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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]

Surgery Delayed for 30 Days

November 8, 2007 by Jeremy · Comments Off

Hedi was happily drinking a bottle when I arrived at the hospital today and found him and his sweet mother sitting in their room in the children’s ward. We visited for a bit, and I gave Hedi an inflatable fish toy which had been sent in a ”goody box” to us from someone in the US — thanks from Hedi!! He loved it.

Yesterday while at the hospital with the student group, we found out that Hedi would be treated with steroid medication commonly given for asthma associated with allergies. Today, he was not wheezing when I was there, and did not cough much either.

When I spoke to the doctor yesterday, we also talked about Hedi’s surgery. Dr. Katz informed me that Hedi would probably not have his surgery for about 30 days. This was a big disappointment for his mother, but we trust that the doctors know the best timing for each child’s surgery to be scheduled. There are several cases which are more urgent than Hedi, and the surgeon will be out of town to train doctors in another country next week. He cannot perform some of the most complicated surgeries and leave town, because he must monitor these patients closely, so the surgeries must be scheduled accordingly. Hedi’s is tenatively scheduled after some of the extreme cases, and this adds up to about one month. Had he not had the problem with the cough, maybe it could have been done more quickly.

Filed Under: Delayed, Heart Surgery, News, Our Kids Tagged: asthma, cough, delay, Dr. Katz, future, Heart Surgery, Hedi, hospital, Jeremy Courtney, steroid medication

Anonymous Donor Partially Funds Two Children for Buy Shoes. Save Lives.

November 6, 2007 by Jeremy · Comments Off

Hedi, 8 months old

Thanks to an anonymous gift directly to our partner organization on behalf of Buy Shoes. Save Lives., Hedi will be able to have the operation he needs to fix the hole between the ventricles of his heart. Your advocacy among your friends is apparently working! Keep it up!

Hussein, 3 years old

Hussein is from one of the few Arab (non-Kurdish) families who made it safely to the October screening. Doctors singled him out as urgent, as he periodically runs out of breath and cries. Our partners at Brothers Together took him across the Jordan River Monday with Hedi (above), and thanks to an anonymous gift on behalf of Buy Shoes. Save Lives., his sponsorship was completed at three minutes to midnight the same day!

Filed Under: Amazed, Giving Away Money, Go Blog It!, Heart Surgery, Our Kids, Partnerships Tagged: Advocacy, anonymous, Arab, Brothers Together, BSSL, Buy Shoes. Save Lives., buyshoessavelives, grateful, Heart Surgery, Hedi, holes between the ventricles, Hussein, Iraq, Jeremy Courtney, Jordan, Jordan River, Kurdish, thank you

Receiving Treatments for Wheezing

November 6, 2007 by Jeremy · Comments Off

Dr. Katz performed his echocardiogram late yesterday afternoon, and expressed to us that Hedi needs surgery soon for the large VSD – hole between the ventricles – in Hedi’s heart.
First though he must be well, and the doctor wanted him to have breathing treatments throughout the night and today for chest congestion and wheezing. The thought of staying there alone in this strange place with her sick child was overwhelming to Hedi’s young mother and she wept at that reality. He awoke this morning with his usual happy disposition. Through the day he continued to receive breathing treatments, which he lets everyone know he does not like one bit! But he did enjoy visiting with his good buddies Mustafa and Hussein who returned to the hospital from the SACH house for further tests.

Much to his mother’s disappointment, it was determined late this afternoon that Hedi needed to stay in the hospital again tonight to continue the breathing treatments until at least tomorrow. I felt it was safe to leave Hedi’s mother there tonight since she has made the acquaintance of other mothers and knows the routine, the nurses, and the layout of the children’s ward. It is tiring to care for her sick infant alone, and traumatic to consider what is ahead.

Filed Under: Medical, Our Kids Tagged: chest congestion, Dr. Katz, echocardiogram, Heart Surgery, Hedi, Jeremy Courtney, VSD, wheezing

Hedi Hospitalized, and Winning Hearts

November 5, 2007 by Jeremy · Comments Off

After waiting in Amman for almost a month since the medical screening, Hedi finally received both visa clearance and sufficient funding (just past midnight!) to be brought over to X and hospitalized today. Hedi is sort of a celebrity-to-be, as the camera crew will follow through with his surgery and post-operation progress and feature him in an upcoming TV news story along with 2 of the other boys.

