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)

A Glance Back, A Long Look Forward

April 19, 2012 by matt · Comments Off 

I’m sure this has never happened to you, but today I got distracted at work…

I blame the internet (read: Twitter) for being so interesting. But at least it was a semi-productive kind of distracted; I started reading back through some of the very first posts on this blog, written by Jeremy way back in the day.

This was back when we still emphasized our Buy Shoes. Save Lives. program, and Jeremy ended a few of the emails with quirky phrases like “shod thyself” and signed off with some pretty epic monikers like “the rad-ifier” (someone who makes things rad, obviously) and “the wristbandits,” just to name a couple.

But all this rabbit-trailing was a great reminder of PLC’s history and what you have made possible! Some of you have faithfully read this blog for years. You’ve been with us through serious tragedy, and sky-high elation. You stuck with us when we failed (and wrote about it in-detail) and when we transitioned to our current Remedy Mission model.

You rooted us on back when this was all just a big, beautiful mess-of-an-idea. You believed in us, and I hope you know how grateful we are for it.

PLC turned 4 years-old last February, and that quick look back at our history reminded me how much further we have to go. By the end of the year we’ll be developing heart centers in 5 cities across the country—great news, right!? But the key word there is ‘developing,’ because these centers will likely take 5-8 years before they’re fully independent and self-sustaining.

So we need you to stick with us, to keep reading, and to remember that this won’t happen without you. Countless thousands of children are still waiting, and countless thousands will be saved if we can just keep moving and looking forward together.

With you to the end,

The Rad-ifier

Healthy Danar Can Now Experience New Life Because of His Lifesaving Heart Surgery

July 7, 2010 by Esther · Comments Off 

from Preemptive Love on Vimeo.

Since, his surgery in January, Danar has steadily regained his strength and has begun to have new life.

Danar is one of nearly 50 children who have undergone surgery with PLC. And it is because of your donations that he can run, laugh and share life with his family.

You can continue to make a lasting difference in the lives of children like Danar by donating to our Remedy Mission —  two weeks of partnering local doctors with international surgeons to provide 30 local heart surgeries for Iraqi children.

And we encourage you to share that spirit of making a difference with others —  creating a ripple of change amid your family, friends and co-workers in your circles of influence. By giving through Remedy Mission, buying Klash from our Buy Shoes. Save Lives. program, or creatively partnering with PLC to find new ways of providing these heart surgeries, you can show your community a glimpse of peace and hope in Iraq as it becomes reality for children like Danar.

How Preemptive Love Works Toward Local Solutions to Local Problems

August 21, 2009 by Jeremy · 2 Comments 

VISION & VALUES

By the end of Quarter 2 2009 PLC had spent $225,605 to fund heart surgeries for Iraqi kids, impacting forty families in life-changing ways, and decreasing the overall backlog by an additional ten percent.

You’ve heard that the Preemptive Love Coalition exists to eradicate the backlog of Iraqi children waiting for life-saving heart surgeries and to create cooperation between communities in conflict. But it is important to us that you understand how we seek to accomplish this mission and why.

We strive to fulfill our mission by creating…

- Local funding for local problems
- An ethos of volunteerism and community in hopes of subverting the prevailing distrust of one another
- International partnerships and infrastructure that will outlast our own organizational presence in Iraq

When we started in 2007 we began to calculate the need in terms of $10,000 surgeries for 4,000 children… or $40,000,000. The scary thing was the reality that surgery prices would likely go up with the global economic situation and that the 4,000 on “THE LIST” were probably just representatives of a larger number.

As we stared down what seemed to us to be a giant need, we finally realized that we would need to change the system and the rules of engagement if we would ever be a part of achieving the results we wanted. After a year and a half of ambling through different procedures and a lot of trial and error we implemented what proved to be our most impactful strategy to date: to partner with families for their healthcare.

Many in Iraq told us the U.N. had created a culture that prevented Iraqis from engaging in their own advancement

Many in Iraq told us that the United Nations (and others) had created a culture here that prevented Iraqis from a willingness to engage in their own advancement; that the mentality was one of waiting around for others to give handouts. Still, we were hopeful that partnering with families for 25% of the package price would be a revolutionary start.

