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)

Our Animated Manifesto

August 5, 2011 by Ted · 1 Comment 

Allow me to introduce PLC’s newest video!

If you’re unfamiliar with our work, we consider this our manifesto. Everything we do boils down to this belief: reconciliation happens through healing.

With your help, that which has been destroyed and ‘unmade’ can be rebuilt. It can be healed.

—

For all you video connoisseurs, what did you think? Give us some feedback in the comments section below, or connect with us on Vimeo.

Mohammed’s Still Smiling And Is One Day Closer To His Remedy!

July 3, 2011 by Alex · 2 Comments 

My friend Mohammed is back!

Mohammed made me feel so welcomed when we first arrived, and I’ve missed him as he’s been out of the hospital these last few days. But now he’s back and brightening everyone’s day with his contagious smile!

Besides seeing my new friend again, something else has me smiling all day: hearing that Mohammed is scheduled for surgery this week!

Each kid we meet here captures our hearts, but there’s something extra special about hearing how the remedy is coming to a little boy or girl you have a personal connection with. I can’t even imagine how special the feeling of hope and excitement must be for each of these kids, their parents, families, friends, and communities all over Iraq.

Thank you for bringing that feeling of hope to Iraq, and to my little friend Mohammed!

He’s one day closer to his remedy. Get ready!

Our Partners:

Mohammed’s Here For The Remedy

June 29, 2011 by Alex · Leave a Comment 

Today, I hesitated outside the entrance of the hospital ward in southern Iraq. Kids spend most of the day waiting for surgery in this room.

Mothers and their children filled the room, and I didn’t want to barge into a room that these families might have thought were off-limits to outsiders.

But as I stood there, recognizing that I was the outsider, looking confused and out-of-place, a 6-year-old boy named Mohammed walked up, smiled, and took my hand as if he knew exactly what I was going through.

He safely escorted me to the back of the room so I could meet the family I had come to see.

Mohammed never left my side, but just kept holding my hand and making me feel more at-ease until he felt that his duty had been completed.

We couldn’t speak to each other and even though we interacted for only a few minutes, I can’t help but to look forward to spending more time with Mohammed.

What makes me more excited is that Mohammed isn’t just here to help out this goofy foreigner; he’s here to have his failing heart restored.

He’s here for the Remedy.

The doctors are still unclear as to how complicated Mohammed’s heart condition is, but they’re beginning the tests that will help them know what needs to be done to reclaim his heart.

In the meantime, we’ll just keep waiting.

Stay tuned for more updates on Mohammed.

While you wait check out Rokya’s Mom documenting her daughter’s Remedy in Iraq on our Facebook page.

Our Partners:

3 Reasons You Can Give Someone To Show Them Iraq Is Changing For The Better

June 26, 2011 by Cody · 1 Comment 

Yesterday on the drive to southern Iraq we ran over a pothole. Actually, we ran over several potholes.

The biggest pothole of the day – and the same one that made the loudest noise as our van clung to its parts – was the same one that caused my Iraqi friend next to me to groan and say, “I just want to see change. I want to see something different now that the war’s over. Where are the new roads? Where are the signs that Iraq is changing?”

The next pothole we hit launched us both into a conversation attempting to answer that question. It kept us busy for most of the drive, but we kept coming back to the same 3 immediate signs that Iraq is changing for the better.

Sign #1: Right now, families are traveling from all over southern Iraq to come to this Remedy Mission. Before, families were lining up to leave the country trying to find the doctors that could save their children from their heart defects. Today, families are lining up outside a hospital in southern Iraq, waiting for their child’s chance at a lifesaving heart surgery. For the first time, families don’t need to leave the country to find the cure.

Sign #2: This week, a Sunni family will hand their child over to a Shiite doctor to be saved. In 2007, at the height of the violence in Iraq between Sunni and Shiites, this would have been unheard of. Now, the disease that’s threatening their children is bringing them together!

