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)

Highlights From Our Remedy Mission XVI

April 2, 2013 by Cody · Leave a Comment 

Today is the last day of our Remedy Mission here in Najaf!

We still have a full day’s work before we head home tomorrow, but here are some highlights as we wrap up Remedy Mission XVI.

—Getting to meet Hama, Kadeeja, Musa, Ali, Diya, Shakir, Mohammed, Noor, Zainab, Zahara, Mahdi, and Yousef. All twelve of those children received lifesaving operations this trip!

—Watching one of our local heart surgeons completely correct a heart defect – without any help!

—Witnessing our cardiologists screen close to 200 more children.

—Sitting down with the local medical team to talk about longterm development and the training they want to receive this next year.

—Being overwhelmed by the gratitude and joy expressed by all the families of those we served this mission.

Thank you so much for making this mission possible.

I’ve said this before, but we haven’t provided a single heart surgery in Iraq apart from the support and generosity of others.

You give; a child is saved; peace is waged. It’s a cycle we can’t continue without you, so thank you!

As soon as I leave here, we’ll start preparing for two more Remedy Missions this month in the cities of Fallujah and Tikrit.

You can be a part of the community that makes those operations possible by donating a few dollars below.

Peace from Najaf.

Give now to bring hope to families in Tikrit!

Hama Is On His Way Home (Finally!)

March 30, 2013 by Cody · Leave a Comment 

This afternoon, Hama gets to pack his bags and walk out of the hospital with a fixed heart.

He gets to leave behind the surgeons, the nurses, and the heart defect that almost took his life. Now he gets to go home with his mom and dad, breathe a little bit easier, and start to experience life without a heart defect.

Hama’s dad said it best when he emphatically said, “thank you, thank you, thank you!”

Thank you helping save Hama’s life.

There hasn’t been one heart surgery in Iraq that didn’t have the backing of others.

You continue to make all the difference for these children.

Meanwhile, the operating team hasn’t slowed down. They’ve already saved 9 lives and they’re hoping to save another 3 more before we wrap up the mission!

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I’ve Never Been So Excited To Not See Hama!

March 26, 2013 by Cody · Leave a Comment 

I walked into the ICU today to check on Hama but he wasn’t there. This is great news!

On my way to the hospital this morning, Hama was having his wires, tubes, and IV’s removed because he was given the green light to leave the ICU.

By the time I arrived, he was already upstairs in the hospital ward.

Walking into his room was a welcomed change of pace for everybody. The room wasn’t full of monitors and rusty oxygen tanks. It didn’t even have any nurses in it. It was just him and his mom and Tom & Jerry on the television.

The things we got to talk about today are completely different than before. Instead of talking about the operation and the risks involved, now we’re talking about what lies ahead. Things like when he can play soccer again, when he can swim, and when the scar will be his only memory of his heart defect.

These are the best conversations to be a part of.

Thanks for showing your support for Hama. He’s almost home!

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Is There Room For Failure In Development?

March 23, 2013 by Cody · 2 Comments 

You know that old Chinese proverb that says, “Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime”?

It’s true. In fact, I remind myself of this on a weekly basis. It’s an ethos that defines and directs our vision for Iraq.

And that’s why none of us will say our jobs are easy.

If we’ve ever made these lifesaving heart surgeries and our vision of developing heart centers across the country look easy—it’s not. In fact, it’s the most challenging vision we’ve ever tied ourselves to.

I love fishing but teaching a man how to fish isn’t the same as teaching a man how to delicately correct a heart defect, and throwing another fish in the boat isn’t the same as helping a sick child recover in the ICU.

But the principle holds fast—if all we do is provide lifesaving heart surgeries, our impact is immediate and measurable. If we teach locals how to provide these lifesaving surgeries, our impact is enduring and immeasurable.

Just providing lifesaving heart surgeries would be much easier for us as an organization. It would take a huge burden off of our minds and souls each week. We would succeed a lot more at our work. We certainly wouldn’t fear failure as much.

