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)

Nivar Rests in ICU Extubated and Breathing on Her Own

July 23, 2010 by Jeremy · Leave a Comment 

Friday was another great day of progress for Nivar. She is still in ICU due to a small chest infection, but she is breathing on her own and eating. As soon as the infection is cleared up, she will be transferred to her room upstairs. Stay tuned for more from Istanbul on Nivar’s progress…

This little boy, Yahya, still needs a few thousand dollars to cover the costs of surgery and travel from Iraq to Istanbul so he can experience the same life-change you’ve given Nivar. To take Yahya out of line and get him to Istanbul for surgery, please enter the amount of your choice below and click “Donate Now!”.

Follow Nivar on Twitter: @NivarMohammed. Subscribe to Nivar’s updates via RSS HERE. Follow Nivar’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.

Photo of the (Yester)Day: Nivar Recovers in the Cardiac Intensive Care Unit

July 22, 2010 by Jeremy · Leave a Comment 

While the risk of death and attendant complication associated with Nivar’s open heart surgery was estimated to be just 5%, there is still something that inside of us that say the human body should not be opened up and closed again; something that says that is excessively dangerous and causes us to hold our breath in anticipation of good news.

And that’s why this photo is so poignant. There is nothing as satisfying as hearing that your little one is out of surgery and that all went well and there is nothing like seeing her alive and well – all put back together again. Well, nothing except hearing that she’s being taken off of all the machinery and living entirely on her own… but that story is yet to come!

This little boy, Yahya, still needs a few thousand dollars to cover the costs of surgery and travel from Iraq to Istanbul so he can experience the same life-change you’ve given Nivar. To take Yahya out of line and get him to Istanbul for surgery, please enter the amount of your choice below and click “Donate Now!”.

Follow Nivar on Twitter: @NivarMohammed. Subscribe to Nivar’s updates via RSS HERE. Follow Nivar’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.

Nivar’s Surgery Results in Total Correction!

July 21, 2010 by Jeremy · 1 Comment 

After nearly 5 hours in surgery we heard the news that Nivar had received a total correction for her heart defect and was resting under heavy sedation in ICU. Here is how one of our volunteers and donors on site described the scene as her father rushed to hear the news:

Have you ever observed something that made you feel just a little more alive than you did the second before? The senses sharpen, everything else around you stops, and it seems as if the state of your very existence could hinge upon your understanding of that precise moment. Life all of a sudden becomes more valuable and hope of something unintelligible, unexplainable and far off fills your being from deep within. THIS is how I felt when I dodged a father running to see his daughter’s doctor following the completion of her open heart surgery…

In the post-op consult we learned that Nivar has been misdiagnosed and that her complication was more severe than originally thought. Once her chest was opened up Nivar was found to have a defect known as “Double Outlet Right Ventricle” in which both great arteries arise wholly or in large part from the right ventricle. Dr. Çiçek corrected her great arteries and patched a massive hole between the lower chambers of her heart and sent her on her way.

We were able to place three of our summer interns in surgery yesterday – two pre-med students and a photographer – which was a very rewarding experience for all involved. Above are two snapshots of what they experienced during surgery….

Nivar is resting in ICU right now. We deeply appreciate your generosity in seeking to save Nivar’s life and your attentiveness this week as we’ve posted updates on her progress each step of the way. Has she captured your heart? You should tell someone about it!

Please use the “Share This”, “Twitter box,” and “Facebook Comments” box below to spread the word about our work right now. A tweet, a Facebook “like,” or an email to a friend can go a long way toward helping us bring more kids like Yahya to surgery in a few weeks.

Follow Nivar on Twitter: @NivarMohammed. Subscribe to Nivar’s updates via RSS HERE. Follow Nivar’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.

Nivar Goes in to Surgery After Endless Games of Patty-Cake

July 20, 2010 by Jeremy · Leave a Comment 

A hospital is a lonely place if you don’t have someone you love and trust to share it with. Nivar is here in Istanbul – away from her home and family and brand new baby sister in Iraq – with her dad. Dad’s are great for little girls… but let’s be honest… little girls need other girls!

It has been a tremendous ending to our Preemptive Love Summer Internship this week watching Lydia Bullock and all of our other interns give themselves to these kids and their parents as much as they can.

In the video above Lydia plays patty-cake again and again and again with little Nivar – which effectively staves off the worry and fear that could have easily set in as Nivar waited for surgery this morning. Her dad was worried and scared, but a little humility and willingness to meet a child on her own level meant that Nivar had nothing to fear.

Nivar went into surgery at 10 a.m. this morning… stay tuned for more updates on her progress….

Follow Nivar on Twitter: @NivarMohammed. Subscribe to Nivar’s updates via RSS HERE. Follow Nivar’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.

Thoughts on Nivar, My Own Little Girl, and Injustice

July 20, 2010 by Jeremy · Leave a Comment 

You know I have a daughter… she’s not quite Nivar’s age. But I have deeply enjoyed the years I’ve had with her. She has her own personality. We have our own little jokes. We have secret phrases that no one else understands. And she loves candy… especially suckers.

