Project: Ensuring survival opportunities for children – pfm supports
the treatment of cardiac children in Bolivia
He’s made it! The operation has gone well and the little patient is fine!
Cologne, 26.03.2009. pfm Produkte für die Medizin AG, one of the leading German medical
technology companies, enables free treatment for children with heart diseases in Bolivia. As part of
an innovative Public Private Partnership (PPP) project, this medium-sized and family-owned firm is
cooperating with Gesellschaft für technische Zusammenarbeit GmbH (GTZ – Germany’s federal
enterprise for technical cooperation) to improve medical care for cardiac children in that country.
Using cardiac catheter treatments, the team significantly improves the young patients’ chances of
survival.
While the rates of survival for children with congenital heart problems are clearly rising in Germany,
for many children in the poorest country in South America a cardiac defect still amounts to a death
sentence in many cases. To make sure that the little patients are no longer left to their fate, last year
pfm AG and GTZ started a project that supports the federal government in providing German
development cooperation. The aim of the project is to treat the affected Bolivian children on the spot
and, in the long term, to establish an efficient interventional paediatric cardiology service in the
country.
Within the PPP, specialised medical teams are dealing with about 400 children. They are given free
cardiological diagnosis, treatment and aftertreatment. The jointly initiated aid measures are already
demonstrating success: for 50 patients with congenital heart disease it has already been possible to
insert life-saving implants using heart catheters.
Other important components of the project are the training of Bolivian doctors in dealing with heart
catheters, the so-called interventional procedures, and awareness-raising campaigns among the
population to be able to identify and treat heart diseases more quickly. All these measures are
intended to contribute to an improvement of the medical care situation in the country.
Altogether more than half a million Euros are available for this project. 55% of the budget is
funded by pfm AG, 45% by the public enterprise GTZ within the Public Private Partnership (PPP)Program with funds from the Federal Ministry for Economic Cooperation and Development (BMZ). It
is planned to extend the project to other Latin American countries in the coming year. In this way the
project, which is designed for three years, will ultimately guarantee better cardiological care for about
30,000 patients. Plans are already being made to ensure ongoing treatment for the children beyond the
current term of the project. The German Development Service (DED), the German-Bolivian Chamber
of Industry and Commerce and other independent organisations working in the country are supporting
the project.
»The aim is to introduce the interventional technique nationwide, thus providing access to life-saving
cardiological treatment for children in the poorest circumstances,« explains Aurel Schoeller,
Chairman of the Board of pfm AG. The company has got involved in Bolivia with a high social and
financial investment because in some parts the situation in that country is disastrous. »The children
often die during cardiac operations even though they could be cured with minimal invasion using
interventional implants and could then leave hospital in many cases after a few days. Against this
background, as an internationally active enterprise we see ourselves absolutely committed to our
social responsibilities,« said the Chairman of the Board.
Poverty and extreme climatic conditions take their toll
More than two thirds of the Bolivian population live on the Altiplano plateau at a height of 3,000 to
4000 metres above sea level, in other words at the greatest height of any region still inhabited by
humans. At the eastern edge of the plateau, between the Western and Eastern Andes, at a height of
3,600 metres, is the highest metropolis in the world, La Paz, with an extended poverty belt in which
more than two million people live. More than half the roughly nine million inhabitants of Bolivia live
below the poverty line. The health system in the country is only poorly developed and is by no means
sufficient to ensure comprehensive minimal medical care. About 80% of Bolivians have no health
insurance. In particular the indigenous Bolivian rural population is in part completely isolated from
medical care.
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Heart diseases among children are a special problem in Bolivia. Many children suffer from
congenital heart problems which are especially clearly developed and serious because of the lowoxygen altitude.
Obvious symptoms
The oxygen-poor air combined with a heart defect can lead to severe cyanosis. In this case a bluish
colouring in skin, lips and fingernails makes a heart disease identifiable at first sight among many
children. Shortness of breath, apathy, and growing exhaustion and weariness are further symptoms.
Babies drink poorly and are easily infected. The little hearts have to pump very quickly to supply the
body with oxygen.
The medical care situation is inadequate
In 60% of the children who suffer from the serious consequences of so-called »open hearts« it would
be possible without problems to introduce a small net-like implant through the veins and arteries using
a catheter, and thus close the holes. The children could be cured at a relatively low level of risk, both
quickly and cheaply. However, Bolivian doctors close the holes in almost every case in complicated
operations on the open heart with only a very slight chance of survival for the little patients. The chest
is opened up and the children are attached to a heart-lung machine, which is associated with high risks
because of the situation regarding medical care in the country, which has to struggle with power cuts,
water shortages and poor hygiene. A large number of the children still die during such operations.
Even if the children can get to a municipal hospital the chances of a cure are consequently poor.
However, under existing medical conditions most children have generally hardly any access to
cardiological treatment. Their life expectancy is correspondingly low. In the rural districts there is no
basic medical care covering the whole area. Treatments are unaffordable and parents often fail to
recognise the dangers in which their children are living. The staff of the PPP projects are aware of
these problems. For that reason they set off along the weary path to the highland villages, to inform
people about the disease and the opportunities for treatment and to offer help to affected families. Not
an easy job, for in Bolivia live a large number of Indian tribes with their own languages and dialects,
for which in most cases there is not even a written form of the language. Information events, films and
personal conversations are often the only ways to pass on information. But it is worth the effort for
every sick child treated under the project receives a new opportunity to live.
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The attending surgeon Dr. Franz Freundenthal with the parents of the troubled child after successful operation
Interventional procedures are the future
»With our aid project we want to change the precarious situation for the long term. Bolivian medical
specialists must be trained quite specifically in the field of interventional paediatric cardiology so that
in the long term more children, especially from the poor levels of society, can autonomously be
treated more quickly, with fewer risks and more cheaply,« explains the pfm Chairman of the Board,
Aurel Schoeller. Well founded specialist knowledge and high-quality medical technology must be
used for this purpose. »We in pfm AG see the transfer of knowledge as our core task,« Schoeller
continues.
To embed the innovative technology firmly in the Bolivian health system, close cooperation
between Bolivian and international doctors and hospitals is necessary. In Bolivian cooperation clinics
local doctors learn to deal with the interventional procedures and to insert the implants. Training
sessions, scholarships, congresses and symposia are other important measures for raising the standard
of medical care. »In the end we have to build up a complete self-sustaining system,« the CEO adds.
This also means that the implants are produced by cooperation partners in the country, so that
in the long term care can be guaranteed and workplaces created. From the entire project a functioning
cycle has to emerge, which represents a great challenge. »We are on the right way, and that gives us
the strength to continue performing committed work and continually remove obstacles from the path,«
says Schoeller. »Healthy and happy children’s faces after successful treatment are our greatest
motivation for that.«
Jeanette Cotta
in close cooperaton with
Dr. Frank Thiel
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