Being young and innocent has its advantages. While the other 2 boys screamed and cried the moment they were undressed to be weighed, Hedi was quite co-operative throughout the check-up, captivating the medical staff with his bright smile and cheerful playing. He started to join in the chorus of cries only when he felt the prick of the needle when his blood sample was taken.

After the echocardiograms were done, the doctor confirmed that Hedi should be immediately admitted to the ward for close monitoring, while Mustafa and Hussein were released to the Save a Child’s Heart house. Hedi’s mother started to sob out of fear being in unfamiliar surroundings and unable to speak the local languages, so a volunteer decided to spend the night with her at the hospital.

Filed Under: Go Blog It!, Heart Surgery, Our Kids, Volunteers Tagged: Amman, blood sample, camera crew, echocradiogram, Hedi, hospital, Hussein, Jeremy Courtney, Jordan, Mustafa, Save a Child's Heart, volunteer

First Taste of Ice Cream

November 5, 2007 by Jeremy · Comments Off

Having spent the past month in Amman since the medical screening, Hussein finally arrived in Jordan today, together with Mustafa and Hedi. These boys appear so different from my first encounter with them during the one-day medical screening in Amman. Then, they were bursting out in tears each time I approached them with my camera but today, Hussein willingly handed me his ice cream to remove the wrapper and then readily posed for a picture licking his welcome gift!

The three boys were some sort of celebrities today, as a camera crew from a TV channel were also present to film their arrival for an upcoming feature.

Mustafa and Hussein have become the best of friends during the past weeks living together in Amman. They came through the arrival gates sharing a seat atop a luggage bag.

At the Wolfson hospital, Hussein had to go through the usual routine of being weighed and measured, and having his blood sample, x-ray and echo-cardiogram taken. To allay Hussein’s fear of the rubber glove which the medical staff would put on when taking the blood sample, the doctor inflated a rubber glove for him. Nevertheless, Hussein burst into the tears and screams the moment he was asked to lie down for the procedure.

This evening, Hussein and Mustafa were transferred to the Save A Child’s Heart house where they were warmly welcomed by the Iraqis presently staying there. Karwan’s mother promptly brought out some home-cooked rice, chicken and french fries for the tired group, who ate their dinner heartily and went to their room soon after for an early night.

Tomorrow, Mustafa and Hussein will return to Wolfson for more detailed medical checks.

Filed Under: Coverage, Heart Surgery, Our Kids Tagged: Amman, blood tests, CHD, Hedi, Hussein, ice cream, Iraq, Iraqi children, Jeremy Courtney, Jordan, Mustafa, Wolfson Medical Center

Visas Approved, Travel Early Monday Filed by Donna Petrel

November 4, 2007 by Jeremy · Comments Off

Even little Hedi (center) understands this is good news: he and two other Iraqi boys who need urgent heart surgery are finally grasping their permission to enter their final destination for surgery.

Filed Under: News, Our Kids Tagged: Donna Petrel, Hedi, Hussein, Iraq, Iraqi children, Jeremy Courtney, Jordan, Mustafa, Surgery, visa

Visas Issued, Travel Early Monday

November 4, 2007 by Jeremy · Comments Off

Hussein (right) may not realize it, but he’s holding his life in his hands: he and two other Iraqi boys who need urgent heart surgery are finally grasping their permission to enter Jordan. Our staff starts rolling at 5 a.m. Monday from Amman, Jordan, to get them across the Jordan River and to the hospital in Jordan. Watch this space tomorrow for a full update.

Filed Under: Go Blog It!, Heart Surgery, News, Our Kids Tagged: Amman, Heart Surgery, Hedi, Hussein, Iraq, Jeremy Courtney, Jordan, Jordan River, Mustafa, urgent, Visas

Full of Smiles

November 2, 2007 by Jeremy · Comments Off

Hedi, at eight months old, has shown the most obvious signs of the respiratory virus which has affected all the children and parents waiting in Amman. He has had a fever and cough, and because of a sore throat has not had much appetite. Besides this, he is also cutting teeth. But when we’re around Hedi, most of the time he is full of smiles and coos! The only time he cries is when he is so tired that he needs to sleep, but doesn’t want to miss out on the action of the bigger boys who are busily – and sometimes noisily – playing nearby.

