followthrough

June 10, 2011 by Adam · Leave a Comment 

Yusuf is a brave 1-year-old who underwent heart surgery this past March. When his family brought him to the hospital, Yusuf blood had low levels of oxygen that had already tainted his skin blue. The surgeon needed to fix four heart defects for Yusuf to survive.

But thanks to caring donors and local support, Yusuf is very much alive!

You helped Yusuf receive a heart surgery, and, because of you, I was able to visit and make sure his recovery is going well. This is what we call Followthrough. CLICK HERE to learn more on the importance of Followthrough.

As we sat down with Yusuf and his family I was overwhelmed with all the cultural differences around me, but there was a strange sense of familiarity as well.

Shortly after we sat and talked in Yusuf’s living room, his family rolled out a giant feast for us. We ate until we were full, and there was still enough left to feed us for dinner! Then we drank tea, and the refills seemed to be endless.

As we drank tea and took photos of Yusuf, his older sister played with him and entertained us with her hilarious faces. Yusuf’s grandfather would toss his phone across the living room floor while Yusuf would scoot across the room to return it again and again.

The familiarity I recognized during my visit was the same warm family dynamic and rejoicing I experience with my own family.

Even though we ate sitting down on a concrete floor, followed a completely different set of manners, and understood very little of the words spoken, the joy and relationship between these family members was the same as many American families I know.

We laughed and enjoyed the fact that their son’s life had been rescued. At this point in the visit I began to see these faces as my family and friends rather than as distant strangers.

This family was so grateful for us, for their son, for his surgery, and for a community willing to come together to provide a solution for their needs. I felt the warmth in their home through photos of Yusuf, endless cups of tea, a floor full of food, and a room bursting with smiles.

No matter how great the cultural barriers there are some values and moments humanity can rejoice in and enjoy together. These shared moments and values are the most significant puzzle pieces of our own identity.

Adam is spending his summer using words and writing to connect hearts and minds to children with CHD. That means poring over newsletters, blog posts, and photo captions to make sure these children are heard and that they get their shot at surgery. When not buried in metaphor, Adam enjoys playing the violin, hiking, and photography. He's also on Twitter @adamhallbrandt.

Meet the Interns: Our First Impressions of Iraq

June 7, 2011 by Ted · Leave a Comment 

Ted is making the magic happen as PLC's videography intern this summer ('11). He'll be the first to tell you: he shoots and edits to the glory of GOD and the benefit of Iraqi kids. When he isn't panning his camera, well... just go here to read just a few of Ted's lovable idiosyncrasies. He's also an avid Tweeter: @tedvid.

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.

Remember Nivar?

May 21, 2011 by Lydia · 2 Comments 

There are people in my life whom I haven’t seen in months and probably won’t see but once a year. When we meet again, we’ll spend most of our time discussing what’s happened since the last time we talked, trading stories and catching up on all the details. But when it comes to this particular Kurdish girl, it’s all different.

As an intern last summer I connected deeply with 8-year-old Nivar. Her sweet personality won all of us over, and her striking eyes captivated many of you. Her case was urgent and her parents’ money tight, but after a few pictures and stories, the donations poured in. You made it possible for Nivar to get surgery in Turkey last July.

I went with her, and I spent most of my free time in her room playing hand-clap games and learning the Kurdish names for colors. Without any language we became fast friends. I was there during her operation, and the photo below is the last I saw of her before leaving Istanbul for America. I didn’t get a chance to say goodbye.

But this morning, after 10 months, I got to see Nivar again. I was both nervous and excited. I couldn’t remember any of my Kurdish colors, the names of animals, or the rhyme we’d used in our hand-clapping games. We were greeted at the door and ushered into the house by Nivar’s parents. Just then, Nivar came running in from a back room, healthier than I’ve ever seen her. She seemed shy at first, very quiet and polite. After a few minutes I went out to the car for something and Nivar followed me. She threw her arms around my neck and kissed my cheeks, then started laughing and speaking Kurdish.

Not understanding a word, I quickly grabbed what I needed and let her pull me by the hand back into the house where she led me past all of the grown ups and into her room. First thing? Hand clapping games. We played with her doll, a toy piano keyboard and a story book written in English.

When her dad came in to call us to lunch she spoke hurriedly to him in Kurdish. He laughed and pointed at Nivar, then at me, and said carefully, “I love you”. My heart smiled. I remembered in the hospital in Turkey when Nivar had sent the same message through her (non-English speaking) father to me the morning of her heart surgery.

After lunch Nivar brought out her parent’s point-and-shoot to take pictures of me, her favorite way to tease me for the millions of pictures I’ve taken of her. It was so great to watch this little girl run around the room laughing; its hard to believe its the very same girl who could hardly catch her breath the last time I saw her.

As we got ready to leave, Nivar smiled and said something shyly to one of the Kurdish-speaking PLC staff. “She wants you to be her sister,” they translated.

My friendship with Nivar ranks high on my list of PLC Summer 2010 memories. Watching her grow more and more sick as her surgery approached, then actually standing at the foot of her operating table while doctors worked to correct her heart condition created an unforgettable bond between me and this little girl. 10 months later, I’m ready to start another summer of memories with Nivar and others like her.

Lydia Bullock wrote and photographed for us during the 2010 summer internship and then again for 7 months in 2011. She documented surgical missions in northern and southern Iraq. See more of her excellent work on our Flickr stream, or follow her on Twitter: @lydiabullock.

Encouraging Words From a US Marine

May 15, 2011 by Jeremy · 2 Comments 

Just in case the image didn’t load or if you’re having trouble reading the letter:

“Dear PLC, My name is —- and I’m sending this check to you in order to support —- in her Summer Internship to Iraq this year. As an Arabic Linguist in the Marine Corps with a background in studying Arab and Iraqi culture, as well as Terrorism and Insurgencies, I want you to know that I see what you do to help the Iraqi people as being one of the greatest ways to help stabilize Iraq and disarm the violence in the region. The medical missions trips and fundraising that you do is an amazing way to reach the Iraqi people that really protects the most valuable part of their lives – their children. Your mission of saving lives is the greatest way to spread God’s universal message of love. That same calling to love is why I am sending you this check now. It’s not a payment for any kind of material goods or services, it is simply my support for both a wonderful student and a great organization, the two of which I know will change lives and have a great impact on the World for God. Please stay safe, and persist always in love.”

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.

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.

Former PLC Intern to Marry PLC Artist & Donate Their Wedding Fund to Save Lives in Iraq

October 12, 2010 by Jeremy · Leave a Comment 

Former PLC Intern to Marry PLC Artist & Donate Their Wedding Fund Christin interned with Preemptive Love in Iraq in 2009 and Ben has been a volunteer artist for various PLC needs since 2007. Now they are getting married and using their wedding as an occasion to save lives in Iraq!

Last August during our first Remedy Mission we served 25 kids. That means all the children in the photos below could easily be served in February if we can bring the American surgical team back to Iraq. You can save lives like Christin and Ben are by donating 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.

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	Matt Willingham is the PLC press secretary and writes primarily on politics, history, general updates and visual peacemaking through photography and film.
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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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