William: Team Heart Patient & Student
William first sought medical care with Team heart in 2019. He was an 18-year-old from the Kimironko neighborhood in Kigali who first noticed body swelling and breathlessness three years earlier, when he was just 15 years old. He had been admitted to the hospital multiple times for fluid retention and difficulty breathing. His symptoms ultimately progressed to the point where he had to drop out of secondary school. He could no longer walk uphill due to shortness of breath, and even long conversations were difficult due to his breathing.
When William was first examined by Team Heart, he was so short of breath he could not lay flat. We performed an ultrasound of his heart (Echocardiogram) that showed severe rheumatic mitral valve disease. As a result, his heart had become enlarged and the pumping function was severely reduced. High pressures built up in his lungs, causing the right side of his heart to fail as well. This in turn led to liver congestion and signs of liver failure. William had advanced heart failure at just 18 years old.
Our first day of surgery was almost a week away, and William was so sick we worried he wouldn’t make it through a big operation. With the assistance of our Rwandan colleagues, we decided to admit him to a local hospital and start intravenous diuretics to hopefully relieve some of the fluid buildup and congestion.
William’s case was reviewed at our selection meeting. He was being considered for heart valve surgery (mitral valve replacement). If his mitral valve was not replaced, his heart failure would progress and ultimately prove fatal. He was brought to King Faisal Hospital for more testing, but ultimately it was decided that he was still too sick to undergo surgery at that time. He was placed on medical therapy for heart failure, but we knew this was only a temporizing measure. Definitive treatment with surgery was needed, and the clock was ticking. With each passing month the risk would grow, but William would have to wait.
In February 2020, the members of Team Heart returned anxious to see William. As he walked through the door he was notably thin, with muscle wasting from his chronic heart failure. But his beaming smile distracted from his underlying chronic heart disease and worry. Over the past year his heart failure symptoms were managed by Dr. Gloria Mukeshimana, one of just a handful of cardiologists in a country of over 12 million people. She expertly managed his condition; however, medical therapy was now failing. While his swelling had resolved, his lungs were frequently congested with fluid and his kidneys were now failing. It was now or never for William and he knew it. His heart would not wait another year or maybe not even another month. We decided that although William was high risk, he was medically optimized and now suitable for surgery.
On February 12, 2020 William underwent replacement of his mitral valve with a mechanical prosthesis and repair of his tricuspid valve. Despite the severity of his illness he recovered from surgery. At 19 years of age, William has undergone a successful open heart surgery and has a second chance at life. His symptoms are expected to improve, exercise tolerance increase, and we are hopeful that he will return to complete his schooling.
Charlotte: Activist, Teacher and Mother
Charlotte is a teacher and mother of four. Her symptoms of rheumatic heart disease occurred when pregnant with her 4th child. Her life has been changed from a valve replacement surgery and she is now the active mother and community leader she was before her illness.
“I am a female cardiac patient who had heart surgery by Team Heart in February, 2014. I grew up in a poor family. I sometimes suffered from tonsillitis. During those episodes, my parents advised me to drink warm water mixed with salt. They did not know that some types of sore throats could be a cause of rheumatic fever and, subsequently, of valvular heart disease. In 2013, when I was pregnant with my 4th child, I felt very bad, with coughing and difficulty breathing. I was no longer able to teach (my daily job), and I spent whole nights without sleeping due to shortness of breath when lying down. I could not climb even a small hill. My life was in danger. I went to a hospital. There, the doctor examined me and did a radiographic examination. He told me that I suffered from heart disease. He gave me some medications, but I continued to have severe symptoms. I returned to the hospital. I was advised to have an abortion and to look for funding to go to China for heart surgery. I became confused. My family was not able to take me to China, and I did not want to have an abortion. I prepared for my death and for my children to be orphans. Thanks to God, I heard from Team Heart. That is how my life was saved. After being operated upon, I feel good.“
CHARLOTTE’S WORDS OF INSPIRATION
“My children now have hope. I am doing well in my job and I am able to serve society as a contributing citizen.”