Sometimes when I hold Hedi, I notice a change in his body as he begins to breathe rapidly and with exertion as his diaphragm is seemingly controlled by the pounding of his heart. Afterwards we’ve noticed he seems tired and almost dazed for a few minutes. Each time this happens when his mother is holding him she points it out to me, then sighs, as we wait for the day when this heart malady can be healed.

Both of Hedi’s parents are here in Amman since his father wants to stay with him and Hedi’s mother as long as he can before they travel for surgery. It is clear that they adore each other, and I believe having both mom and dad around is one of the reasons Hedi is so happy. Each of them play with him and he loves the attention. The other moms along with Hussein and Mustafa also give Hedi attention, so he does have plenty of reasons to smile.

Although there is an air of impatience in the apartment since all of the parents are ready to travel for the purpose of their journey, for the most part things are going smoothly. While we were visiting last night however, the difficult reality of their lives in Iraq seemed nearer when Hedi’s dad got a call from a friend in their city reporting that there had been a bombing there which had killed someone he knew. We sat in silence for a moment after expressing our sorrow, as Hedi’s father left the room. Again I noted to myself that these are remarkable people dealing with issues I cannot imagine, yet they put their lives on the line to get help for their children by going to a purported enemy to save their baby’s life. In the midst of everything they are gracious and willing to work together with us strangers in totally unknown surroundings and function without knowing what is next from day to day. It will be difficult for this husband and wife to say good bye, and for this daddy to say good bye to his son, when the time comes for Hedi and his mother go to the hospital in X. Hopefully Hedi will soon be over this virus, so that when we go his surgery will not be delayed by it.

Filed Under: Heart Surgery, News, Our Kids Tagged: Amman, bombing, CHD, Heart Surgery, Hedi, Hussein, Iraq, Jeremy Courtney, Jordan, Mustafa, virus, X

Easy to Please

October 28, 2007 by Jeremy · Comments Off

Hedi and two other Iraqi boys are waiting in Jordan following the October 9 screening by the doctors, who told us that these children need treatment urgently. We hope to be able to transfer these little boys to the hospital this week, but until we can do that, they will stay in their latest ‘home away from home.’ While it was a little disconcerting to have to change their surroundings, especially for the adults, before long the two older children were happy on riding toys kept at the apartment.

When I visited the families again today, it seemed they were feeling more at home. I shared with them pictures of the progress so far whichsome of the other kids have made since arriving at the hospital less than two weeks ago. They asked many questions and I was able to help them see on the pictures as well as explain in person some of the things they want to know about what is about to happen. Ultimately though, I cannot tell them the timing of the travel (we still need both visas and funding for their surgeries) or of the surgery and the length of their stay. It is with a mixture of thanksgiving for the opportunity and fear of the unknown that they approach our departure to the hospital in the coming days.

Filed Under: Amazed, Go Blog It!, Heart Surgery, Our Kids Tagged: Amman, CHD, Hedi, hospital, Hussein, Iraq, Iraqi children, Jeremy Courtney, Jordan, Mustafa, Thanksgiving

“I Don’t Mind Waiting” 

October 28, 2007 by Jeremy · Comments Off

Hussein and two other Iraqi boys are waiting in Amman, Jordan following the October 9 screening by doctors, who told us that these children need treatment urgently. We hope to be able to transfer these little boys to the hospital in Jordan this week, but until we can do that, they will stay in their latest ‘home away from home.’

When I visited the families again today, it seemed they were feeling more at home. I shared with them pictures of the progress so far that the kids currently in Jordan have made since arriving in Jordan less than two weeks ago. They asked many questions and I was able to help them see on the pictures as well as explain in person some of the things they want to know about what is about to happen. Ultimately though, I cannot tell them the timing of the travel or of the surgery and the length of their stay. It is with a mixture of thanksgiving for the opportunity and fear of the unknown that they approach our departure to Jordan in the coming days.

Filed Under: Amazed, Heart Surgery, Our Kids Tagged: Amman, CHD, family, Heart Surgery, Hedi, hospital, Hussein, Iraq, Iraqi children, Jeremy Courtney, Jordan, Mustafa, opportunity, pictures, questions, screening, Thanksgiving