The only problem is that it’s too small of a vision. There’s a greater vision out there for Iraq, but it involves a whole lot of risk, sweat, and the possibility of setbacks and failure.

If we’re going to fail at something, we want it to be something worth failing for.

Every child in Iraq deserves to be within a day’s drive of a lifesaving heart surgery, and we think that’s worth going toe-to-toe with setbacks and failure.

Why am I talking about this?

Because it’s something I’m dealing with right now on this Remedy Mission.

There have been five lifesaving heart surgeries so far—which is great!

But, remember? It’s not all about surgeries. It’s about teaching and developing a local healthcare system that can do this all on their own one day. And, honestly, that vision has had a lot of setbacks this mission.

Mistakes have been made. Things have had to be taught again. We’ve taken a step back in some areas and in other areas we’ve had to go back to the very beginning.

It’s just an occasional reality in development, and it’s the reality right now for our work in this heart center.

But we press on. We teach it again. We go back to the beginning and retrace our steps.

We’ll wake up tomorrow, grab our fishing poles, and get back to teaching because, some days, it’s just a tough day fishing.

So what visions are you backing right now? Are they too small but guarantee success every time? Or are they big and worthy enough to take risks and face setbacks for?

Is there a place for failure and setback in development work?

I hope so. If anybody tells or tries to show you different, I would question their vision.

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Why Dads Are Whispering in the ICU

March 21, 2013 by Cody · Leave a Comment 

Iraq is loud.

Even in the hospital the noise is overwhelming at times. Cars are honking outside, trying to make their way out or into the already overcrowded parking lot. Rusted oxygen tanks are being rolled down the ward to replenish the cache in the ICU. Hospital gurneys are clamoring their way down the ward, bumping into food carts and abandoned wheelchairs.

Sometimes the best way to communicate is by overpowering all the noise, and, sometimes, it just takes a whisper.

I walked into the ICU today to see this little boy with his daddy. Dr. Sanchez was screening him while his big eyes were glued to the image of his heart pulsing on the echo machine; his dad leaned over the bed whispering words into his ear.

Because of the noise, I can’t tell you what he was saying but I can tell you that it made all the difference for his son.

If this were your son, what would you be whispering in his ear?

What would you tell these kids as they wait to hear if their heart defect is fixable or not?

Let us know—we’ll pass it on!

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Hama Is Looking Up!

March 18, 2013 by Cody · Leave a Comment 

Hama made it through those first crucial hours in the ICU.

The correction made on his heart continues to hold fast as the rest of his body adjusts to a fully-functioning heart. In between surgeries today, Hama’s dad came into our break room to say “thank you, thank you, thank you!”

These next 8 years will look completely different for Hama and his family. No more searching, no more waiting—just a whole lot of living.

Now, we just need to get him well enough to leave the ICU.

Thanks to all of you who are showing you support for Hama by sharing his story on Facebook, Twitter, and e-mail. Keep it up, his story isn’t over!

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Hama Made It Out Of The O.R. And He’s Doing Well

March 14, 2013 by Cody · Leave a Comment 

It took the surgeons five and a half hours, but they were able to completely correct Hama’s heart defect.

Did you catch that? It was a complete correction; an absolute victory; a complete undoing of a previously life-threatening heart defect. This is as sweet as it gets in the operating room!

Hama was rushed out of the operating room just as quickly as he was rushed in. Now his battle moves from an operating table to an intensive care bed.

The entire medical team is gathered around Hama, monitoring his heart and ready to help his body adjust to a fully-functioning heart. His heart defect may not exist anymore, but how his body responds to the operation will determine everything.

As he gets settled into the ICU, I should know more about how he’s doing. These next few hours are crucial for him.

Stay tuned…

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We Can Fix Hama’s Heart

March 13, 2013 by Cody · Leave a Comment 

“We can fix Hama’s Heart.”

That has to be the best thing I’ve heard all mission.
But for Hama’s parents, that’s the best thing they’ve heard in 8 years. That’s how long they’ve been waiting to find someone who could and would fix Hama’s heart defect.