At the same time, we committed ourselves to seeking an additional 25% in local funding from charities, businesses, and local philanthropists.

All the while, we work diligently to maintain and extend the scope of our logistics and medical partnerships so that we can continue to provide the greatest services at the greatest prices.

Here are a few more details on how all that works…

MARKET vs. PLC PRICING

The life-saving heart surgeries we provide take place at the world-class Anadolu Medical Center (ASM) in Istanbul, Turkey. Before discounts and partnerships, the total market prices on the services offered by PLC begin at $22,000. For heart conditions that are more complicated, prices would easily exceed $50-75,000.

Through partnerships with Atlasjet Airlines, Anadolu Medical Center, and medical supply providers around the world, PLC is able to regularly facilitate life-saving heart surgeries for Iraqi children at 60-70% off market prices.

After all of our partnerships, discounts, subsidies and patient family contributions the remaining cash need per child is approximately $5,000 before we can schedule a surgery.

PLC also keeps cash reserves on hand for the occasional surgery that runs far above the average cost.

After PLC provides 60-70% discount off market prices for airfare, in-city transportation, and hospital services, local Iraqi sources (families, charities, businesses) pay an average of 57% of the remaining cash needs, and PLC pays the remaining 43% through our internationally donated funds.

FAMILY FUNDING

Families of children seeking heart surgery are expected to contribute $2,500 toward the health care of their children. This $2,500 helps PLC offset the remaining cash needs related to international travel, diagnostic testing, hospital stay, surgical expenses, and/or post-discharge room/board needs for their children.

When the patient’s family cannot contribute this $2,500 out of their own personal savings, they are encouraged to appeal to extended family, friends, employers, and religious communities for financial help. Unlike many who work in the relief and development world, we do not believe that Iraqis are helpless or that we are their saviors. They have proven to be people of great dignity, creativity, and worth and our overarching commitment is to come along side them as they pursue hope & a future.

LOCAL IRAQI FUNDING (CHARITABLE)

For each surgery, PLC seeks an additional $2,500 from Iraqi businesses and charities (such as our partner, Kurdistan Save the Children). Charitable donations solicited by PLC are not intended to substitute for or reduce the family’s share of the total costs.

Through the shared responsibility for the funding of these surgeries, we hope to nurture a value of volunteerism and community that will eventually produce a greater love for all in our community and more local funding to solve local problems.

LOCAL IRAQI FUNDING (COMMERCE)

By investing over $25,000 to date in micro-enterprise development across multiple villages and cities through our Buy Shoes. Save Lives. program, we have sold enough hand-made Kurdish Klash shoes to fund 11% of our life-saving heart surgeries to date (other merchandise sales excluded).

This Buy Shoes. Save Lives. money is different kind of local solution to these local heart problems. Though the revenue itself is not “local” (Iraqi), neither the 11% for life-saving heart surgeries nor the $25,000 in micro-enterprise development would be available without PLC’s Buy Shoes. Save Lives. program.

This is yet another example of the people of Iraq working for their future, doing more than taking hand-outs, and playing a significant role in developing their own systems and sense of civic responsibility.

The Preemptive Love Coalition covered by NEED Magazine

February 16, 2009 by Jeremy · 48 Comments 

Thanks to Michael Duffield and NEED Magazine for covering Kadeeja’s stories and lending your voice in support of the effort to help Ahmad and the others from the Great Eight whose surgeries we are funding in Turkey right now.

Click here to read the article online.

“Buy Anything. Save Lives.” at iGive.com

December 14, 2007 by Jeremy · Comments Off 

Buy Anything? Save Lives?

For some of you, it may already seem ludicrous that buying shoes could in any way be connected to saving lives. And now we are about to tell you that buying just about anything can help to save lives.

We recently stumbled across a New York Times article that tipped us off to a website that makes a percentage donation from any purchase on participating partner webstores to a cause of your choice (Buy Shoes. Save Lives., anyone?).

