From 0 to 321 – Pediatric Catheterization Procedure Now Routine at UHI
In their initial meeting, Dr. Kanishka Ratnayaka could tell that Dr. Sulaiman Lubega was a skilled, intelligent hard worker, and he was committed to the children of Uganda. That was the foundation for Dr. Ratnayaka making the decision that World Children’s Initiative (WCI) should invest in Dr. Lubega and the Uganda Heart Institute (UHI) .
Their shared vision was to make sure that local doctors could treat the thousands of Ugandan children who needed help right there in Kampala. Their hope was that a fully independent Ugandan Heart Institute would serve all of East Africa, and be a model for the whole continent. Most basically, they wanted to see local children smiling, playing, and going to school again.
But, in 2012, when Dr. Ratnayaka conducted a needs assessment at UHI, there was no hardware, software, equipment, trained personnel, or expertise to perform minimally invasive heart procedures in children. Children with heart problems had very limited options for treatment.
So, Dr. Ratnayaka and Dr. Lubega started from scratch.
They started a weekly skype telemedicine call to review a chapter in a textbook for each call. As the two doctors continued their telemedicine calls and training, WCI and UHI continued to partner with the local government, NGOs, and companies to equip the heart center, develop a supply chain, and outreach to patients to develop the UHI children’s heart program. The first two years were mostly training, with Dr. Ratnayaka heavily involved in teaching the UHI personnel how to fix heart defects in children.
By WCI’s third trip to Kampala, however, there was a major shift. Dr. Ratnayaka did not scrub into the case. He simply watched from the control room. Dr. Lubega and his team were well-prepared, thoughtful, careful and completed all of the heart procedures without assistance. Shortly afterward, independent pediatric catheterization cases without any international assistance became routine. Since then, the number of cases completed by UHI – independently, with no foreign assistance - has continued to grow.
2013 – 3
2014 -17
2015 – 55
2016 – 61
2017 – 100
2018 – 108
2019 - 56 to date
As his skills progressed, Dr. Lubega’s weekly calls with Dr. Ratnayaka also changed. What started textbook review sessions, transformed into a nuanced discussion between two peers. They explored theoretical cases, planned for specific complications, and discussed risk mitigation strategies. More recent discussions have even focused on capacity building and strategic initiatives to move UHI from a center of excellence in Uganda to a regional referral center for East Africa.
Six years from the initial trip, UHI has completed almost 500 total cases and 321 independent cases without international assistance. That means hundreds of children have been treated with local resources. Hundreds and thousands more will be treated in the coming years. Thousands of families in east Africa have children who will live longer and play harder, thanks to WCI’s collaboration with Dr. Lubega and his team.