Sign #3: The notorious “brain drain” that happened when 20,000 of the 34,000 registered doctors in Iraq fled during the war is being reversed. During our last Remedy Mission in northern Iraq we met one of the doctors who had returned. Today we’re not only seeing doctors return, but – thanks to Remedy Missions – the doctors who never left are being equipped and trained, too. Their training is changing the tide of healthcare in Iraq.

So, the next time you hear someone looking for a reason to believe Iraq is changing for the better, start by giving them these 3.

Or better yet, show them the above photo of Rayed smiling before he received his lifesaving heart surgery during Remedy Mission V. Then tell them to stay tuned because Remedy Mission VI is already underway here in southern Iraq!

Our Partners:

Why Father’s Day Means So Much to Hafez And His Son

June 15, 2011 by Jeremy · 1 Comment 

At exactly this time last year, Hafez (pictured above) was facing down the worst Father’s Day of his life as he desperately worked against the clock to save his son’s life.

At exactly this time last year, we asked for your help… and you came through in a huge way, raising more than $30,000 in just a few weeks so we could launch our first-of-its-kind Remedy Mission inside Iraq.

At exactly this time last year, you made this father’s day and helped secure for him a happier life than the one he was facing without you.

Meet Abdul Kareem – the son of my friend, Hafez. When I met them, they did not have the money to pursue surgery outside of Iraq like all the rich people, people with political clout, or the lottery winners.

I’ll never forget Hafez’s plea to me – certainly the same plea I would make on behalf of my son – “Just do something for him. He’s just a little boy.” He got so emotional that he excused himself from my office. This father, having done all he could for his son, walked away from the office crying. Abdul Kareem needed heart surgery before his first birthday or he was likely to become entirely inoperable – “a lost cause.”

But you weren’t about to let that happen!

The day our surgical team arrived from all over the world for Remedy Mission I, Hafez must have seen us on the news because he called me ten times: “Is my boy going to surgery? Mr. Jeremy, just do something to help my little boy!”

His boy was going to surgery, thanks to those of you who gave in response to our request last year’s for Father’s Day and our Remedy Mission launch!

There is another moment with my friend Hafez that I won’t forget – the day his son Abdul Kareem had surgery. I remember it so distinctly because after the surgery Hafez grabbed me, kissed me, and gave me an tearful “thank you” for keeping our word; for saving his son’s life.

Once Abdul Kareem was discharged to return home, Hafez sent me a message from the road. The message said something like, “Thank you so much for your organization and for helping my little boy. We will not forget you.“ With tears running down his face, he wanted to thank you each by name. You made a father’s dream come true. And you prevented his big brother, Abbas, from growing up without a soccer-buddy.

Dad, I love all the great memories we’ve made together. This year, I wanted to add, “saving a child’s life in Iraq” to the list, so that another child and his father can make great memories together too.

We want to make it easy for you to honor your dad this Father’s Day and help save the life of baby Ghazel. A simple $10 donation will help us save her life and cover the cost of two hours of hands-on training with local Iraqi surgeons! A $25 donation will accomplish that and add hours of training in Iraq for an additional three Iraqi doctors and nurses! If you like, we’ll even provide you with a free downloadable card that you can print and give to your dad this Father’s Day!

3 Reasons For “In A Word” Mid-Week Photos

June 12, 2011 by Liz · Leave a Comment 

For a month now we’ve posted mid-week photos titled “In a Word,” and we’ve received some great feedback from you guys.

We want you to know that these aren’t just pretty pictures, they’re tools to help as all build an understanding of Iraq through the artists who live here.

We know you care about the future of Iraq, the kids and the training of nurses and doctors, but we want to offer you even more perspectives.

So here are 3 reasons we believe “In A Word” matters:

1. Images can be used to promote peace.
“Peace is waged when a child is served, a voice is heard, a story is told, a dialogue is created, and a community is engaged.”

