- The foundation is registered in the State of Maryland and has obtained tax-exempt status under section 501(c) (3) from US Internal Revenue Service as a Public Charity, Section 170 (b) (1) (A) (vi), document locator number – DLN 17053043306005 effective May 15, 2014. Tax I.D. 45-2856374.
- We are registered with the Ministry of Health of the Republic of Rwanda, fulfilling the requirements to operate legally as an International Non-Governmental Organization.
The Adele Heart Project has been actively underway in Rwanda since March 2015. Dr. Gakuba and Odette have already secured permanent residency in Kigali to better manage the day to day affairs of The Foundation.
The Foundation has found a temporary clinical operating space in Kigali, Rwanda, where volunteer medical staff provides clinical care to patients and are establishing a local presence.
Chris and Odette continue to reach out to visiting medical staff, such as Team Heart from Boston, to offer services through the Foundation as well as to the hospitals to which they already serve. The Foundation believes visiting professorships and clinicians are the best way to develop local competence in all required technical fields.
The Texas Heart Institute Journal in November 2008, published an article entitled: “The Development of Cardiac Surgery in an Emerging Country: A Complete Project”, by Vladimir Valebit and Others. (Volume 35, Number 3, 2008)
“The training of foreign residents in developed countries is not easy….Furthermore, if and when trainees return to their own countries, initiation of a program is difficult, because no infrastructure and no team ready… The alternative is transmitting knowledge within a developing country itself by making regular and frequent visits to a selected center and performing surgery with the local specialists. This alternative manner of training has the further advantage of giving immediate high quality care to the local population…this is the method we have used since 1998 and would like to describe.”
They go on to describe their experience in Tbilisi, Georgia (former Soviet Republic), Algiers, Algeria, Sarajevo, Bosnia and Herzegovina, and Skopje, Macedonia. A second article in the same issue of the Journal described the challenges and experience of starting a Cardiac Surgery program in Nigeria.
With great excitement, we see ourselves in this same starting position, and look forward to the future. We are ready for the challenge.
Addressing the problem of improving cardiac care in Rwanda, there are 4 issues to consider:
This problem will require time to resolve. The Medical Schools in Rwanda are training more and more Generalists but not many subspecialists, such as cardiologists. In the US subspecialty training requires 4 years of college, 4 years of medical school, 3 years of general medicine residency, 2-3 years of general cardiology and for those participating in cardiac catheterization and for performance of angioplasty and stenting, another year or 2. In Rwanda we could shorten the time required, as in Europe, without sacrificing the quality, combining general college studies into a medical education in a 6 year program, or even less if classic college studies are abbreviated. Then combining general medicine with general cardiology over 4 years finally adding 1 year of cath training, perhaps out of country. This would shorten the process by 5 years, but still a very long time line. A similar accelerated course of action can be adopted for Cardiac Surgery: 2 years of General Surgery, followed by 2 years of Cardiac Surgery. The Adele Heart Center would play a central role in this educational experience through visiting professorships.
Our trainees would rotate through local hospitals, interact with visiting staff, attend locally and regionally organized conferences, and be given the opportunity to attend international conferences such as offered by American College of Cardiology, European Cardiology or Thoracic meetings.
We will set up curricula to train technicians in the field of Echocardiography, Nuclear Cardiology and other imaging modalities. In the US this education is carried out by Community Colleges, or hospital based accredited educational programs.
B) OPERATING FACILITY
The Adele Heart Center is a 3 phase plan of construction and services.
The first phase will be a 10,000 sq ft facility including clinics for outpatients, diagnostic area with echo and stress testing (not nuclear yet), business area, conference and teaching rooms. Additional unused build out will be sufficient to add programs planned Phase II.
Phase II : will be to set up nuclear cardiac scanning and a combined cardiac catheterization and heart Rhythm study laboratory with and overnight stay area.
Phase III : will be a major expansion for a Regional Learning Center
Preliminary discussions, concerning a conceptual design, were carried out with the Baltimore Firm of Hord/Coplan/Macht.
At the outset, we would like to open the facility with clinical areas for out-patient diagnosis and treatment, providing echocardiography, X-ray and fluoroscopy, heart rhythm ambulatory monitoring, exercise stress testing and routine EKG. Conference rooms and teaching facilities will be a large part of our mission and will be included in the first phase of construction.
On our wish list for a modern cardiac diagnostic facility, we consider nuclear cardiac diagnostic capability, a hybrid catheterization laboratory and the ability to study heart rhythm disorders to be indispensable to our mission of complete cardiac care at the local level. Once our training program has matured, we hope to provide cardiac surgery at our facility as well. One day, we may even be able take emergency cardiac cases directly into an intensive care area, a post-surgical intensive care unit. The Center will contain an administrative section, a library, a lounge for Physicians and a separate lounge for Nurses and Technicians.
We plan a limited number of in-patient regular beds and a limited number of private beds for acute care patients. Our concept is not of a full – fledged hospital but of specialized Center where we could take care of cardiac patients with special needs. Our colleagues in the field of Pediatric Cardiology are invited to share the facility and join us in our mission.
We are now starting our financing initiative, the United States, Europe and Rwanda. This is obviously a multi-million dollar effort, but we feel achievable through tax exempt contributions from individuals, family foundations, civic organizations, church sponsorships through mission giving, governmental agencies and organizations whose mission may be to improve the health care of Rwanda and possibly the region.
Once the Center is operational with out-patient diagnosis and treatment and a full calendar of conferences and teaching curricula, the challenge will be to keep it running .We envisage inviting and sustaining visiting voluntary teaching staff from the US, Europe and Nairobi. We already have low cost, high quality lodging, meals and ground transportation arranged. The Rwandan staff, physicians, nurses and technicians will be receiving salary supported by insurance and private pay generated from clinical services of the Foundation. The quality and novelty of this new level of care certainly will draw from those with insurance and those willing a able to pay personally for services.
For supplies, we plan to solicit US and European hospitals and corporations to donate unused or unneeded material .Using this approach we have already obtained 15 heart monitors from Sinai Hospital in Baltimore, and many cardiac catheters and guide wires from two other facilities.
We plan to market our services and our Center to the neighboring countries which form the East African Community, and to East Congo. Those countries have a combined market size of close to one hundred million inhabitants. Currently Rwandans who need advanced cardiac care are sent to India or South Africa. Even routine cardiac care travels to Nairobi. If we are successful, we are confident that the Rwandan Government and the national health insurance companies will be happy to use our services.
In addition, we plan to carry on teaching activities which also will generate funds which we can use to support the Heart Center.