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)

Photo of the Day

June 17, 2010 by Lydia · Comments Off 

Like any 10-year-old boy, Mohammad Star is quick to show off the scar left over from his heart surgery this past fall!

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.

Three Kids Headed Home with Happy, Healthy Hearts

March 10, 2010 by Jeremy · Comments Off 

It’s been a great journey for Muhammed, Baroof, and Sozyar. Both Muhammed and Sozyar were “urgent.” It was unclear whether Muhammed or Baroof would even be operable. And look at them today!

In our talks today with Dr. Resmiye at the Anadolu Medical Center she used words like “miracle” and “unbelievable” and “they won their lives back” to describe these kids.

Usually we try to keep a healthy balance of the “miraculous” and that which can be reasonable calculated according to the medical numbers. It’s hard to build a budget around miracles! But we are thrilled to celebrate GOD’s kindness in the lives of these children alongside the Turkish doctors who, themselves, have said that it is GOD’s doing and not just their own.

By the time this posts, Muhammed, Baroof, and Sozyar will be resting at home – in the city or the village – with their daddies and extended families who have been missing them so much.

As much as the surgery at this point, the fact that you’ve paid for round trip airfare through our partnership with Atlasjet Airlines for these kids is a great source of comfort, because healing means precious little when it separates you from the ones you love the most!

These children are now enrolled in the Preemptive Love Followthrough program. We’ll track their progress as Baroof goes back to school and Muhammed and Sozyar learn how to walk, and we’ll offer a number of services to them for the next six months (and often, much longer).

Followthrough Program With our Followthrough program we monitor a child’s healing and re-entry into their home culture, teach the importance of activity and a balanced diet, and address issues like racism and other radical ideologies. This amount represents the costs of medications, special needs, teaching materials, etc. Donation:

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

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

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

Baroof Works His Lungs After Discharge from ICU

March 8, 2010 by Jeremy · Comments Off 

At first Baroof was a little ambivalent toward the exercises designed to improve his lung capacity and rehabilitate him after his heart surgery. As much as he wants to get back outside and play football (soccer), he has a hard time connecting these “meaningless” exercises with his real end game!

But when Jessica – our Family Services Director – pulled out the camera and made it a game, Baroof was plenty excited to show off.

Baroof is looking really great and his mood is as happy as we’ve ever seen it. His fear of the Turks attending to his needs (“Turks” about whom he has no doubt heard plenty of disparagement in his border town) has turned into affinity; and his uncertainty about these weird Americans always trying to speak his language and take his pictures has turned into was just might be abiding friendship.

Comprehensive, human-scale peacemaking efforts and long-term, whole person family services – two of our core values at the Preemptive Love Coalition in action here in Istanbul, Turkey and in Iraq this week.

We are on the brink of sending six kids back to Iraq with healthy, happy hearts this week. And it’s all because of you. Still, we know you do not only want us to mark surgeries like notches on a belt. We’ve heard your desire that we invest ourselves – and your money – in long-term followthrough. To keep us engaged in long-term followthrough for these kids and others once they arrive back in Iraq, all you have to do is: - Enter a dollar amount of your choice below - Press “Donate the Amount of Your Choice” - Spend 2 minutes entering your credit card information Alternatively, you can make a check payable to “Preemptive Love Coalition” and send to: Preemptive Love Coalition 373 Freear Dr. Buellton, CA 93427 You can also speak with a real person and make a gift over the phone by calling 805-245-4666 during normal business hours. We’ll get the next child on their way in a few weeks!

With thanks and joy!

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

Baroof Off Life-Support, Breathing on His Own and Hungry in ICU

March 2, 2010 by Jeremy · Comments Off 

We were surprised to find Baroof this morning extubated in ICU so quickly after his surgery. We knew he had high pulmonary pressure – which often leads to a longer, riskier recovery period. So we were thrilled to see him doing so well. But his pressures are completely under control right now and he is doing phenomenal well after the surgeons closed the hole/fusion between his aorta and pulmonary artery yesterday!