We’re waging peace when we LISTEN to and TELL a story about Iraq, kids with CHD, local healthcare, local solutions (i.e. politicians, donors, doctors, etc.), Muslim and Eastern perspectives, Christian and Western perspectives, the war, etc. These photos give us the opportunity to engage another community. They tell stories and create dialogue.
They’re opportunities for us to understand.

2. We live among the people here.
We work with them, care for them, argue with them – we love them. And many of you have expressed interest in what those things look like here, so “In A Word” is our way of helping you visualize our day-to-day. It helps our families, friends and supporters ‘come around’, and for a few seconds, that makes us feel like you aren’t an ocean away.

3. It’s a platform for artists.
These Iraqi and Kurdish artists are unsung heroes, and their work deserves to be showed off and shared. They show their people that beauty can bring hope and truth in the midst of devastation.

“In A Word” is a forum – a sounding board – where artists can show off their work and prove emphatically: we’re here, and we’re talented.

Do you have any photos that you’d like to submit for an “In A Word” midweek post? If so send to liz@preemptivelove.org, subject “In A Word”

Finding Familiarity In An Unlikely Place | An Intern’s Perspective on Followthrough

June 10, 2011 by Adam · Leave a Comment 

Yusuf is a brave 1-year-old who underwent heart surgery this past March. When his family brought him to the hospital, Yusuf blood had low levels of oxygen that had already tainted his skin blue. The surgeon needed to fix four heart defects for Yusuf to survive.

But thanks to caring donors and local support, Yusuf is very much alive!

You helped Yusuf receive a heart surgery, and, because of you, I was able to visit and make sure his recovery is going well. This is what we call Followthrough. CLICK HERE to learn more on the importance of Followthrough.

As we sat down with Yusuf and his family I was overwhelmed with all the cultural differences around me, but there was a strange sense of familiarity as well.

Shortly after we sat and talked in Yusuf’s living room, his family rolled out a giant feast for us. We ate until we were full, and there was still enough left to feed us for dinner! Then we drank tea, and the refills seemed to be endless.

As we drank tea and took photos of Yusuf, his older sister played with him and entertained us with her hilarious faces. Yusuf’s grandfather would toss his phone across the living room floor while Yusuf would scoot across the room to return it again and again.

The familiarity I recognized during my visit was the same warm family dynamic and rejoicing I experience with my own family.

Even though we ate sitting down on a concrete floor, followed a completely different set of manners, and understood very little of the words spoken, the joy and relationship between these family members was the same as many American families I know.

We laughed and enjoyed the fact that their son’s life had been rescued. At this point in the visit I began to see these faces as my family and friends rather than as distant strangers.

This family was so grateful for us, for their son, for his surgery, and for a community willing to come together to provide a solution for their needs. I felt the warmth in their home through photos of Yusuf, endless cups of tea, a floor full of food, and a room bursting with smiles.

No matter how great the cultural barriers there are some values and moments humanity can rejoice in and enjoy together. These shared moments and values are the most significant puzzle pieces of our own identity.

Bubble-Blowing, A Work-Out? Moustafa’s Recovering Beautifully!

June 3, 2011 by Lydia · 1 Comment 

Did you know bubbles are a part of the routine for discharging children from ICU?

It’s because blowing bubbles is a fun way for kids to strengthen their lungs and improve their breathing after hours of being on a heart-and-lung machine. Don’t believe me? Go here to find out more on how blowing bubbles is beneficial to your health.

You may remember that I was looking forward to giving you good news about Moustafa’s surgery, and I got it! Moustafa passed his healthy heart and lung test and is ready to make the trip back to his hometown – praise God!

You helped send Moustafa to surgery, and because of your donations and prayers his once-broken heart is now mended.

Thank you for choosing to be a heart-mender, and thanks for helping to save Moustafa!

Our Partners:

Remember Nivar?

May 21, 2011 by Lydia · 2 Comments 

There are people in my life whom I haven’t seen in months and probably won’t see but once a year. When we meet again, we’ll spend most of our time discussing what’s happened since the last time we talked, trading stories and catching up on all the details. But when it comes to this particular Kurdish girl, it’s all different.

