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)

Saving Lives, Sans Surgery—Why Diagnostics Are So Important

April 24, 2013 by matt · Leave a Comment 

The girl in this picture was misdiagnosed as a baby.

Her family thought she needed surgery. They waited and worked, wondering if their daughter’s heart would give out.

As she gazed at the image of her heart beating, her father shared how hopeful they were that their daughter would get well.

Minutes later, he got his wish. After years of carrying around the wrong diagnosis, his little girl had a healthy, defect-free heart all along.

We’ve introduced you to a lot of sick, blue children over the past 5 years, but we haven’t always shared stories of already-healthy children. Thanks to highly trained cardiologists like Dr. Kirk, Iraqi children are receiving top-notch diagnostics testing in the form of preliminary echos, TEEs, and diagnostic catheterizations.

“We don’t do as many diagnostic caths in the US as we used to because we catch most heart disease early, before we have concerns about operability. Internationally, the situation is much different,” Dr. Kirk explained.

Over a span of # years, Dr. Kirk has screened hundreds of children across Iraq, and they’re often well beyond the ideal age for diagnosing a heart problem.

“Many of the children we see are being diagnosed or considered for surgery at a time which is much later than what we see in the west. The diagnostic cath tells us if a child is appropriate for a surgery or if a child would probably live longer if we didn’t do anything. There are many children who we think are inoperable because of their age, but we take them to cath and find they are indeed a good candidate for surgical repair. In this case we’ve probably added years to their lives by getting them repaired.”

In short, good diagnostics inform decisions, illuminate the situation for doctors and in-the-dark family members, and they save lives.

“The diagnostic cath isn’t as exciting as an interventional procedure to most, because, even if the news is favorable for surgery, another procedure is still needed.

If we can get away from focusing on what’s done today and look at what was learned today and what is best for the child, we realize we positively change the lives of children with a diagnostic cath.“

“Diagnostic caths either allow children to be repaired safely, or they prevent them from being harmed by surgery.”

Diagnostics take dollars—help us make it happen by donating below!

Our Partners:

As Communication Director, Matt Willingham spends most of his time trying to get the word out on PLC's work in Iraq. On the side, he likes reading stories, devouring the great food his wife cooks up, and DSLR camera work. He's also mildly obsessed with Twitter: @mehtin.

In The News: “Still Raw Wounds Greet US Medics In Iraq’s Fallujah”

September 25, 2012 by matt · Leave a Comment 

A couple months ago, you helped us do something that others thought was impossible: we took an American medical team into Fallujah to save lives.

We’ve gotten used to being considered a little crazy, but Fallujah? Even we weren’t sure what to expect.

This was something new, and it was a massive, collaborative effort. We couldn’t—nor would we want to—have done it alone. Watch the above video to see an AFP story sharing more about that historic trip.

The expertise of our partners, Living Light International (LLI) and For Hearts And Souls (FHAS), made this historic mission a reality. The cultural and historical nuances of a place like Iraq’s Anbar province are vast, but the LLI team’s—and particularly Nadwa Qaragholi and Dr. Wieam Ahmed’s—ability to navigate culture and read between the lines cleared the way and made 7 operations possible during this trip.

But operations don’t happen without trained, competent doctors, which is why we’re also grateful for Dr. Kirk Milhoan and his team at FHAS. They used their expertise to pave the way for more missions that, hopefully, will be able to ease tensions between at-odds communities through the healing of children.

These friends of ours in the battle against The Backlog are invaluable, indispensable, and we can’t wait to work alongside them in Fallujah again soon!

In addition to savvy cultural guides and skilled doctors, these missions don’t happen without you—thank you for doing what others thought impossible!.

Every dollar you give helps us in our effort to eradicate The Backlog in Fallujah, and now we need your help going back.

Help us go back to Fallujah to save more lives by donating below!

Our Partners:

As Communication Director, Matt Willingham spends most of his time trying to get the word out on PLC's work in Iraq. On the side, he likes reading stories, devouring the great food his wife cooks up, and DSLR camera work. He's also mildly obsessed with Twitter: @mehtin.

