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Carl J. Pepine, MD, MACC, Professor and Chief, Division of Cardiovascular Medicine, University of Florida College of Medicine, Box 100277, 1600 Archer Road, Gainesville, Florida 32610-0277, USA.
The mission statement of the American College of Cardiology (ACC) makes no reference to geography or nationality relative to supporting patient care, nor does it discriminate with regard to a patient's class, race, religion, origin, or ability to pay. On the contrary, our College's mission is a simple statement of responsibility—as old as medicine itself. It imposes no restrictions or limits on advocating for quality cardiovascular care, and neither do many of our members. As evidence, I cite just a few examples of the benevolent spirit of some ACC members, as well as the passion and creativity they bring to the delivery of cardiovascular care. I hope these stories inspire you as they have inspired me.
Pacemakers as peacemakers
Twenty years ago, Federico Alfaro, MD, a Guatemalan cardiologist, told his mentor about economically needy patients who were dying because they could not afford a pacemaker. Soon after, a handful of unwanted pacemakers found their way to Dr. Alfaro's mentor, who was known for both his brilliant mind and his generous heart. In short order, those pacemakers—as well as the thousands more that followed—were sent to developing countries throughout the world. Far from the homes of their benefactors, these devices saved the lives of local men and women who most likely would have died without them. To date, more than 6,000 patients have received a second chance at life through these donations, along with the opportunity to raise their children, participate in their communities, and perhaps make a difference in the lives of their countries.
The cardiologist who transformed this rather small donation of medical devices into a chain of benevolent works was Henry D. McIntosh, MD, MACC, a former ACC President and founder of Heartbeat International (HBI). Today, Dr. McIntosh's vision lives on in the ongoing and expanding work of HBI, which has established pacemaker banks in 28 developing nations and has contributed more than $16 million in pacemakers and other medical equipment.
Dr. McIntosh believed that a small cardiac device could improve the quality of life for people living where cardiology simply does not exist as a flourishing medical specialty and does not represent an accessible health care option. A host of dedicated volunteers—many of them ACC members—are still making that vision thrive. HBI, working in close collaboration with Rotary Clubs throughout the world, makes certain that only economically needy patients receive the pacemakers. HBI also offers educational workshops and symposia, and its board is considering expanding its work beyond pacemakers to other cardiovascular devices, such as mechanical valves and implantable cardioverter-defibrillators.
A large part of HBI's success has been its bare-bones approach. It is astonishing that an organization with such great outreach manages to put more than 95 cents of every dollar received toward its mission. The commitment of its volunteers, donors, and Rotary Club sponsors makes this possible. ACC members and other readers of the Journalinterested in participating in this charitable and medically meaningful activity can also contribute to Dr. McIntosh's vision.
Indeed, there are many ways to help. The College, as an institution, donates ACCELaudiotapes and CDs to HBI, which in turn sends these educational tools to health care providers who cannot afford subscriptions. If you live and practice outside the U.S., there is a good chance that there is a pacemaker bank near you. Your skills and service would be welcome. If you enjoy teaching, HBI might be able to put you to work lecturing at a symposium or proctoring implant procedures. If you are a Rotarian, you could encourage your club to sponsor a pacemaker bank, or you could make a financial donation toward HBI's mission—HBI recently began acknowledging donors of $1,000 or more as Henry D. McIntosh Fellows.
Through his personal vision and a caring heart, Dr. McIntosh has touched the lives of many people, patients, and physicians. It would be an honor to be linked in fellowship with his vision. For more information on HBI and how you can participate, visit http://heartbeatintl.orgor e-mail firstname.lastname@example.org.
Education far from home
Benevolence takes many forms, exists on all scales, and springs up in unlikely places. Take Milwaukee, for example. A group of cardiologists practicing in Uzbekistan, Moscow, and the Republic of Georgia will forever recall Milwaukee as a city of hospitality and generosity and as the place that provided them with a unique experience in medical education.
