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)

Why Heart Surgeons Are Like Rock Stars

August 22, 2011 by Lydia · 1 Comment 

I’m in an Iraqi hospital room, surrounded by five conservative, Muslim women, discussing Michael Jackson. Wait–what?

During our last Remedy Mission in southern Iraq I became curious about what these families think when they see me. When they meet a young, white, American girl do they take me for who I am, or do stereotypes and reality TV characters precede me? What kind of reputational baggage have American media, troops or aid workers left in Iraq that I don’t even know I’m up against?

Needing to get to the bottom of this, I grabbed a translator and headed to the hospital ward to ask these mothers, “Who or what represents ‘America’ to you?”

The first few answers were easy– “democracy”, “freedom”, “independence.” But these were not the answers I was looking for. I wanted to hone in on who was the singular “face” of America. So we started asking just that, “Which single person represents the United States to you?”

The most popular answer? Michael Jackson. I couldn’t help laughing out loud. Really? Michael Jackson? I was expecting Lady Gaga, Brad Pitt or perhaps Katy Perry (or President Obama, at the very least). But MJ? And I got this answer from not one but several Iraqi families. Pretty interesting, right?

But the resounding response I also kept hearing was….Dr. Novick! Our very own, world-renowned, rockstar heart surgeon from Memphis is revolutionizing the way Iraqis see Americans.

Many of the women agreed that this ICHF team had completely exceeded their expectations on the kindness of the West. I guess saving their child’s life leaves a stronger impression than “American Idol.”

Dr. Novick–Michael Jackson’s got nothing on you!

The Most Disappointing Thing About My 10 Weeks In Iraq

August 1, 2011 by Adam · 2 Comments 

Remember Jenga? That crazy game where you pull blocks out of the wooden tower, hoping it doesn’t tumble over? Making plans often feels like a game of Jenga. You build a tower of ideas piece-by-piece, then life pulls at pieces of your plan, and sometimes our tower of plans comes crumbling down…

About a month ago, we received some disappointing news, and the PLC staff had to make a difficult decision. The Remedy Mission we all hoped to experience in our city, Sulaymaniyah (aka, “Suly”), was canceled. For many of the interns, this Remedy Mission was the biggest reason we fought so hard to get the PLC internship. From the start of our internship process, we wanted to meet the families and kids who would be on the receiving end of lifesaving surgeries. Some of the intern’s assigned work even revolved around there being a Remedy Mission VI.

To make a complicated situation simple, the hospital and a local nonprofit partner didn’t prepare enough for the impending surgical mission. The hospital wasn’t as equipped to handle these complex surgeries as it should have been and funding was withheld. Surgical missions always have some risk involved, but PLC won’t dive into a Remedy Mission with unnecessary risks that could cost children their lives.

PLC could have provided more funds to make the surgical mission in Suly happen and just hoped the hospital’s current equipment was sufficient, but this is about long term solutions over short term gain. The problem could have been temporarily fixed with a handout, but we would much rather empower local organizations and hospitals to take ownership and responsibility for their community–for saving the lives of their children.

We don’t ram solutions down people’s throats. We’re here to aid local desires and local initiatives. So when local preparations fall or local enthusiasm wanes, we don’t force it. Part of creating long term solutions lies in ensuring that this is something local doctors, government officials and parents of sick babies really want–without our patronage.

Thankfully, PLC was still able to host a Remedy Mission, but it was relocated to a better-prepared, southern Iraqi hospital–a place most interns were unable to go.

When the rug is pulled out from under us, we can’t help but feel disappointment. However, we must come to the realization that GOD will reconcile our plans. Even when our Jenga tower crumbles to the floor, GOD is still in control.

Now Remedy VI is finished in southern Iraq, and we can praise GOD for each of the 18 kids who received a successful heart surgery and for zero fatalities!

The internship is now over and–Remedy Mission or not–each of us experienced so many valuable events and lessons. Our plans never really work out quite how we anticipate, but we’ve seen that GOD is trustworthy and will work everything out for the best.

Never Have I Ever Spent An Entire Afternoon At A Tea Shop… Until I Came To Iraq

July 17, 2011 by Adam · 1 Comment 

Kurdish men spend a lot of time drinking tea, playing games, and socializing at tea shops. A Kurdish tea shop is completely different from how I imagined a tea shop, since I only had Starbucks and Teavanna to compare it to.

Please allow me to describe my first experience at a legitimate Iraqi tea shop buried in the center of the bazaar.