Guest Post—Dr. Kim Milhoan Shares About Her Experience In Fallujah

August 16, 2012 by Craig · Leave a Comment 

On our recent Remedy Mission X in Fallujah, we were privileged to work alongside Drs. Kirk and Kim Milhoan. Dr. Kirk, one of the most traveled and experienced cardiologists in the world, brought a team of 6 Americans to Fallujah last week and provided 12 Iraqi children with an operation—it was an incredible success!

We had such a great time working with the team that we’ve asked them to share a little about their experience, and Dr. Kim Milhoan has graciously obliged. Keep reading below…

###

So, I’d be absolutely lying if I said I wasn’t nervous about this trip. Everyone who reads my writing prior to this trip knows that I spent the week really asking God for what He is trying to teach me. And often I find the lesson is very different from what I thought it would be.

By the time I arrived in Fallujah, I was actually excited for the honor and opportunity to step out in faith. In my mind, this had never been required of me to this level, where I truly thought my personal security and safely could be at risk. Here comes the part where I absolutely praise our Fallujan hosts: they have gone out of their way to protect us with constant armed guards, armored vehicles, etc. I never felt unsafe.

I believe that all of man’s defenses are ultimately penetrable, but they did everything in their power to keep us safe. They were gracious, welcoming, generous, and concerned for our every need and comfort. I could relax. And, as strange as it might seem, this confused me. I was actually looking forward to a difficult week of utter reliance on God. I realized how quickly I can revert to reliance on man.

The same is true in our care for the children. We’ve done this a lot. We’ve gotten good at making the best of less-than-ideal-circumstances. Once again, I began to rely on my skills or supplies rather than on God’s provision. So if I wasn’t exercising utter reliance on the Lord for safety or for patient outcomes, I was at least being a good witness for the Lord in whom I believe. It’s like the bible says, “they will know we are Christians by our love.”

We can laugh as a team because we’ve been doing this together so long that we know each other’s idiosyncrasies, weaknesses, and hot buttons. I’m sure mine are quite evident to my teammates. After we finished our five days of twelve caths and all the children were doing well, we were treated to a trip to the province Governor’s house late one evening. What an amazing caravan we were part of, absolutely impossible to describe! On the way home I was reflecting on all these things. I was disappointed in myself for not relying on the Lord like I wanted, for not praying without ceasing like I thought I should, and for failing to let His light shine through me. Then one of my favorite verses in the Bible (Injil) came to mind:

But we have this treasure in plain, earthen vessels, so that the surpassing greatness of the power will be of God and not from ourselves.

It brought tears to my eyes. It’s not about me. I’m so “earthen” and limited, and so I fail. But the power to heal and love is God’s, not mine—thank God!

Once again I’m astounded by the freedoms I enjoy. No one chooses the country they’re born in. I was born into opportunity and choice. I’ve been given the gift of privilege and position. I can choose to be courageous and go and visit and hopefully help, serve, love, and encourage those who find themselves in completely different circumstances not of their choosing.

I pray we have the opportunity to bless and be blessed by the Fallujan people many more times to come.

We just need 25 more suture packs for our upcoming Remedy Fellowship training program! Help us save lives, and cut it to 24 today!

Our Partners:

Craig's Mom is our hero. She brought not one, but two sets of twins into the world, and Craig is the best that we've met of his siblings. As our copy editing intern, he is spending his summer serving Iraqi children through writing and editing, and on the side he enjoys playing Taboo, hanging out in teashops at night, and jamming out to classical piano music.

Meet The People Who Made Remedy Mission X In Fallujah Possible!

July 24, 2012 by Jeremy · Leave a Comment 

Remedy Mission X in Fallujah is over, but the exhaustion of it all doesn’t compare to the overwhelming joy I feel right now.

