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)

New Beginnings For Fallujah!

May 16, 2013 by matt · Leave a Comment 

We’re pleased to announce that our most recent Remedy Mission in Fallujah went extremely well!

This was our third mission to Fallujah, and spirits are still high. Doctors and nurses are learning, children are being treated, and there’s a lot of optimism among our partners about this program.

But most importantly: we’ve seen calculable growth.

On our first mission to the city, the team worked with Dr. Firas and his staff to perform 12 procedures in 4 days. On the second mission, they did 16 procedures in 5 days. And now 16 kids in just 3 days!

That means our children-to-day ration climbed from 3 kids per day to 3.2 kids per day to now 5.3 kids per day, and that kind of progress means everything to those who have been waiting years for their chance at a lifesaving operation.

Thank you for making this kind of progress possible—maybe next mission will see 6 children saved per day!

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.

Highlights From Our Remedy Mission XVI

April 2, 2013 by Cody · Leave a Comment 

Today is the last day of our Remedy Mission here in Najaf!

We still have a full day’s work before we head home tomorrow, but here are some highlights as we wrap up Remedy Mission XVI.

—Getting to meet Hama, Kadeeja, Musa, Ali, Diya, Shakir, Mohammed, Noor, Zainab, Zahara, Mahdi, and Yousef. All twelve of those children received lifesaving operations this trip!

—Watching one of our local heart surgeons completely correct a heart defect – without any help!

—Witnessing our cardiologists screen close to 200 more children.

—Sitting down with the local medical team to talk about longterm development and the training they want to receive this next year.

—Being overwhelmed by the gratitude and joy expressed by all the families of those we served this mission.

Thank you so much for making this mission possible.

I’ve said this before, but we haven’t provided a single heart surgery in Iraq apart from the support and generosity of others.

You give; a child is saved; peace is waged. It’s a cycle we can’t continue without you, so thank you!

As soon as I leave here, we’ll start preparing for two more Remedy Missions this month in the cities of Fallujah and Tikrit.

You can be a part of the community that makes those operations possible by donating a few dollars below.

Peace from Najaf.

Give now to bring hope to families in Tikrit!

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

Zombies, Baby Blood, And The Call of Duty To Love Our Neighbor

January 22, 2013 by matt · Leave a Comment 

I fidgeted on my stool, trying to focus in spite of the noise.

Off-duty doctors huddled nearby. They were glued to a Jason Statham movie, awaiting his next kill.

My stomach churned. Between the cigarettes and the high-volumed intensity characteristic of blown out Iraqi speakers, I honestly couldn’t take one more head-shot.

BANG!

The one-liner is delivered and my friends rumble their approval, scooting their chairs closer to the flat-screen. I snapped my computer lid shut and retreated—nauseated—as more thunder echoed be behind me.

Half an hour later, I stood in an O.R. filming doctors as they pulled blood from a beautiful baby boy named Abdul before his heart operation. In a way, Abdul’s blood and shrieking made Statham’s flick seem gore-free, but arriving in the O.R. actually helped settle my stomach.

Somehow this was different, and I began to realize it wasn’t about blood.

It was the violence.

All of this happened on my fourth day in the city of Fallujah—the medical mission progressed, and spirits were high. But I couldn’t stop thinking about my physiological reaction to that movie. It’s hard to pin-point why, exactly, but my body and mind can no longer handle violent media.

Photo Credit: “Six Days In Fallujah“, Atomic Games

In college, violent movies and games like Call of Duty never really affected me—they were just fun past-times. But something about being in Fallujah, with all its bombed-out buildings and birth defects… it got too real, too fast.

During research for a video I was making, I watched a ton of archived footage from the battles that happened in Fallujah. The helmet-mounted cameras made the killings almost indistinguishable from my favorite 1st person shooter games—except these were real.

The snarky comments made by soldiers, the way both sides treated prisoners and dead bodies, and all the blood. So much blood. Nobody was respawning after these fights—no ‘extra lives.’

