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)

The Coalition For Good—Recognizing Our Partner in Iraq: Living Light International

June 23, 2012 by Cody · Leave a Comment 

A wise man once told me if I ever wanted to kill a giant, I needed to hang out with a giant killer.

His point was that if I wanted to do something that made a difference in the world then my first task was to find someone that was already making a difference and then spend as much time with them as I could.

A week doesn’t go by where I don’t remember that advice. It’s something that shapes my best days and holds me accountable on my worst days.

Even today, it continues to shape my work with PLC. The “giant” we’re out to bring down is infamously known in our office and our writing as “The Backlog”. It’s a list with thousands of names of children on it, all who are waiting in line for lifesaving heart surgery. We know children who have been on that list for their entire lives – but we’ve also had the great privilege of watching children’s names be taken off that list after they’ve received a lifesaving operation during one our Remedy Missions. But The Backlog still has claim to thousands more.

We hate The Backlog.

We hate everything it stands for in Iraq and we strive for its demise. It’s an enormous and ugly foe. It truly is a “giant” and that’s why from day one, we’ve been looking for other “giant killers”. We’ve been on the search for other organizations that have the tools, resources, and downright grit to to make The Backlog a thing of the past.

That’s what led us to our partners at Living Light International (LLI).

LLI started taking on giants back in 2007. Currently, they lead one of the largest efforts to date in helping care for the orphans in Iraq. They embody love to orphanages overflowing with children by providing essential medical care, education, and support groups.

Simultaneously, they are on the front-lines of supporting women’s rights in Iraq. They tirelessly advocate on behalf of women, finding them jobs, providing them with necessary training, and empowering them in their local communities.

As if these “giants” aren’t enough for one organization, they are continually on the look out for the next one, which is what ultimately led them to The Backlog.

Since partnering with PLC in the fall of 2010, they have helped us take hundreds of names off the waiting list by helping us provide children with surgery. They have forged partnerships with doctors and hospitals all across Iraq, even to the point where we have had to tell them to stop because we couldn’t keep up with that kind of growth!

And they do it all of this pro-bono. LLI is completely volunteer led and they don’t have any intention of changing that. They continue to give and give without asking for anything in return.

And that’s why we love LLI.

They are indispensable in our fight against The Backlog and when this “giant” falls, it will be because the Coalition has these kinds of partners.

So join us in giving some of that love back to LLI. Click over to their Facebook page and thank them for all they’re doing to save kids like Hussain. (If they don’t respond to you right away then that probably means that they’re out on the front lines again, looking for the next thing to take on.)

Beating The Backlog takes a Coalition, and we’re grateful that LLI is a part of it!

His Heart Condition is Threatening His Life – Have You Met Alawi?

February 18, 2011 by Jeremy · 632 Comments 

You need to.

This just may be the cutest and most adorable boy in Iraq.

Alawi Hussein is just under three and a half years old and he was born with a congenital heart defect.

At 9 months old, instead of taking bets on what his first word was going to be, his parents were coping with the devastating news that Alawi had a heart problem. It was a heart problem, like most heart problems in Iraq, that could only be fixed outside of Iraq.

The list of countries that could help him was long.

Iran.

Turkey.

Jordan.

India.

America.

Basically – many other countries except the one he was born in.

While the list of opportunities was long, the list of actual possibilities for Alawi was short.

Hearing about all the doctors overseas that can heal your son is simply cruel if you don’t have the money – or even a passport – to pursue the option.

His family had to learn to enjoy the time they had with Alawi and just hope for a remedy the doctors might have somehow missed.

That surprise came this month when they were called by their local cardiologist here in southern Iraq and told that Alawi no longer needs to go overseas to be saved, because of a team of doctors and nurses that was being brought in to save his life at the hospital just fifteen minutes from their home

It was thirty-two months later than they were hoping but remedy finally came to southern Iraq.

We still hope that Alawi’s family will visit foreign countries someday, but not as last chance medical tourists!

You are the Remedy.

You bring in medical teams every time you give. Our medical teams teach Iraqi doctors and nurses. Our medical teams save lives. So Iraqi doctors and nurses learn how to save lives. Our medical team goes home. The Iraqi’s keep saving lives.

It’s one beautiful domino affect!