Given Fallujah’s history and our team’s desire to bless and serve the city, we’re humbled by what just happened. Think about it: 7 lifesaving operations, performed by an American team (6 of which were women), in one of the most war-torn, challenging cities in Iraq. And not only did they invite us back for 4 more trips in 2013, but we were also invited to work in a new city!

This kind of work just isn’t possible without an entire coalition of people, so, if you’ll allow us a moment, I’d like to point out those responsible for this historic Remedy Mission:

I’ll start with you. We make it a priority to remind you of your role in all of this because some people—not you!—are prone to forget what they’re capable of. Seriously, though, this work doesn’t happen without a continued grass-roots effort. People like you gave up their birthdays, gave monthly, and held fundraisers to make sure kids in Fallujah got the operations they need to live healthy, happy lives. You are essential.

This also couldn’t have happened without the talented local doctors at Fallujah General Hospital, who went above-and-beyond to make us feel comfortable and safe, and the incomparable Nahoko Takato and her Japanese partners, who gave $14,000 toward making this mission happen. Our partner organizations were also essential: Living Light International, our cultural compass; and Dr. Kirk Milhoan and his medical team of For Hearts And Souls volunteers.

All of these groups work tirelessly to make sure Iraqi children get their shot at a healthy heart, and we’re honored to work alongside them!

###

The work in Fallujah is finished for now, but our yearlong Remedy Fellowship program starts a week from today!

Our partner doctors are foregoing frequent flyer miles and, instead of constant travel back-and-forth, are moving here! Dr. William Novick and his team of International Children’s Heart Foundation volunteers are coming to LIVE in southern Iraq for a year!

In preparation for our upcoming year of training and life-saving, we’re raising money for medical supplies, one of which is listed below. Please consider funding sutures, and our doctors will use them to mend hearts!

Our 85 suture kits are FULLY funded — Thank you for helping fund $765 worth of medical supplies!

Our Partners:

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.

Our Fallujah Remedy Mission’s Success Creates Opportunities In Tikrit!

July 22, 2012 by Jeremy · Leave a Comment 

As our mission here in Fallujah draws to an end, we want to celebrate our new friend, Dr. Mohammad. We first met him a few months ago with our Japanese friend, Nahoko. Dr. Mohammad is a pediatric cardiologist who recently returned from a six month training fellowship in India, where he made serious advancements in his skills. Unfortunately, in the city of Tikrit, where he works, they do not have the capacity to serve children.

In an effort to reward his initiative and hard work, we recommended that he ask his counterparts in Fallujah for permission to participate in the inaugural Fallujah Remedy Mission. Thankfully, he has great friends in Fallujah—colleagues from med school—and we were able to give Dr. Mohammad a chance to practice his new techniques in the context of his home country.

Whereas Dr. Firas was the “first man on the moon” in Fallujah—he quickly and humbly insisted that Dr. Mohammad should be Buzz Aldrin and take the second procedure. It was a beautiful sight to see these two guys “over the moon” about their historic moment together.

As our relationship developed over the course of the week, we began exploring the possibility of launching a similar program in Dr. Mohammad’s hometown of Tikrit in the coming months. Saturday, after our work was done in Fallujah, our gracious hosts at Fallujah General Hospital agreed to take us up the road a few hours to Tikrit Teaching Hospital to meet with its leadership and explore possibilities for future partnership.

Touring the hospital was a sobering experience. So many sincere, passionate doctors who used to be at the height of healthcare in the Middle East are now struggling to serve their patients.

After the tour, Dr. Kirk and I sat in the director’s office with the two lead pediatric cardiologists—Dr. Alaa and Dr. Mohammad. When I asked how many other teams from around the world had visited the hospital, I was surprised by their response. It was almost confusion:

“What do you mean? No one has ever come to visit us. You are the first team to even visit. If you decide to work here with us, you will be the first to teach here and treat children here.”

Dr. Kirk, Mrs. Qaragholi and I are all very humbled to be invited into such an amazing, opportunity. Because this is probably the thing that most defines our Coalition: we want to be where no one else wants to be. Find us a group of people who have been excluded or written off by the majority and you’ve found our kind of people.

