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Heart Drama

November 23, 2011, 16:20 3814 Author: Yana Sasina, translated by Yuliya Grytsenko www.deti.zp.ua Zaporozhye Department of Cardiac Surgery is “stalling” due to lack of equipment and drugs

Out of thousands of Zaporozhye newborns twenty percent get diagnosed with “heart disease” and five babies require immediate surgery. How long a child will be able to last without surgery depends on type of condition; however, specialists recommend to get rid of heart problems, if possible, by age of two. The underlying reason for delay is financing – parents must fork over more than 10 thousand hryvnias or 1,241 US dollars on medical supplies and drugs. Those who require pacemakers find themselves in more intimidating situation. If a picture of a child can touch a string in heart of wealthy benefactors, the older patients in Department of Cardiac Surgery must rely only on their own funds.

Not a Child’s Puzzles

A 7-year old Dianka Titor from the Volnyansk district was dreaming of going to the first grade and solving math puzzles. Ironically, her mom, Olga, was the one left to deal with complex arithmetical calculations. It would seem that the standard procedure - a trip to pediatrician to get a note for the school ended for this girl in the operating room of the Department of Cardiac Surgery in Zaporozhye Regional Clinical Hospital. A more detailed examination revealed that a child who never had any health complaints had a congenital heart disease. The decision to operate was only the first strike to hit her mother. The second strike did not take long when doctors announced the full list of drugs and medical supplies need for procedure; a total worth of 10,198 hryvnias that left Olga Titor feel utterly hopeless. Diana was lucky: donors helped charity fund to raise necessary fund and surgery was done on time.

Dianka Titor

But Yuliya Kovdrya from Berdyansk lives every day of her life as it is the last one. She has been having sudden cardiac arrests since she was 10 years old: not once doctors made her heart beat again in emergency room and her mother learned how to keep her daughter alive with defibrillator while waiting for the ambulance. In 2005 the girl received a cardioverter defibrillator through a state-run program but tree years ago the pacemaker battery reached the minimum, which means that it won’t be able to save Yuliya anymore. The girl was placed in the waiting list for new product, but Ce la Vie - state program is now closed.

Now, Yuliya's life is worth 120,000 hryvnias (15,883 US dollars). In the meantime, her mother has to be near her daughter around the clock and pray that the ambulance arrives on time. How to explain this girl, who studied the basics of law in school, that the third article Ukrainian Constitution which states that human health is the highest public value - is the purest profanity?

Yuliya Kovdrya

What can be said about government purchase of pacemakers when hospital doesn’t receive even less expensive oxygenators that cost on average 5,500 hryvnias? During heart surgeries this disposable device basically performs hear function by pumping blood and therefore, making it impossible to perform a surgery without it. Unfortunately, most parents cannot afford to buy needed medical supplies. Orphans and children from low-income families end up in a dead-end. Anesthesiologist-perfusionist from the Department of Cardiac Emergency of Zaporozhye Regional Clinical Hospital, Oleksandr Podkopaev states: “on a daily basis the head of Department of Cardiac Surgery, Vyacheslav Osaulenko, examines 20-30 kids who require heart surgeries but only few children end-up having them. What’s the destiny of those whose parents were not able to find money to buy everything necessary – doctors can only guess. Therefore, besides their professional line of work, doctors from Departments of Cardiac Surgery and Cardiac Reanimation are forced to write letters of appeal to various Charity Foundations.

- Ironically, a family can buy an expensive oxygenator – because it’s a big device and they believe in its need. But the cannulas (tubes), without which I cannot connect this oxygenator to a child, many refuse to buy, - says Oleksandr Podkopaev – “and all because they can’t afford to pay 2,600 hryvnas for ‘some kind of tubes”. After all, it’s mostly people from rural areas with incomes below average.

The thing is that the diameter of the required cannulas can be determined only on the operating table after surgeon opens the chest. Consequently, doctors ask parents to buy cannulas of both sizes and after such request most families just disappear.

- Quite often I heard: “My child feels great and without your surgeries!” But very often such a priory approach is erroneous; if congenital heart disease is not treated on time, sooner or later it’ll become evident. In most cases like this we are not able to save the patient.

Today a few kids from baby orphanage “Solnishko” and a child from regional orphan home need surgeries. They can rely only on help of people who care.

In 2011, 2,5 million hryvnias were allocated out of regional budget to buy necessary equipment and medications for the Department of Cardiac Surgery. They’ve been waiting for shipments from July. All due to a “nightmare” of all Ukrainian government subsidized facilities – tender red tape. The Regional Board of Health (Oblzdrav) explained that several tenders failed due to complaint of one of the participants regarding irregularities in the conduct of the procedure. According to the establish order the Antimonopoly Committee of Ukraine is looking into the issue.

As for supplies and drugs purchased by the state - oxygenators, stents and medications for the heart coronagraphs - their delivery has been postponed indefinitely. With the appointment of a new health minister all documents prepared by the previously one lost their validity.

Despite that fact that in pervious few of years situation in system of healthcare was more favorable it was still impossible to cover all the needs of Zaporozhye Cardiac Surgery. And that, taking into consideration the fact that government program provided for 30-40% of all things needed.

Wait for Change

According to transplant surgeon, Professor Alexander Nikonenko, each year, per million residents there are 1,000 heart surgeries, 300 of which – kids.

- 60% of deaths among Zaporozhye residents are related to cardiovascular diseases - ischemic heart disease, strokes, and various heart defects. Our specialists are well qualifies to prevent, admonish negative effects of these medical conditions and perform large number of complex surgeries; but to save lives we need to properly equip the department.

Today Zaporozhye Department of Cardiac Surgery is forced to deny surgeries for children under age of one – due to absence of incubators and respiratory equipment.

Doctors confer high hope on the opening of Interregional Center of High Technology in Zaporozhye in which, in addition to heart surgeries, they are planning to develop transplantation. It is assumed that the facility will be fully funded by the government. This year 26,000 million hryvnias were allocated from the country’s budget for the purchase of building for the future center. Time will show if the purchase is made before the end of the year.

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