We hope we can save Alawi’s life this week… and not just because he’s one of the cutest boys in Iraq! Follow Alawi’s story this week on the blog and on our Facebook page (<-- link) to see what comes next...

Our Partners

Meet Ali. He Finally Got His Lifesaving Surgery on Our Second Trip to Southern Iraq

February 17, 2011 by Jeremy · Comments Off 

Ali gets his surgery from Dr. Novick and the ICHF during our February 2011 Remedy Mission to southern Iraq.

An interview with Cody Fisher about his first encounter with Ali and the journey to where he is today.

Push play above to meet little Ali….

With you,

If you’re on Twitter this week be sure to use the #RemedyMission hashtag to describe all the good news coming out of Iraq this week via @preemptivelove.

Our Partners

Overwhelmed by 350 kids on Local Waiting List as Remedy Rolls into Southern Iraq to Train Locals

February 16, 2011 by Jeremy · Comments Off 

It’s been a long journey from our home in northern to southern Iraq but we just can’t stay away – the doctors, nurses, and people here want their own fully functioning heart surgery center so badly!

Today marks the end of Remedy Mission Day #1 with the International Children’s Heart Foundation and Living Light International.

Push play above for a quick overview of day one and a setup of what’s to come this week from southern Iraq….

With you,

If you’re on Twitter this week be sure to use the #RemedyMission hashtag to describe all the good news coming out of Iraq this week via @preemptivelove.

Our Partners

Old Friends With New Hearts

December 15, 2010 by Cody · Comments Off 

Remember Ahmed, Noor, Hussein, and Riza from our first Remedy?

They remember you!

They were the group of four who traveled 600 kilometers north to receive their life-saving surgeries last August. Today, they only had to go down the road to show us how well they were all doing!

I didn’t even recognize any of them! Can you? Together, all four have gained a total of 33 pounds since their operation! All their parents said the same thing, “They won’t stop moving or eating!”

All signs that their body is getting stronger each day with their whole hearts.

Ahmed’s parents are doing great after their car accident. His father is back at work and his mom has the new full-time job of keeping up with Ahmed!

Riza’s mother said, “She’s a completely new child since the surgery. Before, she couldn’t stand or crawl but now she’s running everywhere!”

Hussein’s mother said, “He has a fresh face now! Before, he was tired and his heart would beat fast. Now he’s full of energy and his heart doesn’t hold him back.”

They thanked GOD for you today and they remembered how you made Remedy possible. They told me, “We’ll never forget what you did for us!”

Our Partners:

Hussein’s Story

January 8, 2009 by Jeremy · 7 Comments 

Hussein, a 3 year old with bright brown eyes, has been one of our more urgent cases and one we’ve been trying to raise funds for very quickly. You may have seen the banner “Save Hussein”. Here’s his story:

November 2nd- Hussein is often short of breath, and although his adorable smiles in these pictures do not show it, he will occasionally simply run out of energy and cry as his mother holds him awhile. His case is quite urgent; the diagnosis is DTGA, meaning he will undergo an operation to switch his great arteries of his heart. His mother is very anxious for him to get the surgery done. As we talked tonight about what it will be like for them at the treatment center, such as the food, and the room where they will stay, she humbly and with tears in her eyes said, “I don’t care if I have only tea and bread, just help my son have his operation.”

November 6th- During one of Hussein’s initial exams, while the doctors asked for some family medical history, his mother shared that her oldest daughter had died of a heart problem in Iraq, as the doctors there could do nothing for her. We can’t really imagine what she must be going through as Hussein is now also approaching treatment.

December 17th- Hussein undergoes a 7 hour surgery, but the surgeons weren’t able to complete the artery switch. Stress is high for his mother and she hasn’t been sleeping at night.

December 18th- Hussein’s 2nd surgery is successful. As soon as his mother sees him recovering in the ICU she notes how pink his skin is and how high his oxygen levels were reading. His heart is finally working properly!

December 24th- Hussein is blooming before our eyes! He’s playing with his mom and making great progress in healing. Now that Hussein is on his way to full recovery, the relief and joy in his mom is so evident.

January 13th- Hussein and his mother finally depart the treatment center and make their way back home to Iraq. What a long road this has been for them and their family. They return to Iraq with very joyful news and a very healthy son!

