Five-year-old Ethiopan girl Estub celebrates her birthday at the SACHS house at the Wolfson Medical Center. She was brought to Israel for heart surgery.On a day in late March six small children – two from Ethiopia, one from Nigeria, and three from Gaza – are recovering in a special intensive care unit at the Wolfson Medical Center in the Tel Aviv suburb of Holon. Two of the patients are such tiny infants that it is hard to imagine where there was room to conduct the intricate heart surgeries they’ve just undergone.

The children are the latest beneficiaries of the Save a Child’s Heart organization, the largest such program in the world providing urgent free pediatric heart surgery and follow up care for children from Third World and developing countries. More than 1,600 children from 26 different countries have been brought to Israel for life-saving surgery under the program since it was founded in 1992, and more arrive every week.

When the founder and chief surgeon of SACH, Dr. Amram (Ami) Cohen, died suddenly at the age of 47 in 2001, there was a brief moment when his fellow surgeons and staff wondered how they would carry on. The American-born Cohen – who died while climbing Africa’s Mount Kilimanjaro – had conceived and nurtured the program.

“When Ami died we were at a crossroads. He was the figure who did everything, going abroad, bringing the children, and he had a solution for everything,” recalls senior pediatric cardiologist Dr. Akiva Tamir, Cohen’s friend and colleague. “But we realized this was much bigger than just being a cardiologist or a surgeon; this is a mission and a vision. A child in Israel can go anywhere for treatment, but these children don’t have anywhere else to go; if we don’t treat them they will die. This is really the essence of medicine.”

In March the SACH medical team traveled to Ethiopia and Rwanda for a five-day medical mission, to screen children suffering from heart disease and to initiate a new program in Rwanda. Among the patients Tamir examined were 30 Ethiopians who had received valve replacements at Wolfson Hospital in 1998-1999.

“Frankly, we were a little worried because after valve replacement the patient needs to be monitored and given coumadin [blood thinners] and we know that this is often a problem in Ethiopia, even with our assistance in obtaining the drug,” Tamir told ISRAEL21c. “So I was surprised that most of the patients did very well. I got so much satisfaction from that.”

That satisfaction is compounded by the fact that one of those early patients is now a medical student, another is a health worker in the villages, while another studies computers.

While the SACH staff often travel overseas to educate and to perform surgery in cooperation with local personnel, an important part of the organization’s outreach program is to bring doctors and nurses to Israel for in-depth training in all facets of pediatric cardiology.

The goal of SACHS is to create centers of competence in developing countries, in which local medical personnel can do the job themselves. It is based on a model that the Israeli medical profession went through itself. Until the late 1980s, Israeli children had to go abroad for heart surgery since Israel didn’t have the necessary infrastructure.

“What did we do in Israel?” explains Simon Fisher, SACH executive director. “The Israeli way of doing things is to ‘go and learn’ – acquire the knowledge and bring it back. That’s what we did here, and that’s what we want to help others to do.”

Medical personnel from China, Ethiopia, Moldova, Eritrea, Nigeria, Vietnam and the Palestinian Authority have received advanced training, including in anesthesia and intensive care, at the Wolfson Medical Center.

“These doctors are ambassadors of good will to Israel,” Tamir told ISRAEL21c. “For me this is even more important than the medical part.”

SACH’s partner in Ethiopia is the Children’s Heart Fund of Ethiopia founded and run by pediatric cardiologist Dr. Belay Abegaz, who met Amram Cohen in the US in the 1980s.

Cohen promised him that as soon as he could set up a program in Israel, he would begin bringing Ethiopian children over for surgery. He also promised to help them set up their own facilities. The Children’s Heart Fund of Ethiopia is now in the final stages of constructing a cardiac center in Addis Ababa.

“We hope by next year we can send people to Ethiopia to work with local doctors to perform open heart surgeries,” states Fisher. “Ami had a vision of enabling local medical personnel to provide needed treatment in their own environment. But in the meantime we want to treat as many children as possible here, because these children cannot wait till the center is constructed.”

To date, more than 300 Ethiopian children have been operated on by SACH medical teams in Israel and Ethiopia, and the trip in March was SACH’s 10th mission to Ethiopia. This time the team was joined by popular Israeli musician, Idan Raichel, who has integrated Ethiopian music into his songs. With his famous long dreadlocks, Raichel has become a sort of good will ambassador for the organization.

A photogenic five-year-old girl named Estub, one of the children chosen to be brought back to Israel for heart surgery, became the young star of a TV documentary filmed by a camera crew from Israel’s Channel Ten TV station which accompanied the team.

The crew followed Estub from Addis Ababa to the SACH hostel in Yazur, near Holon, then to the hospital where she is outfitted with colorful pajamas, and eventually to the operating room where a team of 10 medical staff is waiting. It was, of course, a happy ending.

