Every day of her young life, blood squeezed through a tiny hole in Deth's heart.
Over time it weakened the vessels in her lungs, robbing the two-year-old of breath.
The X-ray on the hospital wall shows the overworked muscle looming large like a hazy
white cloud.
In most developed countries routine surgery would give her a long, healthy life.
But the only prospect in Cambodia was diagnosis and an early death.
A visiting team of Swedish surgeons changed that. Assisted by Khmer doctors at the
Centre de Cardiologie de Phnom Penh (CCPP), they successfully patched Deth's heart.
Two days later the little girl went home.
Since the team arrived last month, they have operated on 29 patients, an average
of two a day. The life-saving operations, which cost the patients nothing, are part
of CCPP's drive to make heart surgery more accessible to the estimated 20,000 Cambodians
who need it.
The profound lack of medical care inspired the Swedish surgical team to come to Cambodia.
The trip was a long-held dream of Kerstin Hansen, 60, an operating room nurse who
first glimpsed the country from Thai border camps in 1990.
She recalls listening to gunfire during operations and using banana leaves to sterilize
surgical instruments. After work, outside the Red Cross field hospital, she would
listen to the yearning of Cambodians to return home, dreams she grew to share as
well.
"I followed them back," said Hansen. "Even though they are poor, they
are rich in their hearts because they are home. The worst thing that can happen is
not to go back where you are from."
After reading a Phnom Penh Post article about CCPP in 2001, Hansen recruited friends
for a relief trip. At first, she said, only silence greeted her on the other end
of the phone.
"They probably didn't think it would happen," said Hansen. "But it
did happen. And I think it might happen again."
The five-person team - a pediatric heart surgeon, an operating nurse, a perfusionist
and two anesthesiologists - are already talking about returning next year. There
are looking at ways of sending equipment from Sweden to replace functioning but aging
machinery at the Center.
"Some people would call this a luxury," said Carl Dufke, a perfusionist
with the group. "But in the long run, these kids would eventually die. From
that view, this is not a luxury."
CCPP's two bustling operating rooms handled 444 heart operations last year. At least
600 are expected this year. The operations currently hinge on the charity of western
physicians, mainly French, who donate time and expertise. But a new generation of
Khmer surgeons envision a day when they can operate, and teach medicine, on their
own.
Dr Mam Bun Socheat, 31, a French-trained surgeon who performed Deth's operation,
is specializing in cardiology in Phnom Penh. He plans to be the first certified Khmer
heart surgeon at the center within four years.
"What we need most is instruments and more knowledge," said Dr Mam. "I
hope that we can perform heart operations [independently] in the future."
The cardiology center is also exporting its operations beyond Cambodia. Its sister
institute in Vietnam, the Saigon Institute of the Heart, has already treated 12,000
patients over the past 11 years.
Sponsors of the French-managed hospitals hope next year to have affordable medical
facilities, based on the Phnom Penh clinic, in Cameroon and the former Soviet republic
of Georgia.
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