Cláudia Abreu*
claudia.marques@anba.com.br
São Paulo – A group of three Brazilian doctors specialized in paediatric cardiology spent 16 days in Algeria in December, guiding professionals at Abdherramani hospital, the main hospital in Algiers. The training is part of a three-year cooperation agreement between Brazil and the Arab country signed by Brazilian president Luis Inácio Lula da Silva in March 2006.
"The objective is to train Algerian doctors to promote high complexity surgeries on children. Nowadays, all of these surgeries take place outside the country, mainly in France," stated doctor José Caliani, who coordinated the team during the visit. Caliani is the head of the cardiac surgery department at the National Institute of Cardiology of Brazil (INC).
During their stay in Algeria, the group headed by Caliani, which also included an anaesthetist and a specialist in perfusion – the use of a machine that temporarily replaces the function of the heart and lungs, oxygenating blood and pumping it, making it possible to stop the heart for the surgery -, performed 17 surgeries. "In all of them, we managed to totally correct the problem," stated Caliani.
The surgeries were on children aged between 18 months and 15 years. Most of them – 13 – suffered from Tetralogy of Fallot, also known as blue syndrome as those with the disease have bluish lips and fingertips. Children with this disease may suffer blackouts and may also get tired easily while practicing sports.
According to Caliani, all the cardiac procedures promoted by the Brazilian team were accompanied by 18 Algerian professionals – seven surgeons, seven anaesthetists and four specialists in perfusion. "They have good qualification and also a great desire to learn," stated Caliani.
Before the Brazilian team, another two groups – from France and Jordan – had travelled to Algeria, at the invitation of the government, to train doctors in paediatric surgery. However, the projects did not follow through due to the method and to lack of empathy between professionals. With Brazil, the story seems to have taken another route. "We were received very well and continue interacting. Since I arrived from the trip (on Monday 17), I have already exchanged several emails with the doctors there," explained Caliani.
Apart from the exchange of experiences, the cooperation between Brazilian and Algerian professionals should generate an economy to the Arab country. Caliani explains that as the cardiac surgeries are performed in France, the cost for each patient is around 30,000 euros. "We performed 17 surgeries that together would have cost approximately 30,000 euros. So, for the value of one surgery, the Algerians should be able to perform 17 to 20 operations," stated the doctor.
Another factor pointed out by Caliani is regarding the emotional aspect, which is important for the success of the surgery and for recovery of the patient, mainly when the patient is a child. "When the operation takes place in another country, it is hard to acclimatize the patient. Often, neither the patient nor the person accompanying him, generally the mother, speaks the same language as the doctors. Fear is generated, it is hard to establish trust between professionals and patients, for example, it is very uncomfortable," stated Caliani.
Preparation
Before the treatment in December, the Brazilian professionals prepared the ground. In July, the first inspection of the Algerian hospitals took place. The intention was to evaluate the infrastructure at the hospital to serve as a base for the surgeries. At the time, the acquisition of medication, equipment and specific material for paediatric surgery was requested. "They already had a structure for cardiac surgery, but only for adults, " explained Caliani.
Three months later, in October, the Brazilian team returned to the Arab country to inspect the material purchased. "They managed to set up all we needed in record time, which shows the interest in training," said the doctor. In early December, when Caliani and his group arrived for the training, all the questions of infrastructure had been solved.
2008
According to Caliani, another five missions should take place next year. The first should take place in March. "I believe that with another four visits the professionals should already be prepared to perform the surgeries," said the doctor. Caliani also stated that the government of Algeria has already shown interest in continuous collaboration with the Brazilian team during the three-year cooperation period established with Brazil.
*Translated by Mark Ament
