When Bill Gronke left the Dominican Republic last year, one of his
patients was a 12-year-old boy whose heart had been so bad the boy
needed a wheelchair to get around.
But even “before we left, I showed the boy his face in a mirror,’’
said Gronke. American surgeons repaired the boy’s heart on that visit
and immediately “his lips were normal-colored, instead of purple.’’
This year, the same boy ran up to Gronke, shouting “Amigo, amigo.’’
He had recovered completely.
“I started to cry,’’ said Gronke, a respiratory therapist at Danbury
Hospital. “He had the gift of life given back to him.’’
Those are the types of cures that keep Gronke, 46, of Brewster, N.Y.,
and his colleague at the hospital, Dave Kreiger, returning to
poverty-stricken sections of the world for a couple weeks a year.
The two are volunteers for Heart Care International, a
Greenwich-based group that recruits doctors, nurses, anesthesiologists
and respiratory therapists to go to places like Guatemala and the
Dominican Republic and do open-heart surgery on children with severe
heart defects. The volunteers use their vacation time to make the trips.
“It’s completely pediatric — no adults,’’ said Kreiger, 42, of New
Fairfield.
This winter, the group was in Santo Domingo, the capital of the
Dominican Republic, from Jan. 29 to Feb. 10. They set up operations in
the Plaza de la Salud Hospital, and over eight days they operated on 54
children, repairing congenital heart defects.
Volunteers worked side by side with doctors and nurses from the
region so that the local staff can eventually do the work themselves.
That allows Heart Care volunteers to turn their attentions to another
country in need.
After spending four years working in Guatemala, Heart Care decided
the medical staff there could do the pediatric surgery themselves.
That’s when they turned their attentions to the Dominican Republic.
“Our goal is not to be needed,’’ Gronke said. “The staffs at these
hospitals are very willing to learn.’’
Gronke joined the Heart Care mission in 1996, at the urging of Alan
Roth of New Milford, the director of anesthesiology at Mount Sinai
Hospital in New York. Kreiger joined a year later, when a respiratory
therapist had to quit the mission unexpectedly. Kreiger, with a valid
passport in hand, quickly signed up.
“As the need for more care grew, they needed more respiratory
therapists,’’ Gronke said.
Before each mission, Heart Care sends a team to each country to
screen patients, choosing those who most urgently need care. This year,
Gronke said, the team looked at about 200 patients and accepted 63 for
treatment. Some traveled long distances on the poor roads of the country
to get to the hospital.
“They’re some of the best behaved kids you’ll ever see,’’ Kreiger
said.
The hospital provides the space, but Heart Care International
provides all the equipment. The U.S, Surgical Corp. has been a generous
donor to the organization. Each trip costs about $200,000.
Kreiger and Gronke said the volunteers usually arrive to find the
hospital hallways filled with boxes of medical supplies. The first day
on the job is set-up day.
“Typically, they give us an empty room with a table in it,’’ Kreiger
said. “The hospital in Santo Domingo is a very good, modern hospital.
They just are unequipped for pediatric cardiac cases.’’
In the United States, children with heart defects usually have them
repaired in infancy. In poor countries, children with bad valves or
holes in their hearts often grow into adolescence without being helped.
“The assumption used to be that children were just small adults,’’
Kreiger said. “But they have a different physiology.’’
“In adults, almost all the open-heart surgery is bypass surgery,’’
said Dr. Paul Woolf, a pediatric cardiologist at New York Medical
College in Valhalla, N.Y., who provides pediatric cardiac services to
Danbury Hospital. “Children never need that. The nature of the operation
is very different because, with children, it usually involves repairing
structural defects. Sometimes doctors have to add tissue to the heart to
strengthen it.’’
Woolf said children who grow up with heart defects also can grow up
with medical complications that make the surgery more difficult. They
may have very low oxygen levels in their blood, because blood isn’t
circulating properly to their lungs. Over time, low oxygen levels can
damage the kidneys, lungs, heart and brain.
The heart defect can also elevate blood pressure in the lungs and
further damage them. It may also stress the chambers of the heart to the
point where they don’t always recover.
“Plus, after open heart surgery, the heart doesn’t get to rest,’’ he
said. “It has to start working immediately.’’
After the surgeons and anesthesiologists finish their job, Gronke and
Kreiger work with the patient both in the recovery room and intensive
care. They supervise the use of ventilators patients may need to help
them breathe, and give them physical therapy to help them start
breathing normally. They also are in charge of all the oxygen tubes and
tanks, and compressors and any other equipment that helps people recover
lung capacity.
On the Heart Care missions, they often must work with equipment they
haven’t used before, usually with instructions written in Spanish.
If they’re missing some equipment, they have to improvise. On one
occasion, the entire mission had to shut down until more oxygen arrived
from Puerto Rico.
But the intense work schedule also results in a deep sense of
comradeship, Kreiger said. There the chance to talk to colleagues from
other parts of the country and get new perspective on their work.
There’s also the unexpected opportunity to meet baseball stars like
Pedro Martinez and Sammy Sosa. Both are Dominicans who visited the
hospital while the volunteers were there.
And, there’s the chance to revisit last year’s patients.
“We go because of the kids,’’ Gronke said. “They wouldn’t have a
chance for survival unless they get this help. And when you go back, and
see them so normal, the gratification is unbelievable.’’
Heart Care International’s office is located at 139 East Putnam Ave.,
Greenwich, Ct. 06830, For more information about Heart Care
International, you can call 1-203-552-5343, or visit the group’s website
at www.heartcareintl.org
Contact Robert Miller
at bmiller@newstimes.com
or at (203) 731-3345.