But he was quite hungry! He’s in that in between period where he’s awake and aware of what is happening to him, but not yet healthy enough to eat solid foods to satisfy his adolescent appetite!

There is talk of Baroof being discharged from ICU to his private room tomorrow… here’s hoping and praying!

With thanks and joy!

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

Baroof’s Surgery was a Total Success; Huge Blessing for a Child His Age!

March 1, 2010 by Jeremy · Comments Off 

When Dr. Sertaç Çiçek and Dr. Ahmet Arsalan saw Baroof this morning in surgery they found a huge fusion between his aorta and pulmonary artery, effectively creating a hole where there should not be one and allowing dangerous blood flow between that which should be oxygenated and that which should not.

In his entire career, Dr. Çiçek estimates that he’s probably only seen and operated on this type of case less than 20 times (compared to many other surgeries that he’s performed hundreds and hundreds of times). But of the twenty or fewer times that he’s performed a surgery similar to Baroof’s, few if any have been Baroof’s age at 12 years old because usually children with AP windows are inoperable by this age, after years of the body trying to compensate for its deficiencies.

As a result of his condition, Baroof is a few years behind in school – but it’s always a joy to see families here who continue to push their children to excel even in the face of adversity. We hope the impact of this surgery will be the removal any final barriers and that he will excel in his school work.

But Baroof’s surgery went well and after the stress of not knowing whether or not he would be operable at all, his mother – and all of us – are breathing a huge sigh of relief and thanks to GOD for another successful surgery.

As always, however, we have tempered celebration until we see how Baroof’s body holds up post-operatively in ICU. He is intubated in ICU and the next few days will be critical. More to come…

With thanks and joy!

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

Baroof Worries in His Room Before Going to Surgery This Morning

March 1, 2010 by Ruth · Comments Off 

I spent an hour with 12-year-old Baroof this morning right before he was scheduled to have his life-saving surgery.

He’s a really sweet boy from a village in the north of Iraq. He speaks a different dialect of Kurdish from the one I know, but despite the language barrier we were still able to understand each other some. He told me that he’s really missing his dad and his brother and sister who are just a little older than him. He seemed a nervous as he waited which is to be expected, and he was also very hungry from having to fast before the surgery.

He was very excited to be able to talk to his dad for a few minutes before I left him but from the tears in his eyes afterwards we could tell that he is really missing him.

Baroof was taken into surgery at 11:40 a.m. Istanbul time. We’ll keep you updated on Baroof as we hear more in the next few hours.

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

Ruth Simpson was a Family Advocate for the Preemptive Love Coalition in Iraq (2008-2010) and a certified physio-therapist. Ruth hails from Ireland, though she's slowly losing her amazing accent amongst all the Americans. When not sharing her life with PLC's kids in Iraq, she served other constituent groups with her rehabilitative skills and compassion.

Meet Baroof (Twitter: @BaroofAbdul)

March 1, 2010 by Jeremy · Comments Off 

Baroof is the fourth of the initial four children we brought with us to Iraq on February 23rd. He came to us through an organization in northern Iraq. When Prof. Dr. Sertaç Çiçek and his team saw Baroof in our Iraq screening two weeks ago, they wondered whether or not he would be operable. In any case, the window of operability was certainly closing quickly.

Baroof’s condition is known as an “aortopulmonary window” – or AP window – a rare heart defect in which a hole between the major blood vessel feeding the heart and the one going to the lungs. AP windows are so very rare they account for approximately .1% of all congenital heart defects according to U.S. National Library of Medicine.

Baroof was admitted to a diagnostic catheterization on Thursday night in which Dr. Levent from the Anadolu Medical Center determined he would be operable – and confirmed that he very much needed surgery… and fast.

More information to come on Baroof…

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

*In accordance with PLC’s desire to lend a hand-up by avoiding strict hand-outs (when possible), Baroof’s family worked with the regional government and with personal and government funds contributed $6,000 towards PLC’s highly-discounted surgery prices.

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 children in pursuit of peace between communities at odds. We offer the untold thousands of Iraqi kids 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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