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)

Baby Leena Leaves Iraq for Urgent Surgery in Turkey

April 14, 2010 by Jeremy · Leave a Comment 

It was about mid-morning on Sunday when Leena’s dad came into our office, frantically looking for help for his daughter who was dying before his eyes from her congenital heart defect.

We contacted our partners in Istanbul at the Anadolu Medical Center and they concurred: it might be too late for Leena, now 50 days old, but if there was any remaining chance she should come immediately.

With unprecedented speed we worked with Leena’s father and their extended family to get Leena to surgery. The family and friend network rallied quickly sold their car and rallied with a total of $10,000. Within just a few hours we were able to get our local staff, Leena, and her mother on the very last seats out of Iraq on Tuesday’s flight to Istanbul.

The picture above is Leena’s last moments with her father before leaving him to go back to the village where he is 8 year old Mohammed Star’s elementary school teacher, whom we sent to surgery in November 2009.

Are you looking for a way to get involved? Let us suggest the following three actions: - Sign up for our newsletter to stay apprized of news and deals on stuff you can buy to save lives in Iraq. Name: Email: - Send out a “tweet” or a message about us on Facebook, suggesting your friends check out these dear Iraqi kids. - Give your time or money. Both save lives! For volunteering, send an email to cody@preemptivelove.org. For life-saving tee shirt, shoes, and scarf purchases, head over to our Buy Shoes. Save Lives. store for our 25% OFF SPRING SALE. For donating money, please use the fast and simple form 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: @Jeremy_Courtney.

Deelan, Dua, and Sara Arrive Home After Hassle with Airline

March 14, 2010 by Jeremy · Leave a Comment 

Deelan, Dua, and Sara all went home on March 14 from Turkey with healed hearts, hopeful for the future ahead of them! Unfortunately, a tremendous amount of drama associated with the airline company and their departure wrapped us up for much of the week, unable to find much time to blog with reduced staff.

There has been a lot of finger pointing this week, but the airline did not schedule our kids home on the flight like they told us they had by email three days before the flight. This resulted in three kids, three moms, and one of our staff arriving at 9 p.m. at the airport only to hear that there was (1) no room left on the flight and (2) we didn’t have tickets for our kids in any case.

Somehow seats opened up and we were able to pay to “close” our tickets at the counter. But it left our kids in a terrible situation and the airline’s lack of cooperation was a huge trust-breaker. We’ll be considering other options for all future surgical and personal trips in/out of Iraq.

But at the end of the day, the children are all home safe, celebrating Newroz today – the “Kurdish” New Year!

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

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

Follow Sara on Twitter: @SaraMuaeed. Subscribe to Sara’s updates via RSS HERE. Follow Sara’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: @Jeremy_Courtney.

Three Kids Headed Home with Happy, Healthy Hearts

March 10, 2010 by Jeremy · Leave a Comment 

This doesn’t look like the happiest group of people, but trust us, they are! It was 6 a.m. at an airport! Few are happy in that context!

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: @Jeremy_Courtney.

Meet Deelan (Twitter: @DeelanKameran)

March 2, 2010 by Jeremy · Leave a Comment 

Deelan arrived in Istanbul, Turkey last night on a plane from Iraq thanks to Atlasjet Airlines and the generous support they’ve offered to help us get this February group to surgery. If you are one of our summer interns, we highly recommend that you choose Atlasjet to fly into Iraq.

Our Family Services Director, Jessica Courtney, (who, if you’re keeping score at home, is also my wife) accompanied Deelan, his mother, and one other family to Istanbul last night to round out our February/March group of surgeries.

Special thanks to the Alice Abdi at the Anadolu Medical Center for the continual support, for staying late at the hospital to receive these dear kids, and for sending – as always – a special private van to pick up these fearful families. This keeps our costs low, speeds up our travel, and most importantly, shows the kind hearted desires of so many here in Turkey as they reach out to Kurds and the rest of the people of Iraq in providing these deeply discounted, life-saving heart surgeries.