JoJo: Rwandan ICU & Stepdown Nurse, TH Volunteer and Translator
My formal name is Theophile Niyigena, but my nickname is “JoJo.” I was born on August 22, 1988 in the Kicukiro District, Kigali, Rwanda. I am the 4th child in a family of 9 children (6 boys and 3 girls). In 1994, my country endured a horrible genocide. Among the close to one million people killed were members of my family, neighbors and friends. Survivors were traumatized, continued to fear for their lives and had lost social esteem. Some were prisoners.
I began primary school after the genocide. Many of my classmates were living in orphanages, and many others did not have the money for school fees, food, uniforms or school supplies. I initially thought about becoming a priest. I was a good student, loved by many of my teachers. I passed primary school with distinction and continued to do well in secondary school where I studied mathematics, chemistry and biology. My good grades qualified me to enter the university.
My father was diagnosed with hypertension, an enlarged heart and gout. I began to think about a medical career instead of the priesthood. I applied to study nursing at the university. When I was accepted in 2011, I prayed and thanked the Lord. I was hoping that, by learning medicine, I could help my father and other family members. I knew that I would really become a nurse after I bought my stethoscope, blood pressure machine, pulse oximeter and thermometer. We began our nursing studies in November, 2011 with anatomy and physiology. I was really interested when we studied about the heart.
In nursing school, I met a new friend (classmate), also named Theophile. In level 3, he started to feel sick, with yellowish eyes, fatigue, loss of appetite and weight and a decreased ability to concentrate. He consulted with a Rwandan cardiologist, who referred him for evaluation by Team Heart in February, 2013. They diagnosed his heart problem and operated on him at King Faisel Hospital in Kigali. Before his surgery, I and my other classmates feared that we would lose him. We cried and thought, “Bye, bye, we will meet in Heaven one day.” However, he survived his surgery and was discharged after only one week in the hospital. That was my first contact with Team Heart. It made me realize that there are people we did not even know who had volunteered to save people in my country. I also began to appreciate that many people in Rwanda suffer from heart disease. I decided to volunteer in the heart surgery programs in Rwanda. In November, 2013, I worked with the team from Spokane, Washington. I continued my volunteer work as a nursing student with Team Heart from Boston in February, 2014, as a translator, as a nursing assistant in the post-surgical intensive care and step-down units and as a health educator for patients. I worked with Team Heart again in 2015 and 2016, the latter after my graduation from nursing school.
Team Heart has taught me how to diagnose heart problems, by both physical exam and echocardiography, and the members inspire me a lot. Team Heart operates on 16 patients each yearly trip. If they can build a heart hospital in Rwanda, they can save a larger number of patients who would otherwise die each year due to lack of resources or personal finances. Team Heart inspires me to become a provider of cardiac care. I deeply thank Team Heart for their good heart. May the Lord bless all of their members.
Editor’s note: Jo Jo has been a Rwandan volunteer for several years now with Team Heart and with the Spokane Heart Team, using his nursing knowledge, as well as his proficiency in English, to help us provide the best possible cardiac care for Rwandan patients with life-threatening heart disease. Like his classmate, Nishimwe Theophile, who was also one of our patients, he represents the future of Rwandan medicine. It has been Team Heart’s great pleasure to continue to work so closely with both of them.
In 2017, we are returning for our 10th consecutive year of surgeries and teaching.
More then 1000 people have volunteered with Team Heart over the years. Our all-volunteer team donates thousands of hours of their time to run this program.
Our skilled medical professionals have screened more then 5,000 individuals to check for heart disease.
Our surgical teams have performed more than 150 advanced cardiac surgery procedures in Rwanda.
1 out of 4
Team Heart volunteers have performed 1 out of 4 In-Country Heart Surgeries since 2008
Across the globe, Rheumatic Heart Disease takes the lives of 233,000 people every year. That is 638 preventable deaths per day.
15.6 million people are affected globally with heart disease from preventable infections.
5 – 15 Years Old
Those between the ages of 5 – 15 are the most at-risk population.
"I am thankful to Team Heart for saving my life and allow me to return to my studies energetically and it does me proud to be studying public health"
“I consider being a part of Team Heart to be the biggest achievement in my nursing career, and one of the best parts of my life!”
“After I returned from Rwanda, each time I passed my to do list, my pencil hovered to cross off Rwanda--I could not do it. Rwanda was not finished.”
"Rwanda can eradicate rheumatic heart disease in a generation-it is an achievable goal"