Tikrit is a very storied city; one of those places that really represents something. And because of that, it’s a place that is easy to characterize and marginalize.

Dr. Mohammad, Dr. Kirk, & Dr. Firas. Photo credit: Mary Porisch

As we piled into our caravan to drive back to Fallujah, the local doctors gathered around the entrance of the hospital and earnestly pleaded, “Please, don’t forget us. Don’t forget us after you leave.”

We are working every angle we can in hopes of securing a partnership in Tikrit. In any case, we will never forget them, their kindness, and their passion for serving the children of their city. God willing, we will join them in that effort one day soon.

Our 85 suture kits are FULLY funded — Thank you for helping fund $765 worth of medical supplies!

Our Partners:

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.

We’re Making History—Three “Firsts” In One Week!

July 20, 2012 by Alicia · Leave a Comment 

This has been an amazing week!
It was so exciting to be a part of Remedy Mission X. It feels like I hear about new firsts every day:

We’re the first American team to come to Fallujah General Hospital since the war.

This is the first cardiac catheterization lab built in the hospital’s history.

This week was the first time the lab is used.

But most exciting of all: this is PLC’s first Remedy Mission in Fallujah. It’s been a week of history in the making!

Some of the most exciting firsts involved the groundbreaking catheterization procedures (‘caths’). We treated 12 children over the week and the first three days gave us a chance to break the cath lab in.

On the first day of the mission, we performed the FIRST diagnostic cath on 2 year-old Balkis. He has two holes in his heart, known as ventricular septal defects (VSDs). The doctors knew he had these holes because of an ECHO screening done by a local Iraqi cardiologist and verified by Dr. Kirk on our first day in Fallujah. To fix them, Balkis will need surgery. But the surgeons have to know lots of detailed information about the hole and the status of his heart and lungs. The diagnostic cath provided that information.

Balkis can now safely have surgery at any hospital because his parents can take the cath report to any heart surgeon and they’ll know exactly what they need to know!

The second day we performed the FIRST PDA closure in 13 year-old Sara. A PDA (patent ductus arteriosus) is an abnormal connection between the two biggest vessels coming off the heart. However, a simple coil placed in the PDA acts as a plug that closes the connection.

It’s incredible that such a tiny piece of metal could have INSTANT results in changing the blood flow in Sara’s heart. Before her cath, I could literally feel the vibrations of blood flowing abnormally. But immediately afterwards, her heart felt normal! Amazing! She is the first of many more children to be cured by caths in Fallujah General Hospital!

The third day, we performed the FIRST heart valve widening on 5 year old Rawan. Her pulmonary valve was too small for blood to flow smoothly which could have led to heart failure. However, Rawan was treated by a cath that used a balloon to physically stretch out the valve. Now the blood can flow normally, and Rawan can be active and play without her heart getting tired out!

All of these “firsts” were exciting for the local Iraqi medical staff, local and international news agencies, and government officials. But despite the thrill of being a part of a “first”, the greatest impact of the new cath lab won’t be seen for years to come, after countless more children undergo procedures at Fallujah General.

Each child who received a cath had their lives changed forever, especially those who received interventional procedures. To them, it didn’t matter whether they were the first or the last, it just mattered that they were able to be treated.

We have the amazing opportunity to change the course of history here in Fallujah and it’s thanks to your support—thank you for making this trip possible! We helped 12 children and spread goodwill through their families on your behalf, and we can’t wait to come back!

Our 85 suture kits are FULLY funded — Thank you for helping fund $765 worth of medical supplies!

Our Partners:

Alicia Lay is a Texan, foodie, and atypical medical student who is interning as a medical researcher as she works towards her Master’s in Public Health. She is passionate about international medicine, surgery, public health, and Iraqi children. When not in a hospital or doing research on the computer, she enjoys taking photos, reading about global health, and singing the day away as if her life were a musical.

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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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