Deelan is not doing well at all – crying nearly constantly and facing down dangerously high pulmonary pressure in addition to the huge hole between the lower two chambers of his heart .

Deelan is scheduled for surgery on Wednesday.

Follow Deelan on Twitter: @DeelanKameran. Subscribe to Deelan’s updates via RSS HERE. Follow Deelan’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), Deelan’s family contributed $5,000 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: @Jeremy_Courtney.

Baroof Worries in His Room Before Going to Surgery This Morning

March 1, 2010 by Ruth · Leave a Comment 

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 · Leave a Comment 

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: @Jeremy_Courtney.

Meet Dua (Twitter: @Dua_Arif)

February 24, 2010 by Jeremy · Leave a Comment 

We met Dua and her family through a partnering organization on the northern Iraq-Turkey border near the area where Dua lives. As a result, we’re just now getting to know her (whereas we’ve had relationship with some of these other families for months).

Dua was diagnosed in Iraq with “tricuspid atresia” – a defect that only accounts for 1-3% of all congenital heart defects. In short, this defect means there is an absence of the tricuspid valve. From Wikipedia (because a lot of other sites prohibit quoting their information!):

Therefore, there is an absence of right atrioventricular connection. This leads to a hypoplastic (undersized) or absent right ventricle. This defect is contracted during prenatal development, when the heart does not finish developing. It causes the heart to be unable to properly oxygenate the rest of the blood in the body. Because of this, the body does not have enough oxygen to live, and steps must be taken to keep the child alive.

And for bonus points, you can click here to read more on the Fontan procedure for which Dua is a candidate (though her operability is still undetermined).

Follow Dua Arif on Twitter: @Dua_Arif. Subscribe to Dua’s updates via RSS HERE. Follow Dua’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), Dua’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: @Jeremy_Courtney.

Meet Sozyar (Twitter: @SozyarHamdan)

February 24, 2010 by Jeremy · Leave a Comment 

The team of Turkish doctors personally pre-screened and selected Sozyar for surgery when they were with us in Iraq last week working with us to promote more local (Iraqi) solutions to these local problems.

Sozyar was referred to us by a local organization, saying she was in need of “urgent surgery.” Because of the tremendous cooperation of the Anadolu Medical Center and Prof. Dr. Sertaç Çiçek we are almost always able to fast track children like this and see them served before it’s too late. They visited us and we sent Sozyar to surgery in exactly two weeks. We could not do that without your faithful giving and the highly interested and capable Turkish team.

You can click here to read more on the Fontan procedure that the doctors plan on performing for Sozyar.

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.

*In accordance with PLC’s desire to lend a hand-up by avoiding strict hand-outs (when possible), Sozyar’s family contributed $4,000 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: @Jeremy_Courtney.

Meet Muhammed (Twitter: @MuhammedAdnan)

February 24, 2010 by Jeremy · Leave a Comment 

Muhammed’s presence in our life is a testament to the way the Preemptive Love Family Services Team has lived out our Core Values – namely, our pursuit of excellence (or constant improvement) and the way we seek to provide whole solutions for whole people. But all that sounds a little vague, so let me break it down…

In February 2009 a Kurdish soldier knocked on the door of our office. Though I hadn’t done anything wrong, I was sure I was about to be hauled in to give an account for something ridiculous. Thankfully, I was wrong. His name was Hywa and his daughter needed a life-saving surgery…. very urgently. We fast-tracked his family to surgery, but unfortunately he had already missed the optimal surgery window for his daughter when he first appealed to us. His little baby died in March 2009.

But Hywa and I formed a friendship that was somehow wrapped up in our mutual efforts to save his child’s life. When we put Honyar on that plane to Istanbul there was an initial feeling that we had both succeeded. And as I stayed back with him in Iraq, we cried together, somehow feeling like we had both failed that day she died. Of course, it was not the same grief for me as it was for him, and I would dishonor him to imply otherwise. But we celebrated, mourned, and grew together.

