The Namibia National Children's Hearts Trust

Let’s talk Modus Operandi

The Namibia National Children's Hearts Trust plays a vital role in providing life-saving heart surgeries to children and adults in need, with a focus on congenital heart disease and other complex conditions. In partnership with the Ministry of Health and Social Services, the Trust operates surgical campaigns supported by volunteer healthcare professionals throughout the year, alongside a dedicated local team that ensures successful surgeries and long-term recovery. Despite their significant impact, the Trust faces a critical challenge: a shortage of skilled staff. Read on to learn how this organisation is navigating the complexities of pediatric heart care and what more needs to be done to expand its services.

The Namibia National Children Hearts Trust, in collaboration with the Ministry of Health and Social Services, hosts surgical campaigns throughout the year to aid in bringing services to patients in need. These surgical campaigns are composed of a local team and volunteers through Little Healing Hearts. However, the local team also operates on a weekly basis throughout the year.

Campaigns are aimed at mostly addressing complex patients. Visiting teams would not be able to work if the local team did not do the groundwork. This includes the preparation of patients and stock, as well as other logistics around a successful surgery. In 2024, we operated on 70 patients. This includes children with Congenital heart disease, adults and adult rheumatic fever under 18.

Only two patients were referred to Cape Town (an arterial switch) during this period, when we didn't have an additional skilled team. When the team from Little Healing Hearts was present, we successfully performed two arterial switches and a neonatal systemic to pulmonary shunt, a complex neonatal surgery. Human Capital is critical in navigating complexity.

It is crucial to note that despite the success and impact of surgical campaigns, the care to recovery, up until discharge, is done by the local team. This is a small team that is trained in CHD. The last campaign particularly had the most complex patients, and these doctors worked from Monday to Friday. No patient is discharged before then. We work with the volunteer team and continue after they leave. This is when the stretch is felt the most.

The 70 patients served in 2024’s surgical campaigns do not include adult-acquired disease under 18 years (for example, CABG and valvular surgery). These are counted separately.

However, we face a major challenge: a shortage of skilled staff. The current team – one anaesthetist, perfusionist, and cardiologist – can only do so much in a system with limited trained support staff.

It is far more sensible to talk about multi-institutional collaborations for capacity building than emphasising campaigns, which are a single factor in the equation. The 'twinning strategy' with experienced institutions is what has developed these services worldwide. They all learn from each other’s experiences. Most well-trained individuals went to different centres, especially overseas.

“Dealing with complex systems is tough. Many people don’t have experience dealing with those. They would not have trained us to handle such because they didn’t know it either – South Africa had a far more substantial base. But they tried to expose us to what they could. And indeed they should be respected because not every trainee who finishes training has managed to start anything. It is tough, especially in these African systems where the foundation and processes are flawed! Who ends up navigating all of these things to at least do something? It is us! That is not the case anywhere else, in non-emerging countries.” – Dr Shidhika, Paediatric Cardiologist

The socio-economic fabric is beyond the reach of our scope. It is time for the country to zoom in with a laser focus on this element. Health is holistic; it is social, emotional and not merely physical.

Dr. Shidhika and her team use an echocardiography machine for diagnostic purposes and post-operatively. This is one of the NNCHT’s recent purchases, made in collaboration with the MoHSS through donations from our generous donors.

BANK DETAILS FOR DONATIONS

First National Bank

The Namibia National Children’s Hearts Trust

Account Type: Enterprise Business Account

Account Number: 64285811608

Branch Code: 282273

Bank Windhoek

The Namibia National Children’s Hearts Trust

Account Number: 8030901495

Branch: Capricorn

Branch Code: 486-372