July 6, 1999
WE CARE Have a heart Every year about 5,000 children are born with heart defects. Without corrective surgery they will die prematurely or become handicapped. The Paediatric Cardiac Surgery Foundation is striving to give them a new lease of life KARNJARIYA SUKRUNG One of the Foundation's young patients is cared for by his mum in the day after undergoing heart surgery. In time the operation should give him a new lease of life. To run and play is in every child's nature. But until this year nine-year-old Pakphum Suebsamran dare not-for if he had tried he may have died. Born with a problem with his aortic valve, Pakphum's fragile heart had kept him sickly since birth. He became exhausted by simply breathing and his chest hurt even when he sat still. He said: "It was painful to watch my friends running around and enjoying themselves while I had to sit and watch."The boy's illness demanded around-the-clock care. His mum, Ratchanee Seenamuang, 30 said: "I couldn't even let him cry as he would turn blue from the effort. I had to watch him all the time. "When he had the flu, it was much more serious than for other children. He had a very high fever. He quivered and his hands and feet turned blue. He had to have an injection four times a day for three months to cure it."A heart operation was the only way to help Pakphum, but it seemed too far-fetched an idea for Mrs Ratchanee who could not afford it. But then, thanks to a free heart operation offered by the Paediatric Cardiac Surgery Foundation at Ratchawithi Hospital, Pakphum and his mum's nightmares ended. Pakphum's doctor said, had the boy not had the operation, he probably would not be alive today. Now he enjoys the life he was denied for so long, and has become an athlete in school. He said: "I always wanted to run races or play in football matches in school. Now I can."Pakphum is not alone. There are many happy stories of lucky ones who have undergone a heart operation. There are many other children with heart defects, however, who aren't so lucky. And the only thing that really stands between them and good health is money for an operation. "Every year, approximately eight out of 1,000 newborns in Thailand will have heart defects," said Dr Pirapat Mokarapong of the Paediatric Cardiac Surgery Foundation. "This means for the population of 60 million, there will be about 5,000 babies born with cardiac anomalies every year. Unfortunately, only 1,000 young patients will be lucky enough to have a heart operation in a year. The rest must suffer."Dr Pirapat said the complicated heart surgery requires a team of specialists, special medical equipment and intensive care that only a handful of public hospitals can provide-and nationwide, public hospitals can only handle 1,000 cases annually. Last year, Ratchawithi Hospital alone operated on 400 children-only half of those on the waiting list. "Since the queue is so long, children have to wait up to two years to be called for surgery," Dr Pirapat said. "And since about 95 percent of the children are from poor families in the provinces, they cannot afford the high medical treatment in private hospitals. They have no alternative but to wait for their turn, no matter how long.""Sadly, sometimes, we call up a child's case for surgery only to find the child has died," he said. "Some youngsters become handicapped and some develop conditions so severe that even advanced surgery cannot correct it."Dr Pirapat said there are basically two types of heart defects in children, and the conditions are commonly known as blue baby and flooded lung. With blue babies, as its name suggests, the child appears blue. This is due to a lack of oxygen in the blood due to a defect of the heart or blood vessels. Youngsters with severe conditions are very vulnerable and can die soon after birth. For those who survive this lack of blood to the brain may result in disability, paralysis or muteness. Children with flooded lungs have too much blood pumped into the lungs. Apart from impeding growth and exhausting the patient, it also leaves the child particularly susceptible to pneumonia. In these children, the heart loses its elasticity and becomes increasingly stiff and rigid until eventually it reaches a stage which even surgery cannot correct. Dr Pirapat says many Thai children suffer this condition. "Children born with these heart defects will not live long unless they have corrective surgery-and before they are 15 years, otherwise it is too late."The younger the child, the better the chance of a successful operation and living a normal life, said the doctor. Some 97 percent of such operations are successful and more than 90 percent of children are feeling healthier three days after their operation. But for teenagers the operation is more complicated and risky as the condition is likely to be more severe. Like Pakphum, most children with heart defects live restricted, inactive lives. Many cannot go to school because walking up the stairs and playing with friends puts their lives at risk. "Many children would not die or suffer aggravated conditions if they had an operation sooner," said Dr Pirapat. Seeing so many children die prematurely simply because of long waiting lists prompted the Institute of Cardiovascular Disease at Ratchawithi Hospital to found the Paediatric Cardiac Surgery Foundation in an effort to provide more free operations. Over the last two years, the Foundation has given the gift of life to more than 211 children and its charities have shortened the surgery waiting list from one to two years to between six and eight months. Their young patients get a free operation and care until their hearts are healthy. On average, the operation costs between 60,000 and 120,000 baht for each child, depending on the actual problem and complications which may arise. These high fees are absorbed by the hospital and the Ministry of Public Health. A public donation of just 10,000 baht, for example, can help speed up operations for one or two children. The donations help pay for the cost of extra-time operations on weekends, cardiac care unit costs and overtime for nurses and other medical staff. The surgeons, however, work for free. The team of five surgeons: Dr Pirapat plus Dr Wiwat Warinsirikul, Dr Surapot Saengchote, Dr Sawat Asavapiyanond and Dr Tawan Jitjuranon perform at least one heart operation for their child patients every day. Public donations to the foundation also pay for transport and accommodation for children and their families from the provinces. To celebrate His Majesty the King's Sixth Cycle Birthday, the Institute of Cardiovascular Disease has organised a special programme aiming to do 72 extra free heart operations for children-and if possible more. Despite the medical team's dedication, there remain many children who need help. "We are so happy to see Pakphum and other children who have had an operation now living a healthy, happy, active life. It is not only their hearts that are saved, it is their parents' hearts too. "We all hope we will one day be able to help all these sick youngsters, without keeping them on a waiting list so they too can life a normal life," said Dr Pirapat. We Care is a weekly series honouring people who believe in giving. Apart from supporting these causes, you can also let us know about people who unselfishly help others so we can make more people aware of their efforts. Fax We Care on 240-3668 or call 240-3700 ext 3208 or 3212. For a comprehensive list of charities covered by Outlook's "We Care" weekly series, see the Bangkok Post Web site at http://www.bangkokpost.net/outlookwecare. Info for donations Name: Paediatric Cardiac Surgery Foundation. Founder: The late Thanpuying Suprapada Kasemsan and the Institute of Cardiovascular Disease, Ratchawithi Hospital. Contact person: Dr Pirapat Mokarapong. Address: Institute of Cardiovascular Disease, Ratchawithi Hospital, Ratchawithi Road, Ratchathewi, Bangkok 10400. Tel/fax: 247-1027-8. Savings Bank Accounts of "Paediatric Cardiac Surgery Foundation". - Siam Commercial Bank, Ratchawithi Hospital branch, account number: 051-2-327859. - Bangkok Bank, Victory Monument branch, account number 210-027534-2. - Thai Farmers' Bank, Sanam Pao branch, account number 029-2-44000-6. Or send a money order to PO Box Ratchawithi Hospital, Paediatric Cardiac Surgery Foundation, the Institute of Cardiovascular Disease, Ratchawithi Hospital, Ratchathewi, Bangkok 10400. Whether you send a bank transfer or money order, please include your name and address and the amount of the donation, so the foundation can issue a receipt and inform you of the child who has benefited from your cash. Or send your cheque payable to Post Publishing Public Company Limited (For Free Cardiac Surgery) to Kusuma Mintakhin, Editorial Manager, 136 Na Ranong Road, off Sunthorn Kosa, Klong Toey, Bangkok 10110. Telephone: 240-3700 ext 3224-5. Please include your name and address so we can send you a receipt.		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