Lumbidzani Dima, Chronicle Reporter
MPILO Central Hospital’s paediatric cardiologist Dr Davidzo Muringo-Shumba agonises over breaking bad news to parents of children with heart ailments, and one of the worst cases was that of a child whose heart had many holes.
Dr Muringo-Shumba, one of only two paediatric cardiologists in Zimbabwe who also trains National University of Science and Technology medical students, said telling the child’s parents that there was nothing she could do was “very depressing”.
A Chronicle news crew caught up with Dr Muringa-Shumba yesterday, February 14 (Valentine’s Day), a day when the world commemorates International Congenital Heart Defect Day (Sweetheart Day).
“One of the most critical cases I have come across despite all of them being critical, was that of a patient who had many holes in the heart causing the blood to mix and allowing it to flow into the lungs. For that child it was emotionally draining for the parents and myself as well because that condition needs the earliest diagnosis.
Telling the parents was very depressing and difficult. As a doctor I want to help the patients recover, so if I know that it can be treated if attended to earlier, but I can’t offer those services it’s really depressing,” she said.
Dr Muringo-Shumba completed her training in paediatric cardiology in July last year in South Africa and came to Mpilo in September.
“The cardiology department was functional before, because the patients with cardiac conditions were being seen and there were cardiology services that were being offered. So my coming here is to help establish the department more in terms of diagnosing more patients with cardiac conditions and my main plan is to be able to do something about cardiac conditions because at the moment we are able to diagnose them, but we are not able to do any interventions.
At the end of the day, the parents have to find some help outside the country in South Africa and India.
So, the plan is to establish those services so that the patients can be helped locally which is more affordable and more comfortable.
“Since I came, there have only been two patients who have managed to go to India and had a successful operation. Some are still trying to get assistance, and it’s really painful that if they don’t raise funding they will lose their children,” said Dr Muringo-Shumba.
She said the only way to preserve the lives of children with congenital heart diseases is to build a cardiac theatre in the country, as its absence is leading to the death of many after failing to raise funds for surgery in other countries.
“We do not have a cardiac theatre at the moment; a special kind of theatre for cardiac patients. We also need the personnel to be able to function in that theatre. There are two ways in which cardiac conditions can be managed, there is an open-heart surgery where they open the chest and there is minimal invasive surgery in which we deal with the blood vessels. Once those two main services are established, everything is going to be better,” said Dr Muringo-Shumba.
“The infrastructure needs to be in place, maybe a theatre can be built for the open-heart surgery, a called a cardiac catheterisation theatre. In terms of the infrastructure, we need a permanent one, and consumables used by patients.”
She said currently, she is one of the two paediatric cardiologists in the country, hence they need more personnel in the field, cardiac technologies and cardiac trained nurses.
A ward at Mpilo Central Hospital that has been specially designed for congenital heart disease patients is not yet functional due to lack of some equipment.
“We are still waiting for some equipment in the special unit created for the patients, therefore for now we admit them with others in the available wards or ICU ward because when these patients need admission, they are usually critical, needing close monitoring,” said Dr Muringo-Shumba.
She said on average they attend to 40 patients a month although it depends on the referral and the needs. Admissions vary from five to 10 patients a month, depending on the season. More patients are admitted during flu season because they are prone to pneumonia.
“To those needing surgery, we offer medication just to support the child to be more comfortable while they are waiting for surgery. It will help them in breathing processes and all, it’s just supporting it does not cure, because they need the surgery to correct whatever defect they have in their heart.
As time progresses some of them become inoperable because of the damage caused by the defect and if they get to that stage unfortunately nothing can be done for them,” said Dr Muringo-Shumba.
She said children with trisomy 21 (Down’s syndrome) are prone to congenital heart diseases, so half of them have some form of heart defect and the severity varies. Every child with Down’s syndrome has to be assessed to check for heart defects.
According to Dr Muringo-Shumba, the survival of congenital heart disease patients depends on the defect, but they need urgent treatment. For some conditions patients might live longer, but they won’t live a normal life as compared to when they get surgery earlier.
Dr Muringo-Shumba said they are in the process of compiling a database showing the seriousness of the disease so that authorities can help.
“We are in the process of making a database, with our main aim being to show the burden of this disease. It will be easier when we are presenting our case to the authorities when we have the statistics. We need more people to be referred to us because we feel the numbers that we are seeing are not a true representative of the disease,” she said.
Dr Sameh Geress, who conducts echocardiogram (echo) scans at Mpilo Central Hospital, said they charge US$160 for the scan that helps in detecting the congenital heart defects.
He said congenital heart disease can also develop in adults, leading to heart failure.
A number of parents whose children have congenital heart diseases expressed challenges they are facing as they wait for a day when they will get donors to help with funds for their children’s surgeries out of the country, mostly in India and South Africa.
Ms Ana Banda (37) from Nkulumane said when she gave birth to her three-year-old daughter she noticed that she had a bluish colour on the tongue, but when she asked around, they told her that it was normal in babies.
“At eight months she underwent an echo scan, and we found out that she has heart disease. There is an opening on one side of the heart and the other side is closed, leading to the clean and dirty blood to mix up, therefore leading to that bluish colour I saw at first.
Once I see that blue colour, I panic, the only thing that I do is practice what I was taught just to make sure her breathing restarts,” she said.
Ms Banda said she has to take the child to India, but has not yet raised the required US$15 000.
Ms Saliwe Mhlanga from Mahatshula said she was told after giving birth that her child has a heart problem, while Ms Paulina Masuku said the most traumatising stage she passed through was when a nurse shouted that her baby has Down’s syndrome soon after she delivered.
“The way she said it was not polite. I feel like they need to be taught how to deliver such news because they will kill us. For a moment, I got confused on what Down’s syndrome is because of the trauma.
Six weeks later I went to Mpilo, the only institution with an echo machine in the Southern region, where I was told that the child has a 5mm hole in the heart but it might close on its own. I went back for an echo when she turned one and they said it’s 4,25 mm, and last year they said the hole is now smaller which is great,” she said.
Ms Violet Mabhena (22) said she is very cautious with her child who is need of regular hospital care, as her weight is 6,8kg, the weight of a 4-month-old when she is two years old. Her baby has a big hole in the heart and has to undergo open heart surgery in India.
“Sometimes I wake up at night just to check if she is still alive,” she said.
Article Source: The Chronicle