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Making a difference in less-developed countries

EHRA congress news

Yesterday, we were enthralled by the Einthoven Lectures, which were given by Doctor Carsten Israel and Doctor Marc Zimmermann, who described their very important humanitarian work in countries not able to provide the high standard of treatment and care available elsewhere.

Arrhythmias and Device Therapy

Dr. Carsten Israel

Dr. Carsten Israel is the Chief Physician for Internal Medicine, Cardiology at the Bethel-Clinic, Bielefeld, Germany, but he travels at least once a year to Kenyatta National Hospital in Nairobi, Kenya to work with the East African Heart Rhythm Project. He explains, “When I first visited sub-Saharan Africa, I noticed there were many patients with bradycardic heart failure, at a level not seen in Europe, and this was due to the unavailability of pacemakers. In Kenya, pacemakers cost around 20 times the average annual wage and are unaffordable for the vast majority of people who need them.”

Since 2006, Dr. Israel and a team of German doctors and nurses have generously volunteered their time and have implanted pacemakers in more than 300 Kenyan patients. Their work is supported by charitable funding and donations from companies who provide the devices and the surgical equipment needed.

Dr. Israel points out, “Friends often say that whenever they see photographs of our work in Kenya, we always look very happy like we don’t look in Europe. In Africa, the patients suffer and get weaker over time, they know they are going to die, but they do not know what can be done. We have two Kenyan doctors, working with the Kenyan Cardiac Society, who identify the patients and refer them to our visits. These patients often travel over rough conditions and long distances from all over Kenya. After they have received their pacemakers, their condition dramatically improves, and they are so appreciative of our help. It is an emotionally powerful experience, and that is why my colleagues and I are at least as happy as the people that we help.”

“I would love to see this project as a model, which can inspire others to do similar work. Many people are surprisingly willing to donate, and the project could be widened quite easily to show how the developed world can help the not-so- developed world.”

zimmerman-marc-2019.jpgAround 3 years ago, Doctor Marc Zimmermann retired from his position as Head of Clinical Electrophysiology at the Hôpital de la Tour, Meyrin, Switzerland, but he certainly did not retire from electrophysiology.

Dr.  Zimmermann has been working with the Fondation Frédéric et Jean Maurice and the Coeur de la Tour Foundation on a range of humanitarian projects in less-developed countries.

Dr. Zimmermann’s first project involved teaching aspects of electrophysiology (ECG interpretation, technical skills, education on guidelines, etc.) at Central Hospital in Yaoundé, Cameroon. He still returns there every 2 years to give intensive training courses and attend the national congress, but his humanitarian work now focusses on an electrophysiology programme at Open Heart Clinic in Tbilisi, Georgia. Almost 4 years ago, Dr. Zimmermann initially evaluated the site set-up and the local needs. Since then, he has been visiting the clinic every 3-4 months, providing onsite ECG teaching and consultation on arrhythmias.

Dr. Zimmermann has been training a young local cardiologist in theoretical and technical knowledge, with the hope that the young cardiologist will soon be able to carry out radiofrequency catheter ablations himself.

“Humanitarian in this context means to help develop something that is normally unavailable,” explains Dr. Zimmermann. “The work is not without its challenges, for example, ensuring hygienic conditions and fighting against the tough problem of corruption, but trying to decrease the gap between the two worlds is very rewarding.” Regarding setting up new humanitarian projects, he emphasises, “Projects should aim to be continuous in time to be efficient. ‘One-shot’ initiatives are interesting, but they do not have a future—we should build long-term programmes that involve an initial memorandum of understanding between the charitable foundation, the volunteers and hospital, which outlines expectations, roles and responsibilities.”

“Programmes in less- developed countries need to be adapted to best suit what is needed and what we can give to them.”

Dr. Zimmermann concludes, “In Europe, we would normally spend time at a large training hospital to learn complicated techniques, but this is just not possible in many parts of the world. In our training initiatives, such as those we have developed in Cameroon and Georgia, we try to transmit as much scientific knowledge and technical skills as efficiently as we can for the greatest benefit.”