A small nonprofit organization known as the Foundation for International Medical Exchange (FIMEX) was established by a few cardiologists—Valeri Chekanov, MD, FACC; Masoud Mirhoseini, MD, FACC; Teimuraz Gurchumelidze, MD; and a current Board of Trustees member, L. Samuel Wann, MD, FACC—less than a decade ago to promote collegiality in the cardiovascular world. The Foundation achieves its goal, a few cardiologists at a time, when half a dozen doctors (many of them fellows-in-training) and an occasional nurse come to the U.S. every few months to participate in the FIMEX exchange program. The visiting cardiology specialists are welcomed by the cardiologists, administrators, and staff at St. Luke's Medical Center in Milwaukee and the Children's Hospital of Wisconsin. They stay for four weeks, enjoying modest accommodations provided by the hospital, exploring the city by bus, and accompanying hospital staff to the cath lab and operating room. While these visiting health care professionals do not perform any procedures, they do get a crash course in solid, day-to-day cardiac care as it is performed in the U.S. And they, like their hosts, often come away with a profound respect for the fact that our problems, challenges, and triumphs are largely the same, regardless of where we practice.
FIMEX symbolizes grassroots benevolence in the truest sense of the words. The organization's headquarters is on a laptop; its bankroll is a checkbook they try never to use. Occasionally, FIMEX leaders recruit their spouses to help throw a fundraiser; the money raised will perhaps be used to bring sick children to the U.S. for surgery unavailable at home. Mostly, everyone pitches in to make their international counterparts feel at home and to help them create a memorable, if not indelible, stay. Although no one from FIMEX expects anything in return, many say they get something back anyway—the reward that comes of unselfish giving, the honor that accompanies the sharing of knowledge, and the pleasure that comes from seeing yourself through the eyes of a visitor eager to soak up new, useful experiences.
For more information on FIMEX or to make a contribution, visit http://www.fimex.org, or e-mail .
Building a hospital and a source of hope
In the next few years, the people of Bangladesh will have good reason to be optimistic about their options for domestic health care. Those who need but cannot afford costly heart operations will have somewhere to turn, and those who would have traveled to other countries for cardiac care will be able to find it at home. These are big changes for Bangladeshis, for whom standard care for an acute myocardial infarction remains treatment with oxygen and a space on the cement floor of the existing hospital.
Change is coming to Bangladesh, however, in the form of a new heart hospital. Although still in the planning stages, this hospital will be built upon the generosity of a grateful heart patient, guided by former ACC International Committee Chair, Robert Jones, MD, FACC, and rooted in the concepts of evidence-based care delivered at low cost. The hospital's primary benefactor is a Bangladeshi who once received extensive cardiovascular care in the U.S. from Dr. Jones. Over the years, he and Dr. Jones often talked about the inadequate cardiac care available to native Bangladeshis. From those conversations and an interest in fostering benevolence and cardiovascular care has come a concept that could eventually become themodel for care in the developing world. This model might well include contributions of ACC members, including their participation in training programs for physicians who will practice in the new hospital, or donations of short periods of medical service in Bangladesh.
Stay tuned for more information on the progress of this project and the role you might play as a benevolent cardiologist. We have already heard from many physicians around the world who are enthusiastic about participating in work like this—work that can make a real and permanent difference in the lives of those less fortunate than ourselves, our families, and our neighbors.
Your help welcomed far and wide
In the same spirit that gave birth to the benevolent works described above, I announce the availability of a resource for ACC members and others seeking an outlet for their benevolent energies. Next month, at the ACC's Annual Scientific Sessions in New Orleans, we will open the portals to a new, online compilation of organizations, to invite contributions from cardiovascular specialists. You will be able to log on to http://www.acc.organd find information about benevolent groups whose interests, priorities, and activities match your interests and availability. I believe this database will continue to grow over time and that you will contact the College to tell us about other groups that should be included.
Like most benevolent efforts, this one is a work in progress. On behalf of the College, I urge you to participate, if you can, in fostering optimal cardiovascular care and disease prevention, particularly where populations have little hope and few resources when confronting heart disease. As you will see when you visit the new database, your options extend far and wide.
↵1 President, American College of Cardiology
- American College of Cardiology Foundation