I want to be clear: this post is not about boycotting anything—I’m not saying we should all go tee up our action movies and XBOX games and golf club them to oblivion.

I’m just asking a simple question: at what point have we lost touch with reality? At what point did I lose touch?

As a person who strives to follow Jesus Christ and his teachings, I look at the “Sermon on the Mount” and wonder how I got where I am. Jesus stood up and taught radical enemy-love, pain-absorption over pain-reciprocation, and the happiness of peacemakers. Am I training myself toward those things?

Am I preparing my heart to love the limbless family members who brought their sick, war-stricken children into the hospital for surgery? What if their child dies in the ICU and they blame or even try to hurt me—how have I prepared myself to respond?

Or what about the suicidal American solders—more of whom have died at home than on the battle field—am I ready to love them, given the chance?

This is what we mean when we say “preemptive love,” and, if it doesn’t cost me anything, I have to wonder whether it’s even real.

During a recent gaming spree, my wife asked me, “Is ‘Nazi Zombie Mode’ just an excuse to kill things without feeling bad?” She was right, I want it both ways.

Writing endless blog posts that call people to love their perceived enemies while using a broken-off bayonet to hack mine to pieces in a video game really doesn’t add up, regardless of whether or not the game is ‘real.’

Photo Credit: Karim Sahib, AFP

When you think of Fallujah, you might remember the murdered mercenaries in 2004. How did you react when you saw the charred bodies?

With that in mind, don’t you find it disturbing how excited my Muslim friends in Fallujah were by the heart-numbing gore on the screen in front of them?

Don’t you find it disturbing how many Christians in America enjoy the same kinds of entertainment?

What can we do to prepare ourselves to love when it’s difficult? I would encourage you to start by considering the paraphrased teaching from Jesus below—how far should we take these words? Then email me your thoughts, or connect with me via PLC’s Twitter and Facebook accounts. If you disagree, please share why—I promise not to attack you with a broken-off bayonet.

###

“You’re familiar with the old written law, ‘Love your friend,’ and its unwritten companion, ‘Hate your enemy.’ I’m challenging that. I’m telling you to love your enemies. Let them bring out the best in you, not the worst. When someone gives you a hard time, respond with the energies of prayer, for then you are working out of your true selves, your God-created selves.”

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.

Chatting With A Local Hero—An Interview With Dr. Firas (Part II)

January 15, 2013 by matt · Leave a Comment 

Cardiac training programs live or die by the initiative of the local doctors.

Ultimately, this is their program—an investment in them. As soon as they lose their passion to learn, coordinate, and hack through the red tape, the program is in trouble.

Perhaps that is why our time in Fallujah has been so encouraging. Dr. Firas (pronounced fee-rahs) is the only pediatric cardiologist in the Anbar region—Iraq’s largest geographic region and home to a growing number of children with heart problems.

So, given his kindness and compassion for these children, we asked him if he would share a little about his life, his concerns, and his hopes for the future of Fallujah.

(Read part one of this interview here.)

PLC: If you don’t mind, would you share about your life and work during the war?

Dr. Firas: Yes, I was in Baghdad working as a general pediatrician—I have two PhDs that allow me to work in these fields, one in general pediatrics and one in pediatric cardiology. But my family was here in Fallujah at first. So I moved them to Syria and I lived here in Iraq alone to complete my studies and care for children.

PLC: Some might assume you wouldn’t want to work with Americans after the things you experienced—has that been difficult?

Dr. Firas: I believe there are political issues, and there are the American people. I know many of the Americans don’t support what happened here in Fallujah. I know politicians aren’t the same as all the people—there is a difference. Of course, I am not happy about everything that happened during the war. But I’ve seen your team twice now in Fallujah, and you are trying to help our people.

You all give a different view of Americans. Of course, many people have anger in their hearts, but I know that these great amounts of congenital defects are because of the war and the chemical weapons [sic]. About 50% of the congenital heart defects [in Iraq] are in Anbar, our region, and most of those are in Fallujah. It is widely thought by our people that these are because of the war.