So while my daughter is safe at home with a fully functioning heart, I’m doubly burdened by the weight Nivar and her family have carried all these years. Why wasn’t she treated earlier? Why are there so few healthcare options in an oil-rich country like Iraq? Why was she born this way at all?

Did GOD do this? Did Saddam do this? Could we have done this?

These are things that I’m beginning to talk about with my daughter when we pray for little girls like Nivar.

One of the “heart surgery kids” my daughter became most attached to was a baby named Daryan we tried to save a year ago this week. He died. My daughter is remarkably unfazed by death. She still talks about Daryan and prays for him weekly.

Sometimes I wonder if I should I be more like her?

While Nivar’s dad steps outside to get a break and smoke a cigarette, I’m sitting here with Nivar alone in Istanbul thinking how much she’s like my little girl. Thinking about sending my daughter through those harrowing doors into heart surgery brings tears so easily. Every time I see these kids cry in the face of the unknown; every time I see them play through the discomfort; and every time I see them enjoy a sucker in the sunshine I remember that these dark shadows in which they live simply prove the existence of a blazing light; a better reality. Because for all the questions left unanswered in the face of injustice, we can agree that shadows prove the light.

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

Music courtesy The Autumn Film (http://theautumnfilm.com/)

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.

VIDEO: Four Iraqi Children Arrive in Istanbul for Lifesaving Heart Surgery

July 20, 2010 by Jeremy · Leave a Comment 

On July 18th four Iraqi kids arriving in Istanbul, Turkey in need of lifesaving heart surgery. They have entered a country about which they have mostly heard negative stories.

This week will change their perspectives and change their lives forever…

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

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

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

Follow Jeen on Twitter: @JeenMustafa. Subscribe to Jeen’s updates via RSS 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.

Chro & Leah Play While Waiting for Surgery; Mothers Share Fear & Worry

July 19, 2010 by Jeremy · Leave a Comment 

As many mothers of sick children know, outward behavior does not always accurately convey the gravity of an internal illness. Such is the case with Chro and Leah, who are settled into their room and already beginning to attract strangers with their smiling faces. Having been born with defective hearts and yet to discover what life could be like with a healthy body, these young girls have no choice but to enjoy life as they know it. While Leah prefers being held or playing with her rattle, Chro’s favorite activity to pass the time is getting her toenails painted…again and again and again. But when the first words out of her mother’s mouth in the morning are, “when is my child’s surgery?” the immediacy of these beautiful little girls’ situation is unavoidable.

We can’t help but smile at the contrasts present in the hospital room these two mothers and their children share. One woman is a mother of eight, while the other is perhaps twenty years younger, fighting for the life of her first child and five months pregnant with her second.

What the two mothers share in common, however, is concern.

As of two days ago, these women had never traveled without their husbands, flown on an airplane or left their country. Yet they have now experienced an overnight flight to a country they have been taught to fear and a long bus ride through one of the largest cities in the world, all on their own. Surrounded by foreign languages and customs, these mothers now await their child’s first opportunity at a full life, sharing a hospital room with perhaps the only other person in the world that just might understand how they feel.

Surgeries here at Anadolu Medical Center begin tomorrow, and we hope these two mothers will soon have the joy of receiving the news that they may return to their families with healthy children and renewed hope. Then there will be four smiling faces when they leave their hospital room, instead of only two.

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

Follow Leah on Twitter: @Leahibrahim. Subscribe to Leah’s updates via RSS HERE. Follow Leah’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.

HOPE DENIED FOR PARWA

May 17, 2010 by Jessica · Leave a Comment 

This is not a very hopeful blog post, but one that is an everyday reality for many families in Iraq. Today I was sitting with Parwa’s family in their home when we learned she was deemed inoperable last week by an in-country diagnostic procedure. A wonderful team of American doctors came to our city last week and gave free check-ups and catheterizations (a procedure to assess how well the heart is pumping blood) to the children here. That part isn’t the infuriating part. What is infuriating is that this 11-year-old girl missed her chance at surgery; at a “normal” life – and that’s a chance she will never get again.

She should have had surgery 5-6 years ago. Even surgery one year ago may have saved her.

The hole in her heart (VSD) should not have been terminal. VSDs should not be giving death sentences to eleven-year-olds.

From the time I first met Parwa I have loved her. She is an amazing little girl, smiley and full of so much life. Unlike other children with heart problems, she isn’t blue, she goes to school, she plays with her brothers and sisters. If you saw her walking down the street you wouldn’t know that she is dying. And this is part of the problem. No one knew. No one thought to check.

This isn’t a country where most children go to the doctor for wellness checks at 2, 4, 6 months, and every year after that. This isn’t even a country where most children are born in a hospital (and those that are born in hospitals are discharged within hours in many cases without a chance to really assess much more than overt birth defects). Very few provincial doctors know how to check for these problems until it is too late.

In this case, even if they had discovered it at birth, there wouldn’t have been anything the doctors here could have done about it with the medical infrastructure such as it is.

And now it is too late for Parwa. But it is not too late for so many others. Days like today push me forward to walk into more homes and doctors offices and help these little ones who need help now.