A returning 2010 intern, Alex, likes to call this tea shop “the catacombs.” So when he proposed the idea of revisiting his favorite place in Sulaymaniyah, another PLC intern and I were excited to visit this mysterious, catacomb-like teashop.

Alex led us through the winding streets of the bustling bazaar, when out of nowhere he dove into the small entrance of “the catacombs.” We walked through the narrow seating area and tea stand and then the room opened up to a huge floor filled with a mess of tables crowded with men.

The sights and sounds of the catacomb tea shop were awesome! The noise of dominoes slamming against tabletops, dice rolling across wooden boards and men’s laughter and conversation filled the room. The walls were lined in dirty, beige brick. These brick walls held pictures of Iraqi politicians and famous figures that seemed to transcend their canvas and stare creepily at you no matter where you moved.

The tea shop is a place where they can invite total strangers or friends to play games and drink cha (the Kurdish word for tea). The workers went around delivering tea, handing out games or repositioning cheap plastic chairs and metal tables to accommodate more Kurds. Every so often the old owner of the shop would come by to sweep up the endless amounts of cigarette butts scattered across the floor.

We found a small spot near the AC, and immediately our white skin and American-ness attracted eyes of friendly patrons eager to practice their English and help us out in our attempts to play backgammon. Anytime I play backgammon, a Kurd either playing or just watching, would move my pieces for me if I wasn’t quick enough to move them myself.

That day I spent over three hours in the tea shop losing almost every game I played, drinking tea and laughing with new friends. In Iraq, it’s normal to sit down and help strangers or foreigners with anything, even something as simple or insignificant as a board game.

And this friendliness isn’t just occasional. It’s a quality they practice daily. The Iraqi people really understand the value and importance of relationships. The culture here is saturated with qualities of hospitality and friendliness to strangers and friends, and I’ve recognized this level of love and friendliness as something I hope to adapt in my own life.

Meet the Interns: Our First Impressions of Iraq

June 7, 2011 by Ted · Leave a Comment 

Surgery, the “Neglected Stepchild” of Global Health

April 3, 2011 by Alex · 2 Comments 

In preparing for my 2nd internship with PLC this summer I came across an article written by two well-known global health advocates and physicians (a prof at Harvard and the current president of Dartmouth, if you’re into credentials) on the topic of surgery in the global health movement. [Paul E. Farmer and Jim Y. Kim. 2008. "Surgery and Global Health: a View from Beyond the OR." World Journal of Surgery 32:533-536].

After discussing this article with one of the directors at PLC and thinking about our current model for surgical aid in Iraq, a few points stood out:

The authors’ first argument is that surgery is the “neglected stepchild of global healthcare.” The fact is, although surgical diseases (CHD being one of the most prevalent) are a major cause of death and disability in much of the world, the vast majority of healthcare programs don’t address surgical needs.

Why? Because surgical interventions are usually complicated and require a larger investment than other kinds of health interventions, and treating surgical diseases requires a more advanced infrastructure and the involvement of more professionals than treating, for instance, malnutrition or malaria.

There is also the fact that surgical diseases have lacked the same kind of advocacy and exposure that have led to funding and programs for “high-profile” diseases like tuberculosis or AIDS.

The other major issue addressed by Farmer and Kim is that countries that actually have the surgical services often only have them in just a few locales, and the treatment is usually too expensive to be accessible by most of the population.

The question then arises: how do we make this treatment available in settings where infrastructure is poor, trained professionals are scarce, equipment is needed, and “the only thing not needed is disease, which exists abundantly.”

Remedy Missions are our answer to that question.

As you know, we recently moved from sending children abroad for surgery to a model that provides more surgeries at less cost while simultaneously training local professionals.

These Remedy Missions specifically address the impediments to surgery in global health described by Farmer and Kim.

They provide treatment of CHD for families that would never be able to afford traveling abroad for surgery. Our work also means we’re freeing surgeons up to focus on surgery, because, as Farmer and Kim write, “clearly we don’t want surgeons to be dragged out of the operating room to manage logistics, supply chains…and financing.”

Remedy Missions provide crucial training for all the different health professionals that are required for a surgery to be successful (surgeons, cardiologists, nurses, etc.).

This process of providing surgery and training is also an exercise in infrastructure building as we work toward the development of heart centers in northern and southern Iraq. The fact that we can count both regional and national governments as partners addresses the need for surgical care in the public sector in Iraq, and it bodes especially well for poor families who will need to receive treatment in the future.

Lastly, the partnership and advocacy of our supporters (that’s YOU) is helping to raise awareness of the burden of CHD and other surgical diseases in places like Iraq.

