Medical Volunteers Give Tamarisi a New Lease on Life

According to the Ministry of Health, up to 70 lives are lost annually as a result of rheumatic heart disease.
29 May 2019 13:54
Medical Volunteers Give Tamarisi a New Lease on Life
Open Heart International nurse team leader Tania Marques (from left) with Emele Vunibola and her 7-year-old daughter Tamarisi Sali before her surgery at the Colonial War Memorial Hospital on May 28, 2019. Photo: Ronald Kumar

Seven-year-old Tamarisi Sali lay in her hospital bed at the Colonial War Memorial Hospital awaiting a valve replacement surgery.

The young Taveuni lass cuddled up to her mother, wondering why she was not allowed to eat anything.

This was her first trip to Suva and she did not realise that it would be for surgery.

It was a month ago when Tamarisi’s mother, Emele Vunibola, took her to the clinic in Waiyevo, Taveuni. She had a swollen ankle. She was suspected to have Rheumatic Heart Disease.

According to the Ministry of Health, up to 70 lives are lost annually as a result of RHD.

Suspicions and diagnosis

“The doctor in Taveuni advised us to take Tamarisi to Labasa. The hospital in Taveuni did not have the machines to do a proper test,” Mrs Vunibola said.

“They suspected that she had rheumatic heart disease. My husband is a farmer, so it took us sometime to gather the money to make the trip. And it was fortunate that we did.

“It was confirmed in Labasa Hospital after the necessary tests that Tamairisi had RHD and needed surgery.”

The timing could not have been better.

Open Heart International

A team from the medical volunteer agency Open Heart International was due to arrive and through the good work of local medical professionals, Tamarisi was booked for surgery.

This little girl’s story is similar to many who have been helped by Open Heart International. The group made of medical volunteers are on their 26th trip to Fiji.

Forty volunteers, mainly from Australia, are in Suva and their aim is to transform 30 lives who otherwise could die.

For Tamarisi, the medical procedure to save her life could cost $50,000 or more if done in Australia, and $15,000 in India.

This is a sum which her family would take years to gather.

Fijians have limited access to life-changing surgery and this is where Open Heart International comes in.

The humanitarian agency began in 1986 when a nurse visiting Tonga was appalled that Australia’s neighbours were dying from conditions readily diagnosed and treated in Australia.

For Open Heart International, Fiji is a second home.

The agency has been coming to Fiji since 1990. The only thing that kept the agency away were natural disasters and political upheavals.

OHI co-ordinator Melanie Windus is no stranger to the CWM Hospital after a few trips in the 1990s and then making the journey every year since 2002. She said each experience had been different.

For this trip, the focus is mainly on adults after a group of doctors from India performed surgeries on children.

“Open Heart International is delighted to return to Fiji and work with the Ministry of Health and Medical Services. For every year that we have been here, we have observed changes. The local staff are now trained, so on each of the trips we have to bring fewer specialists with us,” she said.

“This current team has four surgeons, four anaesthetists, two perfusionists, two intensive care specialists and more than 20 nurses.

“While we treat patients with RHD and other cardiac problems, we like to train the local teams. We have had classroom sessions. These are full-day affairs and it was good to see doctors and nurses in attendance.”

Ms Windus said they had also brought with them two-and-a-half tonnes of important medical equipment, which included critical heart and lung machines, heart valves, syringes, dressings, painkillers and other items needed before, during and after surgery.

The unused items will be left behind for medical staff to use.

“One of the greatest challenges the team faces is that demand outnumbers patients the teams can operate on during their time, and with their limited resources,” Ms Windus added.

“We would like to do more, but are limited in what we can do and who we came to help. This is where we believe the passing of the skills would become very important. We hope that Fiji is able to do their own valve replacements soon.

“RHD is a killer and if not detected early, many can lose their lives.”

Local Doctors and Nurses from CWM with visiting Open Heart International project coordinator, Melanie Windus and Ward team leader Tania Marques on May 28, 2019. Photo: Ronald Kumar.

Local Doctors and Nurses from CWM with visiting Open Heart International project coordinator, Melanie Windus and Ward team leader Tania Marques on May 28, 2019. Photo: Ronald Kumar.

Successful surgery

Tamarisi underwent surgery late yesterday. The doctors predict she will be able to walk around by herself this afternoon.

This little girl represents the many children whose families are not able to get access to proper medical treatment.

She is the second among her five siblings. She lives at Navakawau in Vuna. Her father is a farmer and mother a housewife.

But despite her hardships, she is one of those lucky ones that will live to tell the story of her first visit to Suva.

And this bright-eyed little girl wants to see more than the walls of her room at CWM Hospital before she leaves for home.

The Fiji/Pacific situation

RHD Heart Disease continues to affect many people in the Pacific, often leaving irreversible scarring on heart valves that become life threatening. Sadly, there is no access to surgical treatment for either of these conditions in Fiji without the help of visiting medical teams.

The Ministry of Health in Fiji has, however, made some ground with RHD screening for infants and young children. The treatment in Fiji involves the use of antibiotics which the patient has to take for years.

There are many in Fiji who have lost their children to RHD.

What is RHD?

Rheumatic heart disease (RHD) is damage to one or more heart valves that remains after an episode of acute rheumatic fever (ARF) is resolved. It is caused by an episode or recurrent episodes of ARF, where the heart has become inflamed.

The heart valves can remain stretched and/or scarred, and normal blood flow through damaged valves is interrupted. Blood may flow backward through stretched valves that do not close properly, or may be blocked due to scarred valves not opening properly. When the heart is damaged in this way, the heart valves are unable to function adequately, and heart surgery may be required.

Untreated, RHD causes heart failure and those affected are at risk of arrhythmias, stroke, endocarditis and complications of pregnancy. These conditions cause progressive disability, reduce quality of life and can cause premature death in young adults. Heart surgery can manage some of these problems and prolong life but does not cure RHD.

Rheumatic heart disease is a chronic, disabling and sometimes fatal disease that is entirely preventable.

What are the symptoms of rheumatic heart disease?

Symptoms of RHD may not be noticed for many years. When they do develop, symptoms depend on which heart valves are affected and the type and severity of the damage.

Most people with RHD have a heart murmur which can be heard through a stethoscope.

Symptoms of moderate to severe RHD can include chest pain, breathlessness with physical activity or when lying down, weakness and tiredness, and swelling of the legs and face.

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