What they’ve heard these past 8 years have been statements like:

“We don’t know how to fix this.”

“The only way you can save Hama is if you leave Iraq.”

“Even if we knew how to save him, there are hundreds waiting in front of him for this same surgery.”

“I’m sorry.”

Being able to watch 8 year-old Hama get carried into the operating room was nothing short of exhilarating for me.

But watching their son being carried into the O.R. isn’t what Hama’s parents have waited 8 years for. No, they’ve waited 8 years for their child to be carried out of the O.R.—without a heart defect.

Hamma’s 8 year wait for a surgery is over. But it’s what comes after the operation that everybody’s on pins and needles for.

Stay tuned, Hama is in surgery now.

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So You Want To Take On One Of The Leading Causes of Death in Iraq?

March 9, 2013 by Cody · Leave a Comment 

Congenital heart defects are one of the leading causes of deaths for children in Iraq.

So when you confront it head on, you better be ready for what comes next.

When we put the International Children’s Heart Foundation medical team back on the ground, the press releases go out, the radio and T.V. stations announce their arrival, and hundreds of families in the city rush to make sure that their child is at the top of the list.

The first thing we do is screen each child. But then more come. And then more. And then so many people that you can’t even get through the crowd to see the child being screened.

Siblings take turns standing in line. The dads and moms show up before our team has even woken up. Some even bring their own mats so they can sleep in the waiting room.

And so we keep screening. Because each echo means that child is one step closer to receiving the treatment that need.

Thanks for bringing us back to Najaf. There’s still so much more work to do!

Our Partners:

We’re Launching Remedy XVI (And I’m Nervous)

March 7, 2013 by Cody · Leave a Comment 

I woke up in Najaf today.

It’s been months since I’ve been able to launch a Remedy Mission in Iraq.

After being in the states to welcome my little girl into the world, my wife and I made our way back to Iraq in January, just missing the Fallujah mission.

Now, it’s my chance again. And I have the jitters.

Having a baby does all sorts of odd things to your emotions, or at least it did for mine. It created space where I thought I had no more room. Space for those fatherly instincts to kick in; space for a new, maybe deeper kind of love and the ability to tangibly experience emotions in ways that have been entirely foreign to me before.

I knew it was coming. A friend wrote and gave me a heads up and he was spot-on.

And that’s why I have the jitters. As I kick off this Remedy Mission, I know I’m going to see dozens of babies fighting for their lives—babies just like mine. I’m going to see 5 year-olds and 12 year-olds who have waited their entire lives for a chance at a lifesaving heart surgery and honestly, I’d rather not see them. I’d rather look the other way and block it all out so that I don’t have to imagine what their parent’s are going through. I don’t want to see their sons poked and prodded with needles or their daughters have to say goodbye before surgery.

I’ve done it all before but this time things seem more real to me, and I think it’s going to hurt.

But I know I can’t have it both ways.

I can’t block out the pain, the fear, and the uncertainty of heart defects and the risky operations that can fix them and still expect to experience all of the hope, the victories, and the sheer joy that this mission has in store for those that will be saved.

So, I’m showing up and I’m going to embrace it all.

I’ll hold the babies. I’ll play soccer with the 5 and 12 year-olds and I’ll listen to their parents talk about what it’s like to have a child with a heart defect. I’ll do my best to take their minds off the needles and remind them that this isn’t goodbye.

And it may sting more than usual. It may be uncomfortable and I’ll feel way too vulnerable as a dad.

But it’s only by standing alongside them now, in these moments, that we can experience the full measure of joy that comes with a chance for their children to win and for their heart defects to lose.

We’ll see hundreds of children with heart defects these two weeks, and the medical team will be able to save just under twenty of them. That’s why we train and that’s why we’ll come right back and do this all over again. And that’s why I have to embrace it all—because it’s through embracing the ‘otherness’ of pain in someone different from me that I learn—that we learn—to press on and overcome together.

Let’s get to it. Stay tuned…Remedy Mission XVI is underway.

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