All you have to do is go to iGive.com, register as a user, and then use their website to navigate to hundreds of well known online retailers. That means when you go shopping at say, Gap.com or iTunes or HomeDepot.com or Expedia or buy.com, a small percentage of every purchase will be given to Buy Shoes. Save Lives.

The percentage donated usually ranges between 1-4%—certainly nothing like the 50+% to fund heart surgeries when you buy handmade shoes or stylin’ tees through our website—but this is a case where money is time and every penny counts when you’re trying to save the lives of Iraqi kids.

And when Americans spend over $100 billion (and growing) each year buying things online, we’d be more than willing to put a paltry one percent of that towards saving lives and investing in the local economy here.

So before you buy those last minute Christmas gifts online, go register at iGive.com and designate BSSL as your cause (No. 44486). Then anytime you shop online, make sure that you stop by iGive first to see if you can shop through a store that will let you buy anything to save lives.

Compassionate capitalism, anyone?

BSSL in Covered in Austin Monthly

December 13, 2007 by Jeremy · Comments Off 

Austin Monthly’s coverage of BSSL as some sort of “philanthropic superhero” doing “cool” things to change the world is on news stands now in the Austin area. We think we are outshone by the other 4 coverstory profiles ($100 laptops for kids in Africa!?!?!?!), but we are so grateful to have been included!

Thanks to Melissa, Robyn, and Lynn at Austin Monthly for all of your hard work.

BSSL TShirts Stuff Stockings Perfectly!

December 8, 2007 by Jeremy · 320 Comments 

Just a friendly reminder that – whether you own a BSSL tee and want one for someone else, or if you just haven’t gotten around to buying one yet – ordering your BSSL TEE today is the best way to guarantee that it arrives in time for your holiday giving.  All orders placed by Dec. 15th will be shipped before Christmas.  You guys are amazing! We’re so glad to have you on board with us… BSSL 

Please Write Ignite Apparel

December 5, 2007 by Jeremy · Comments Off 

Ignite Apparel is a clothing company that donates every penny above production costs to a “cause”… such as Buy Shoes. Save Lives. They base their decisions on who to donate to on the amount of feedback they receive each month for a given organization. Please email fuelthechange@igniteapparel.com and let them know about Buy Shoes. Save Lives., the work we’ve done so far with your help, and the work we’ve yet to do.

Thanks! Jeremy

Aras Arrives in Amman, Jordan!

November 28, 2007 by Jeremy · 456 Comments 

A few weeks ago Buy Shoes. Save Lives. took stock of our assets, our debts, our inventory, and our projected future needs and determined that it was time to give a significant chunk of our money to a child named Aras from the Kurdish city of Halabja in Iraq.

Halabja now stands as an emblem of suffering for the Kurdish people; the site of Saddam Hussein’s March 16, 1988 gas attack against Kurds in which 5,000 died in one day.

It felt significant and symbolic to make our first child the child of the city whose scars are carried on today by children who suffer heart disease – nearly 20 years later – because of the gas attacks of that day.

We were nine and younger in 1988, and yet we feel our hands are dirty and that we am somehow complicit in the problems and pains of Aras’ people. $5,000 cannot repair decades of hurt – and decades to come – but as far as feelings go, it felt good to give our money away to Aras and his family.

Today Cody escorted a very nervous Aras and his mother to the airport, where they flew for the first time, and landed many delayed hours later in Amman, Jordan. They were greeted by one of the many partners in this endeavor, Brothers Together. Aras should be headed on to Jordan later this week for surgery.

We are nearly speechless at how amazing this has been. And we’re fairly certain we’ve received new hearts in this process, as well.

Delshad Now Fully Funded!

November 19, 2007 by Jeremy · Comments Off 

Delshad, 5 years old

Delshad has a hole between the ventricles of his heart, and was singled out by doctors at the October screening in Jordan as a child who needs surgery in the near future, before pulmonary hypertension would leave him inoperable. His visa for travel has already been approved, and thanks to your continued advocacy and purchases, BSSL contributed almost 40% of the necessary funds and he will be headed to surgery this week! Sometimes we cannot believe this is actually working!

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