A few months later Hywa referred his friend Sami to us because Sami’s boy Danar was dying from a similar heart defect. We sent Danar to surgery in January 2010 and Danar can be seen doing really well after his surgery in our video of follow-up echos a few days ago.

After Danar returned from surgery, his father, Sami, referred Adnan to us because Adnan’s son is similarly facing death from extremely high pressure in his lungs as a result of two large holes in his heart.

Call it the “butterfly effect” or “serendipity” or “Providence” or a “job well done.” I’m really proud of our Family Services Team and all the work they’ve done to leave a lasting impact on families like Hywa, Sami, and… hopefully… little Muhammed’s family.

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.

*In accordance with PLC’s desire to lend a hand-up by avoiding strict hand-outs (when possible), Muhammed’s family told us they would sell their car to help their son and ultimately gave $6,500 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: @Jeremy_Courtney.

OUR CORE VALUES: Multi-Dimensional Reconciliation

February 8, 2010 by Jeremy · Leave a Comment 

Photo: Matt Addington

Call it settling accounts, setting to rights, or the restoration of friendly relations – reconciliation is why we do what we do.

There are thousands of children in Iraq who are born with hearts “at odds” with the good intentions of GOD when He created the world. We want to set that physical situation to rights; to reconcile what is with what should be.

But a healed heart is an occasion for only a tempered celebration if your family is living in the middle of civil conflict between ethnic neighbors or regional superpowers. Sure, much of this strife comes from global issues that are beyond our direct reach. But a few days on the ground in Arab Iraq, Kurdish Iraq, Turkey, etc makes it clear that these “global issues” are exacerbated by our closely held opinions about “the other.”

Photo: Matt Addington

So we work to unravel the effects of evil that were wrought by Saddam Hussein’s genocidal campaigns, by years of sectarian conflict between Sunni and Shi’i Muslims, and by ethnic struggles.

For example, Kurds, Arabs, and Turkmen are in a political (and possibly cultural) struggle over the historic city of Kirkuk – each laying some sort of ancient claim to the city; each group (generally) vilifying the other. On his Restorative Justice blog, Dr. Howard Zehr talks about our “temptation to emphasize ‘otherness’,” whether it be through photography, storytelling, or our administration of justice. At the Preemptive Love Coalition, we do not deny “otherness” when working between ethnic and tribal prejudices or religious worldview differences. But we try not to make “otherness” our starting point.

Communication guru Joseph Grenny talks about the important role that “storytelling” plays in our emotions and actions. According to Grenny, (1) we make an observation (e.g., Saddam Hussein was an Arab with largely Arab soldiers that attacked our city) and (2) immediately start telling ourselves a story (e.g., therefore all Arabs in Iraq want “our” land and are evil and would kill us if they had the chance) which (3) leads to strong emotions (like fear and hate), thereby (4) triggering fight/flight instincts inside us such as protectionist policies or aggressive police (or vigilante) action. The fork in the road is that first story we tell ourselves when faced with an observable fact.

You can see how this plays out closer to home, as well. Observable fact: Men who wrapped themselves in Islam attacked America on September 11, 2001. But the stories that have flowed from that fact have been varied. And the emotions that arise from those stories have been serious and sincere. And over the past decade the actions that have come out of those various emotions have changed the course of world politics, international relations, and daily life for millions.

So when you donate, host an event, or buy a tshirt or pair of shoes, you are engaged in something bigger than the shuffling of money from one place to another to save a child’s life. We give people over “here” a tangible opportunity to save a life over “there” and to see “those” people as exactly that: people. Humans. Sons and daughters. We are all more than the images we receive from the professional media. It’s not “us” helping “them” get over “their” problems. It’s “us” becoming reconciled with “us”.

And in case you are wondering… Yes, we are just naive enough to believe that when we start seeing each less as other and more as brother these “global issues” might start to change too. And if they don’t… well, we are still committed to making change in the neighborhoods where we live and work; to be people of peace – whether anyone joins us on the journey or not.

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: @Jeremy_Courtney.

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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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