As an intern last summer I connected deeply with 8-year-old Nivar. Her sweet personality won all of us over, and her striking eyes captivated many of you. Her case was urgent and her parents’ money tight, but after a few pictures and stories, the donations poured in. You made it possible for Nivar to get surgery in Turkey last July.

I went with her, and I spent most of my free time in her room playing hand-clap games and learning the Kurdish names for colors. Without any language we became fast friends. I was there during her operation, and the photo below is the last I saw of her before leaving Istanbul for America. I didn’t get a chance to say goodbye.

But this morning, after 10 months, I got to see Nivar again. I was both nervous and excited. I couldn’t remember any of my Kurdish colors, the names of animals, or the rhyme we’d used in our hand-clapping games. We were greeted at the door and ushered into the house by Nivar’s parents. Just then, Nivar came running in from a back room, healthier than I’ve ever seen her. She seemed shy at first, very quiet and polite. After a few minutes I went out to the car for something and Nivar followed me. She threw her arms around my neck and kissed my cheeks, then started laughing and speaking Kurdish.

Not understanding a word, I quickly grabbed what I needed and let her pull me by the hand back into the house where she led me past all of the grown ups and into her room. First thing? Hand clapping games. We played with her doll, a toy piano keyboard and a story book written in English.

When her dad came in to call us to lunch she spoke hurriedly to him in Kurdish. He laughed and pointed at Nivar, then at me, and said carefully, “I love you”. My heart smiled. I remembered in the hospital in Turkey when Nivar had sent the same message through her (non-English speaking) father to me the morning of her heart surgery.

After lunch Nivar brought out her parent’s point-and-shoot to take pictures of me, her favorite way to tease me for the millions of pictures I’ve taken of her. It was so great to watch this little girl run around the room laughing; its hard to believe its the very same girl who could hardly catch her breath the last time I saw her.

As we got ready to leave, Nivar smiled and said something shyly to one of the Kurdish-speaking PLC staff. “She wants you to be her sister,” they translated.

My friendship with Nivar ranks high on my list of PLC Summer 2010 memories. Watching her grow more and more sick as her surgery approached, then actually standing at the foot of her operating table while doctors worked to correct her heart condition created an unforgettable bond between me and this little girl. 10 months later, I’m ready to start another summer of memories with Nivar and others like her.

Intro To Followthrough: How Mothers Will Change The Tide In Iraq

April 8, 2011 by Cody · 1 Comment 

We’re all about providing surgeries to children – I think we’ve made that pretty clear – but we’re also passionate about getting the rest of the family involved.

That means we aren’t standing by an entire generation of children with CHD but also the communities, the support groups, and the leaders who play a crucial role in improving local healthcare throughout the country.

Without a doubt, some of Iraq’s strongest leaders are the mothers.

They’re leading the way by asking real questions about proper nutrition, pre-natal care, post-op rehabilitation for their children, the causes of heart defects, and how they can be a part of the solution. They aren’t content to be bystanders.

And these questions are encouraging, because they prove that mothers here see that something’s wrong, and they want to do something about it.

That’s why our Followthrough program is seeking to unite mothers all over Iraq and give them the tools they need to be the remedy. Then, once they’ve been equipped, we set them loose to pass it on to the next mother.

‘Equipping’ here means educating them on the value of healthcare, what robust nutrition looks like here with the available foods in Iraq, how to look after children with heart disease, and how all of this will help lower the rate of children born with heart defects each year.

Educating and empowering mothers to better care for their children is the first step toward attacking this CHD problem at the source.

We want them to know that it doesn’t take a PhD to fight heart disease. We all can play a role.

Imagine women all over Iraq, representing multiple ethnicities, faiths, and tribes, all united together with the common goal – to create a better future for their children!

Stick with us during the coming weeks to see how moms are changing the tide in Iraq!

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