Thanks for helping us “Save Hussein”. For this 3 year old- it meant everything.

A Taste of Love to Come

October 24, 2008 by Jeremy · 1 Comment 

Our Friends over at Rosa Loves are in the final stages of work with designer Tim Belonax on a shirt whose profits will go to fund a urgent heart surgery for a child named Hussein we’re working with right now.

We’re not sure if we’re supposed to do this, but we received some typographic mock ups of their brainstorming sessions and we’re giddy to see the final results. We thought we’d whet your appetite for some love to come…

 

Hussein’s heart strong, while mother worries about unrest in Iraq

April 24, 2008 by Jeremy · 1 Comment 

Last week Hussein was given the official clearance to head back home to Iraq! He had a bit slower recovery than the other kids have and required a pacemaker to maintain the health of his heart- but he’s pulled through like a champ! Hussein and his family are excited about his healthy heart, but are also bearing a great weight of concern about the safety of their city in Iraq. Our partner staff in Jerusalem wrote about Hussein’s mother:

“She had an emotional departure from our house in Jerusalem two days ago, and it was obvious when we visited them last evening in the apartment here in Amman that her heart was still full of conflict about leaving the people and the place where Hussein had received the help he needed. She spoke of how wonderful the people are, that there are many good people in Jordan, and how thankful she is for the help they have received. And it is clear to those of us who first met her at the echocardiogram screening in October that the experiences they’ve had have changed the heart of both the mother as well as the son.”

The day Hussein and his mother flew back to Iraq:

“Hussein’s mother was quietly emotional during the time we spent together this day. They return to a very dangerous area of Iraq, and it is beyond the comprehension of most of us the extreme contrast she is experiencing at this time. While with us, she so enjoyed the freedom to go about the city and know she was safe… now she returns to the reality of a life I honestly cannot imagine. She was carrying so many things in her heart! I felt as we rode home from the airport it was as if a revolution was being birthed within her, one which perhaps represents the desires of many others in her nation who have not had the opportunity to experience the things she has. Please join me in praying for this beautiful mother and her son, and their family, as well as for the peoples in the land in which they live, to fulfill the good purpose God had when He created them.”

 

Hussein’s recovery slow, but steady

March 31, 2008 by Jeremy · 1 Comment 

Four year old Hussein’s heart surgery one month ago was a success, but his heart has not been able to maintain a steady beat. On March 12th the surgeons placed an internal pacemaker into Husseins chest to regulate his heartbeat and to ensure that his heart continues to function properly.Hussein’s mother has been burdened with a lot of worry and stress as her son went through yet another surgery (this time for the pacemaker) and then they received news about increasing conflict in their hometown in Iraq.Our partners in Jordan wrote, “Hussein’s mom looked very drained while we were talking, and after a little while of sitting with her, she got a phone call from her husband that made her upset. He told her that there was a great increase of conflict in the city where they live in Iraq, that it was dangerous in the streets and on the paths leading into the city. He told her that he feared for the timing of her return with Hussein. This was very upsetting news.”As Hussein’s heart is healing and being cared for in very tangible ways, we think of his mom and the burdens on her heart. And since it’s nothing that surgery can fix, we pray for peace in Iraq and for the hope that Hussein’s healing heart carries to spread throughout that country.

catch up

February 27, 2008 by Jeremy · 668 Comments 

We’ve got lots of news to catch you up on. Four of our kids have undergone their heart surgeries in the past week! On February 18th both Juliana and Rebar had their turns. Then Aria on the 21st and Hussein on the 24th. And all of them have come through with flying colors!

Juliana (pictured below- calling family back in Iraq) underwent a 7 hour surgery to repair multiple heart defects that were risking her life- narrowing of the vessels and a hole in the interior wall of the heart. In her second day after surgery she already looked better, with the blue tinge in her skin gone!

Aria has had a little more difficulty recovering than most of the other kids do.  But he’s now looking better, beginning to eat more normally and being monitored closely for some blood pressure problems. 

Rebar was transferred out of the intensive care unit only 2 days after his surgery and has been recovering at rapid speed. And Hussein as well has had a smooth recovery and is on his way back to normal health. These kids seem to bounce back so quickly that it’s hard to remember how severely their heart problems were affecting them before.

Four surgeries. One week. And lifelong impact that no one can count.

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