With well-planned, structured interventions that take into account the needs and problems associated with surgical disease globally, and the support and advocacy of a Coalition of concerned individuals and communities (that’d be you again), problems like CHD can cease to be a “neglected stepchild” of global health and instead serve as a model for building health systems and effecting powerful change in global contexts.

Internship | 2011

January 26, 2011 by matt · Leave a Comment 

It’s that time again.

For the past 3 summers we’ve hosted a handful of talented, socially-conscious men and women to assist us in eradicating the backlog. This year we’re excited to have several of our 2010 interns returning for a second summer, but there are still a few spots left.

So instead of spending your summer sleeping in and replaying Donkey Kong 64, why not go here and fill out an application?

We’re looking for passionate people who want to hone their skills for the betterment of the people of Iraq and to have their own life enriched by the experience.

The application deadline is February 1st, and you can send any questions to our veteran interns, Lyda and Alex, at interns@preemptivelove.org.

Go check it out!

Backed Into a Corner: Doctors Adapting to Hardships in Iraq

June 30, 2010 by Preston · Leave a Comment 

As a doctor, decisions that affect a person’s quality of life come with the job, and this is no different for our local cardiologist, Dr. Aso Faeq. While shadowing Dr. Aso in his office earlier this week, I witnessed how the problems in Iraq make these decisions even more difficult.

As I saw patient after patient visit Dr. Aso’s office last Wednesday, the fact that congenital heart disease is a rampant problem here in northern Iraq became blatantly obvious. Families drove for hours just to see this one cardiologist examine their child, and so many of them were told about the urgency of their child’s heart condition.

Though so many cases are urgent, Dr. Aso is restricted from the limited options he has available to him in Iraq. The lack of training and technology for doctors along with poverty and cultural dilemmas prevent many children from receiving surgery in the country. It’s hardships like these that affect Dr. Aso’s decision making every day.

One of his decisions that resonated with me concerned the fate of a three-month-old boy. His parents brought him to the office knowing he had a heart problem, but they needed Dr. Aso to examine and diagnose him. After a few seconds of doing the echocardiogram (an ultrasound of the heart), Dr. Aso’s whole demeanor changed instantly.

He explained to us that two of the little boy’s heart chambers were malformed and merged into a single chamber causing immense pressure to build in his heart. As the family and Dr. Aso discussed their options, the limitations became obvious. The surgery the child needs could be done in a town six hours away, but the family did not have the money to do this. On top of this, the next group of American non-profit surgeons who will perform local surgeries here does not arrive for another fifty days, which could be too late for the dying boy.

For a solid 10 minutes Dr. Aso did not say a word. He sat there, weighing the child’s options and deciding his fate. Imagine the immensity of this decision. Dr. Aso has basically been backed into a corner and told to make a decision on this child’s life. And so, he did. Waiting is the only option. He spoke to the parents, comforted them, signed the papers, and watched as the next patient walked in.

Dr. Aso often finds himself faced with difficult decisions, but with the options available to him he takes the initiative to make the best call for these children. These families are, in fact, some of the strongest people I have ever witnessed. They face impending tragedy while dealing with poverty and neglect. Sitting in Dr. Aso’s office, however, allowed me to see that real initiative can cause real change in the face of immense hardship.

People like Dr. Aso take this initiative as far as they can, and PLC hopes to offer opportunities for this initiative to be extended across the world. Whether it be through buying Klash from our Buy Shoes. Save Lives. program, supporting local healthcare through Remedy Mission, or creatively partnering with PLC to find new ways of providing these heart surgeries, you can also take the initiative to make a difference in childrens’ lives.

Revisiting Nivar Helped PLC Family Advocate Refocus on PLC Goals

June 27, 2010 by Sophia · Leave a Comment 

It is often difficult to measure the level of success of our work here in Iraq. Working with kids and families, donors and budgets is all sometimes daunting.

On a recent visit to see 9 year-old Nivar, I was reminded of how precious life of an Iraqi child with a heart disease is. With little energy to play outside and unable to run around with her younger brothers, Nivar spends her days watching TV and lying down in her family’s home. Her condition is significant and according to her father, she often feels tired and bored now that school is out for the summer.

Nivar is one of the sweetest girls I have had the privilege of meeting here in Iraq. Big green eyes and a smile that captures your heart, she is the epitome of why we here at PLC work to send children to surgery.

We work to see kids outside playing once again. We work to stop sick days and sad childhoods. We work to see smiles and healthy pink cheeks instead of blue ones that show a lack of oxygen.