From Ethiopia the team traveled to Rwanda. It was SACH’s first mission there, and came at the request of pediatric cardiologist Dr. Joseph Mucumbitsi, head of King Faisal Hospital in Kigali. Mucumbitsi gained his expertise in Brussels where he lived for 18 years. Two years ago he decided to return to Rwanda in order to help rehabilitate and develop the Rwandan medical infrastructure.

In Kigali Tamir and Mucumbitsi conducted a joint screening clinic for 13 Rwandan children who suffer from heart disease. “Mucumbitsi decided he wanted to come back to his country to help,” remarks Tamir. “So you see, they have their ‘Zionism’, too, and they also had their genocide.” Five children from Rwanda were chosen to come to Israel for surgery in the near future.

Among SACH’s farthest-reaching medical missions abroad have been the seven trips they’ve undertaken to China. The most recent took place last October, in which a group of 18 Israeli medical professionals led by the chief of cardio-vascular surgery of Wolfson Hospital, Dr. Lior Sasson traveled to the Hebei Provincial Children’s hospital in Shijiazhaung. More than 110 Chinese children suffering from heart defects have undergone open-heart surgeries and other procedures during these missions.

The most publicized cardiac cases treated by Save a Child’s Heart in the last year have been young children from Iraq, who are brought to Israel in an elaborate logistical journey via Jordan.

The first patient came in late 2005 when world media were riveted by the story of Israeli surgeons coming to the aid of a newborn Iraqi baby girl with a defective heart. Communicating via US Army satellite phones Iraqi doctors and the SACH surgeons made the decision to bring the infant to Israel via Jordan for the complex surgery.

Tamir instructed a doctor in Baghdad over the phone on how to perform a minor operation to stabilize the infant, as travel permits were being issued for her and her family. With the aid of the Christian organization Shevet Ahim, founded in 1994 to help non-Israeli children receive lifesaving medical care in Israel, the baby and her parents were flown to Amman, and then traveled by car to Israel, where they were met by the Israeli doctors at the entrance to the emergency room at Wolfson with the Arabic greeting “Salaam alaikum,” or “welcome”.

Commentators wondered if this life-saving operation might signal the future Iraqi government’s willingness to normalize relations with Israel. But despite the highly-publicized drama, this first case from Iraq was a disappointment; the surgery went well, but the patient died a month later from complications.

“Ever since then we have been extremely careful,” explains executive director Fisher. “It’s so important when you establish a new partnership that the first surgery be successful, because that’s what builds confidence.”

Since then 20 children from Iraq, mainly Kurds, have undergone successful heart surgery at Wolfson, and on average there are three or four Iraqi children in Israel at a time.

“It’s a special experience; the parents arrive in a country they consider an enemy state,” says Fisher.

Since travel to Iraq is highly risky for Israelis, the SACH team examines potential patients in Jordan. Shevet Achim is the SACH liaison in Iraq, locating the children, making the arrangements for the perilous journey to Amman, and putting up the families in church guest houses until they are examined, and finally accompanying them to Israel.

According to Fisher, most Jordanian physicians are not willing to work with Israeli doctors. However SACH cardiologists are able to examine the Iraqi children in Jordan thanks to the head of the Red Crescent Hospital in Amman, Dr. Mohammed El-Hadid, who is also president of the Steering Commission of the Red Cross and the Red Crescent in Geneva. Despite the strong anti-normalization feeling of the Jordanian Medical Society (and other Jordanian professional societies, as well) el-Hadid facilitates the treatment by the Israelis of the Iraqi children.

“Dr. El-Hadid insists that he is doing this for the children, there’s no politics involved. That’s why he’s so special,” said Fisher.
It costs an average of $10,000 to cover the cost of each patient, including hospitalization and travel. Training doctors from abroad is about $25,000. While Wolfson – which is a government hospital – makes its facilities available for the project, costs are borne from private funding. SACHS is headed by the Iraqi-born philanthropist, Sami Shamoon, who serves as its international president. It also has ‘friends’ organizations around the world and is closely associated with Rotary and Variety.

The European Commission has granted SACH one million euros for the treatment of Palestinian children and training of Palestinian physicians, under its Partnership for Peace program The EU does not support medical programs, explains organization director Fisher, but rather projects which engender peace.

“In my request to the EU, I argued that through medical activities you’re getting not only professionals to work together, but you are also bringing together Israeli and Palestinian families who are sharing their concerns and worries for their children. This doesn’t change attitudes overnight, but it does show that the other side is humane, and will make an impact on how they see each other,” he said.

“Save a Child’s Heart is a win-win situation for everybody – the children whose lives are saved by the program, the medical personnel from where these children come who are being trained, and for Israel and the Wolfson Medical Center. The fact that this is all happening at a local community facility, and not one of the country’s marble-covered hospitals which provide services to the wealthy, gives real pride to the staff and to the people of Holon and southern Tel Aviv.”