PLC: That “different view of Americans” is something we care deeply about. It’s great that you see these missions as opportunities for peacemaking as well. Today was the final case of the mission. Would you tell us a little about that? I know you were excited.

Dr. Firas: Today, we helped a small child by closing a hole in her heart. It took us nearly an hour just to get inside—it was so difficult. But it was amazing how immediately her system pressures rose and everything improved. It was a very satisfying operation because the child was close to death and our fix helped her immediately.

PLC: Do you feel like you could do corrections like this by yourself yet?

Dr. Firas: For now, no. I don’t have surgical back-up to assist me if something goes wrong. But… I must do something. So I choose the most simple cases and prepare them for our surgical missions. Then we can do them during the missions.

As I said, I also don’t have any help—I’m alone—and I must have other doctors to help guide me as I make the correction. I am hoping to recruit more Iraqis to come train with me. In all of Iraq, though, we only have thirteen child heart doctors. They are very rare here. This year, we had 12 new people applied for adult cardiology, but only two applied for pediatric. Working with children is much more difficult and stressful.

PLC: God-willing, more doctors will come alongside you, and the backlog of children who need surgery will be a distant memory. Thank you for sharing with us.

Dr. Firas: Insha’allah, I really hope so. Thank you.

###

Dr. Firas’ dream of establishing a heart center in Fallujah is possible, and we intend to do whatever we can to help him fulfill it! If you would like to contribute to the training and life-saving that is happening here, please donate below:

$5 or $50—Give what you can to help Dr. Firas save lives!

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.

“Like Landing On The Moon”—Iraqi Doctors Make History In Fallujah!

January 13, 2013 by matt · Leave a Comment 

Iraqis in the western province of Anbar just crossed another heart defect off of their “incurable” list. Our team stood by to support as Dr. Firas and his team corrected a defect that had never been fixed in this region of Iraq.

Little Aya, a 4-year-old with a sweet disposition, was born in Fallujah just a few years after the Iraq War’s deadliest battles. Like so many children in her region, she had a heart defect and no hope for help.

But you’ve already heard that story several times over.

What you may not have heard is that many families in Fallujah have decided to avoid pregnancy because of how many children are now born with birth defects.

Living life with no children—this is no small decision in a progeny-focused culture like Iraq’s. Children are a source of great pride, glory, and honor, and choosing to abstain from child-bearing is a big deal. Some parents I spoke with said they wouldn’t take the risk of having a child unless they knew there were doctors who could provide treatment, and that’s a part of the reason why we’re here.

These surgical missions represent much more than a handful of lifesaving operations—though they’re definitely that. These are about offering solutions and hope to families in need. When mothers and fathers are too afraid to have children because of rampant birth defects and no available treatment, that’s a problem that demands a remedy.

Thankfully, Aya’s heart received a total correction thanks to Dr. Firas and the team, and there are many more still waiting. Hopefully she is the first of many!

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.

Chatting With A Local Hero—An Interview With Dr. Firas (Part I)

January 11, 2013 by matt · Leave a Comment 

Cardiac training programs live or die by the initiative of the local doctors.

Ultimately, this is their program—an investment in them. As soon as they lose their passion to learn, coordinate, and hack through the red tape, the program is in trouble.

Perhaps that is why our time in Fallujah has been so encouraging. Dr. Firas (pronounced fee-rahs) is the only pediatric cardiologist in the Anbar region—Iraq’s largest geographic region and home to a growing number of children with heart problems.

So, given his kindness and compassion for these children, we asked him if he would share a little about his life, his concerns, and his hopes for the future of Fallujah.

PLC: Thanks for taking a few minutes to share, doctor. So why did you decide to become a cardiologist?

Dr. Firas: You know, we’re in Fallujah. There are many cases here; just so many children, but no specialists to treat them. I saw the high percentage of death; all the undiagnosed children; the great need. My first interest was to help my people here…to save their lives, the kids.