Parwa isn’t the only child I saw today. I saw Bawar, a precious two-year-old going to surgery in July, playing outside with his older sister and brother. I also visited Yousif and his ten siblings in their small village house, complete with cows and chickens outside. Bawar and Yousif still have a chance. They are urgent and need surgery quickly. And the best news is that the only thing standing in the way is money. Their parents understand their problems, which led them to appeal to us for help to get to Turkey for their surgeries before it’s too late. Now we are just waiting on the funds.

Can you help?

We plan to send Bawar, Yahya, Leah, Nivar and possibly a few others to surgery on July 18, 2010. All donations will be used to cover their airfare, housing, food, and surgical expenses.

Jessica Courtney lives and loves in Iraq as a co-founder and Family Services Director of the Preemptive Love Coalition. She is also a mother of two children and is married to PLC's Executive Director, Jeremy Courtney. When not absorbed in caring for Iraqi children and sharing life with Iraqi families, she enjoys sewing and scrapbooking.

Successful Surgery for Deelan & Special Call for Lifesaving Funding

March 3, 2010 by Jeremy · Leave a Comment 

It was all smiles after another successful heart surgery here in Istanbul. Deelan’s surgery was a “total correction” – though he is still in ICU on a treatment of nitric oxide to bring down the pressure in his lungs.

In addition to being a by-product of cigarette smoke and rush hour traffic – not to mention a body building supplement – nitric oxide is used in pediatric intensive care. From the source of all online wisdom, Wikipedia:

The endothelium (inner lining) of blood vessels uses nitric oxide to signal the surrounding smooth muscle to relax, thus resulting in vasodilation and increasing blood flow.

and

Nitric oxide is considered an anti-anginal drug: it causes vasodilation, which can help with ischemic pain known as angina by decreasing the cardiac workload. By dilating the veins there is less blood returned to the heart per cycle. This decreases the amount of volume that the heart has to pump.

Nitric oxide should not be confused with “laughing gas” – or, more officially, nitrous oxide – N2O.

Nitric oxide is also very expensive. In fact, we’ve had to use it already on Muhammed and Baroof. In addition to normal surgery costs (which is essential to repair the CAUSE of pulmonary hypertension), NO can undo the previous effects of the now-repaired cause. To fix the cause and not seek to reverse the effects is to leave the net outcome the same.

We spent $2,000 per child on nitric oxide, for a total of $6,000. As much as the surgery itself, this has really proven to be the stuff that saves lives. So today I’m going to ask that you find a way to give generously to the Lifesaving Nitric Oxide Fund to pay down Muhammed, Baroof, and Deelan’s additional costs and to pave the way for future children who will need this treatment.

Molecule of the Year (1992), Nitric Oxide

To save lives through the very specific provision of nitric oxide, please contribute your desired amount below. One container of nitric oxide costs us approximately $2,000.

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.

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 is Taken in for Time-Sensitive Surgery

March 3, 2010 by Jeremy · Leave a Comment 

Deelan and his mom were a little unnerved this morning as they waited – and were eventually taken in to the operating room – for Deelan’s surgery to repair the massive hole in his heart and thereby decrease the life-threatening pressures in his lungs.

Meanwhile, back in Iraq, Deelan’s family waits with a lot of anxiety over the next few hours. This thing they’ve been longing for; this thing they’ve been working for – this surgery – is now a great unknown. It still stands as a beacon of hope for them, but now that it’s upon them, the realities of the risks set in in a way that was previously unknown and unanticipated.

Deelan should be out of surgery in 4-5 hours. More to come…

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.

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.

Next Page »

DON'T MISS FREE STUFF WITH OUR NEWSLETTER






Get our good news stories straight into your reader or inbox for free!




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.

• Popular Tags

  Amman Arab Aras Baghdad BSSL Buy Shoes. Save Lives. buyshoessavelives CHD children Congenital Heart Disease Development echocardiogram God heart heart disease heart surgeries Heart Surgery hope hospital Hussein ICHF ICU Internship Iraq Iraqi children Istanbul Jeremy Courtney Jordan Klash Kurd Kurdish Kurdistan nasiriyah peace Peacemaking PLC remedy Remedy Mission Rezhin Southern Iraq sulaymaniyah Surgery Tarza Turkey Wordless Wednesday

• Archives

  • 2012
  • 2011
  • 2010
  • 2009
  • 2008
  • 2007

• Contributors

  • Adam Brandt (4)
  • Alex Phillips (10)
  • Anton Warkenton (1)
  • Awara Hassan (6)
  • Benjamin Chasnov (1)
  • Cayla Willingham (3)
  • Claire Baker (1)
  • Cody Fisher (99)
  • Esther Perez (6)
  • Jeremy Courtney (83)
  • Jessica Courtney (20)
  • Joshua Gigliotti (23)
  • Lauren Sawyer (2)
  • Liz Jones (1)
  • Lydia Bullock (52)
  • Matt Willingham (51)
  • Preston Wright (4)
  • Ruth Simpson (16)
  • Ryan Rosenberry (2)
  • Sophia Pappas (6)
  • Ted Harrison (3)
  • Tim Mason (1)