We work because we love, and we hope that love can be shared with everyone who donates to a child.

I can’t help but think that if we can help save at least one little girl like Nivar, our job will be a success.

House Visit with Yousif Challenges PLC Intern

June 23, 2010 by Claire · Leave a Comment 

Last week a small group of PLC staff and interns visited Yousif in his village. As we wove through neighborhoods I noticed the muted and dull colors of the concrete walls, gates, roads and air. Amidst the tan, beige and dirt-colored village I kept seeing flashes of bright blues, oranges and reds — colors of the town’s vibrantly dressed residents behind gates and in shops. Their clothes fought my initial impression of his village. When we drove in, it almost looked like a ghost town, but once I started to see the villagers I saw the life and personality of the people shown through their clothing.

We arrived at Yousif’s home, and I was privileged to meet a woman whose personality quite literally burst through the front gate. Yousif’s mother had been summoned in from the field by her daughters because of our arrival. She flew in holding Yousif’s hand, wearing a work shirt and a pair of tattered juli kurdi pants — baggy pants traditionally reserved for men only. This woman oozed strength, confidence and know-how. She appeared as if she could build a house from the ground up, run a farm and raise her 10 children all at the same time. This was a woman I should learn from. There is a good chance I will never work as hard in a week as she does in a day.

Four of Yousif’s sisters brought us water, tea, grapes and cucumbers. Lessons in hospitality are not only something I could learn from this family but from all the Iraqi people. Despite the delicious drinks and snacks it was not long before we were itching to play with the kids. Little did Yousif know, there was a soccer ball in the car with his name on it. Yousif and his siblings had few toys and had to borrow a ball from kids down the street during PLC’s last visit. The ball was brought out and a game quickly ensued, but soon it came time to leave because Yousif’s mother had to get back to work.

As we were walking to the car Yousif’s brother ran out of the gate holding the soccer ball he thought we had forgotten. I was blown away. A child with very little access to his own soccer ball thought we had accidentally left behind this gift and instead of rejoicing and trying to keep it, he chased after us and attempted to give it back.

Time and time again I am humbled by the children and families we work with because of their dedication to hard work and hospitality. And through that dedication, I’ve seen that this family chose to focus on the vigor of life rather than on the fact that their family is dealing with a congenital heart defect.

A PLC Intern’s Thoughts on Brain and Feet Soup and New Cultural Experiences

June 16, 2010 by Preston · Leave a Comment 

Experiencing Iraqi culture in a variety of ways is one of the great parts of being a PLC intern. The tasks we take on allow us to build meaningful relationships with new friends as we work. So far, a few of us interns have been a part of this relationship building through working with our new friend Aram. Aram is a local Klash maker who uses his unique gift to help PLC provide much-needed heart surgeries for children right here in his home country. For the last few weeks, the interns have been working with Aram on new ideas for Klash. Day after day, at least two of us have been frequenting his shop, speaking in broken language, trying to communicate new ideas, and in doing so, slowly building a great relationship while experiencing a new and exciting culture!

This culture is one of great hospitality. Every time we step foot in his shop, Aram is quick to offer water and tea. Often times we try to pay for the drinks he gives us, but the gesture is always denied. Many people here have a joy about them as they serve their guest. Even after three weeks of our visits, Aram never fails to extend his hospitality. On one of our latest visits, we partook in a rather unusual adventure of the culinary type.

While sitting in Aram’s shop during lunch time the other day, he asked if we would like some sêrûpê. This dish that I’ve only heard tale of, has often times made our Iraqi friends laugh by even just mentioning the name. The food that was brought to us was a green-yellow, brothy mixture containing sheep brain, foot, tongue, and mid-region. I know the thought is quiet unappetizing, but after timidly tasting the first bite, we understood that the Iraqi people know what’s going on when it comes to food. They can even make sheep brain and feet taste delicious. Served with a tortilla-type bread called naan, the meal could not have been more delicious.

Along with experiencing the culture through food, we’ve also experienced a type of relationship building that can only be formed by sitting in a Klash shop in the middle of Iraq while sipping hot tea. After sitting around a bit and talking about our new Klash ideas, the conversation can quickly drift to dugolie (the Kurdish word for “soccer” or “futbol”), especially focusing on the World Cup and the many reasons why Aram thinks Germany will win it all. We talk about the trade, argue about sports, and work on Klash together. Spending time in Aram’s shop has been one of the best ways of experiencing the culture so far.

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