PLC: It seems like a lot of cardiologists here get into the field because of a family member who dealt with heart problems—was that your experience?

Dr. Firas: Yes, my father died from heart disease. It wasn’t congenital, but it did help put me on a path toward becoming a heart doctor.

PLC: Now that you’ve completed two Remedy Missions with us and our partners, what do you think? Reactions?

Dr. Firas: The missions were so good—they mean a lot to us. This [heart] center is new, and a lot of people here don’t even know that we have a cath lab and can treat their children. But these missions have brought us a reputation and the people are hearing about our work. It provides us with a good reputation and our people with hope.

PLC: That’s encouraging. What do you hope for the heart center here? Any next steps?

Dr. Firas:I hope to someday see open heart surgery here. I have to send so many cases to Baghdad or outside of Iraq, but I’d like to see children saved with complex cases here, in Fallujah.

###

We share this dream with Dr. Firas, and we intend to do whatever we can to help him fulfill it.

This is only the second of many missions to come—we’re in this for the long haul! Come back tomorrow to read part two of the interview, and consider helping us save more lives in Fallujah and across Iraq:

$5 or $50—Give what you can to help us save lives!

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.

2013—A Year Of Saving 300 Children Begins Right Now!

January 10, 2013 by Jeremy · Leave a Comment 

"It always seems impossible until it's done."                               —Nelson Mandela

We ended 2012 celebrating the 300th surgery since our beginning in 2007! As we begin 2013, we are looking forward to 300 more before the end of the year.

This year we aim to double the number of children we have helped in just ⅕ of the time. We will also double the number of cities we are working in and double the amount of education and training we are able to provide—daunting goals. But, really, it doesn't seem too daunting after the mountains we've already scaled together.

There was a time when sending Iraqi Muslim children to Israel seemed like it would never work. Then there was the fatwa that called for our punishment and death for sending those kids to Israel.

Becoming a full-service, turn-key operation by sending children to Turkey once seemed impossible.

Our dream of hosting surgery teams inside Iraq to operate and train locals took years to realize and seemed more than a little crazy when the country was falling apart around us.

And even after we successfully brought these teams to cities all over the country, the idea of replicating it in an historically difficult city like Fallujah seemed even crazier.

But, with your help and with the help of our excellent partners, we've accomplished all of those things—and now we're headed back to Fallujah again.

Remedy Mission XV begins this week. The first step of our journey toward 300 more surgeries begins now!

To take this trip with us and to meet the children you're helping, follow along on the blog and on our Facebook page all week long. New stories every day!

We promise it'll be worth your while.

For the impossible,

Jeremy

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.

5 Children You Helped Save In 2012

January 8, 2013 by matt · Leave a Comment 

My favorite thing about January?

It’s the only month when it just feels right to look back and to plan ahead. A backward glance helps us remember what God has done during the previous year and all that we’ve learned, while a look forward offers hope for betterment and an opportunity to grow.

And who doesn’t love a clean slate—an opportunity to jumpstart things in a new direction? I’m here to tell you, though, that you did some pretty fantastic stuff last year. If your friend is bragging about their new job or some kind of shiny new gadget, please read this part out loud: “I helped save lives last year.”

Is there someone near you right now? Grab their sleeve and say it again, “I helped save lives last year.”

In 2012, you guys raised money, hosted parties, and spread the word on behalf of Iraqi children. There are children alive now who would not be—you’re heroes!

So—in case you didn’t get to meet them all—here are a few of the children you helped save in 2012:

1) Hussain—I don’t know who came up with the “don’t play favorites with kids” rule, but they obviously haven’t met this boy. I’ve adored him since our first game of “air soccer,” and the first thing I try to plan when we return to Najaf is try to plan a visit to see him and his family. He’s a sweet, sweet child and—thanks to you and the Coalition—he is now home and fully alive. Read his whole story here.

2) Yousef—our 2012 vote for the Most Pinchable Cheeks Award, Yousef received a heart operation at our groundbreaking Remedy Mission X in Fallujah. If you haven’t seen some of his adorable facial expressions yet, do yourself a favor.

3) Zahraa—Sweet, solemn Zahraa. I tracked with her from beginning to end, right up until she carried her dollies into the hospital elevator and went home. Click here to watch our video shorts of her trip through the hospital.

4) Hassin—don’t be fooled by his drooping eye lids and ridiculous eye-lashes, Hassin is sneaky. When the doctors told him he couldn’t eat or drink anything before his surgery, he snuck past his family, out of his hospital room, and down 6 flights of stairs to demand that the snack vendor give him food. His parents found him pounding his fists and declaring, “I need to eat or I’ll die!” I’m happy to report that, after his surgery, he snacked to his healthy heart’s content. See more of Hassin here.

5) Maddy—the 300th child you’ve helped us save, this little boy is sunshine incarnate. I still stand by my claim that he’s the smiliest, most pleasant little boy you’ll ever meet. If you missed the excitement of his landmark surgery, check it out here (the video was especially fun to make!).

2012 was pretty amazing, and 2013 is looking even better. Stick with us as things get started—our 15th surgical mission is coming up in Fallujah!

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.

Kisses, Crayons, And Bubbles—A Look Back On Our Week In Fallujah

August 21, 2012 by Kendelyn · Leave a Comment 

Uncertainty is a way of life here.

When it comes down to it, the answer to questions is often “I don’t know.” This was the answer I got when I asked whether or not I’d be going to Fallujah for Remedy Mission X last July. The problem wasn’t the lack of communication, the real challenge, for me, was the inability to create expectations (and therefore plans) of any kind. It’s often difficult to gauge what a mission is going to look like, especially when the mission is a first-of-its-kind in a new city. And, since Fallujah was a first-ever, it was guaranteed to have bumps along the way. Embracing this fact, I made sure to walk into the week with an open mind.

I’d heard a lot about Fallujah over the years, but most importantly I knew that the city had experienced a lot of pain and difficulty, and all I wanted to do was make it better—somehow. But how? How could I, a 20 year old from America, be able to make any difference in such a big, broken place so far from home?

The more I pondered this question, the more my response made sense to me: I can make a difference by endeavoring to love everyone I come into contact with. But that begs the question: “how do I show my love for these people when I’ve barely just met them?” I strived to find an answer to this question all week.

And the week was a blur!

Children were in and out of the operating room faster than I thought possible. But with the intention to love in the back of my mind at all times, I moved forward in my interactions with the children and their families filled with as much purpose and love as I could muster. I made sure not to let my fatigue and frustration show, and I made sure to have a smile on my face at all times. I was there to be a friendly face and bearer of joy as I documented the mission with my camera.

Looking back, I can barely recall how exhausted I was that week as the experiences of love and joy stand out far more prominently in my mind. The doctors loved the children, the children loved their parents, and the parents loved the doctors.

As love is put into the world, love circles back around. It begets itself.

In the course of a week I took hundreds of photos. Photos of everything from the children hanging out in pre-op to the doctors working in the cath lab. But out of all the images that I took in the course of the week the ones that stand out the most to me are the ones of kisses, crayons, and bubbles—not because they’re the cutest images of the week, but because they best exemplify the love that filled the hospital. The very same love that I tried to foster all week.

But all of that effort made by our team and the local doctors is just a drop in the bucket. Fallujah is still a broken city in need of attention and love, and the past still matters. But if we can continue to push ourselves toward selflessness over and over and over again, mission after mission, then I believe we’ll be able to create a future filled with love towards one another.

I believe we can reshape old perceptions previously founded on hate.

Our Partners:

Kendelyn is a 2012 summer intern who LOVES taking photos, and you can find her strolling the streets snapping shots of anything from flowers to friends to googly-eyed stuffed goats. She's excited to be working in Iraq this summer as PLC's photography intern and looks forward to learning more about its culture and people.

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.

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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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