Why that may not help a 2-year-old with heart disease
It’s a special Wednesday at St Veronica’s Medical Centre. There is a visiting children’s heart specialist from India and many parents have brought their kids to benefit from the services of such a rare specialist. It turns out that majority of these children have nothing particularly worrisome about their health. But not all of them are so lucky. Among them is 2-year-old Kimora Leong Zeze. He sits on his grandmother’s lap in the hospital’s waiting room, intently examining the activities of the children and adult strangers around him, as would any other healthy toddler his age. But this is only a façade. Kimora is sick, very sick. He’s been diagnosed with a serious heart problem known as Tetralogy of Fallot. In layman terms, it means he has a hole in his heart.
“Kimora was a normal baby until when he was 14 months old,” says his grandmother, Bridget. “He is a twin. His twin was born vaginally but Kimora stayed on for two more hours. In fact, his mother had a caesarean section before he was born. But he developed normally and was even walking. That’s when the trouble began. I noticed that sometimes while walking, he would suddenly bend over and start breathing really hard.” That was the beginning of a never-ending nightmare for the family.
“He would have difficulty in breathing and would turn blue. His fingertips and toes would turn blue and so would his lips,” says Bridget. Kimora was taken to at least nine different hospitals in the Northwest, West, Southwest and Littoral Regions, but the doctors were at a loss. After several months and many wrong diagnoses, Kimora was referred to a cardiologist at St Veronica’s who finally identified the problem.
“I paid 30,000 FRS for a test and they told me that my grandson was suffering from a heart problem. Then they said I would need to bring five million francs so that they could operate him… I have never held up to one million francs in my entire life, so when they say five million, I don’t know where to find that kind of money, so I am just discouraged” says Bridget who is a farmer. For now, she is Kimora’s primary care giver because his mother has been hospitalized at the Buea Regional Hospital for the last few weeks due to an illness brought on perhaps, by the pressures of the situation. Her illness aside, Kimora’s mother is unemployed and has no source of income. According to Bridget, his father who lives in Yaoundé is not doing much to help.
Even so, Brigdet and Kimora have a special bond.
“His twin Kilian prefers his grandfather, but Kimora just can’t let go of me,” says Bridget with a hint of a smile. “I usually have to sneak out when I have to leave the house. He loves to share his biscuits with me and his favourite meal is fufu and okro.”
The specialist Bridget and Kimora are waiting to see is Dr Girish Warrier, a cardio-paediatrician from India who is consulting just for the day. When Bridget heard he was coming to town, she dropped everything she was doing to bring Kimora to him.
When Dr Warrier sees Kimora, he confirms what Bridget already knew.
“He has blue baby syndrome caused by Tetralogy of Fallot,” says Dr Warrier, after examining Kimora and the pile of books, files and test results that document his condition and bear witness to his epic tour of hospitals. “He will need fairly urgent surgery, say in two or three months.”
Tetralogy of Fallot is a heart defect that can cause oxygen in the blood that flows to the rest of the body to be reduced. A child with this defect will sometimes have blue-tinged skin because their blood doesn’t carry enough oxygen. Kimora has frequent crises that sometimes require hospitalization. Often, this involves him being put on oxygen.
The Apollo Group of Hospitals
Dr Warrier is part of a group of doctors from India’s Apollo Group of Hospitals, who are in Cameroon very briefly, to explore avenues for partnership with the health sector. The other doctors include a cancer expert, a kidney transplant surgeon and a urinary tract specialist. The Apollo Group of Hospitals is a leading health care provider in India, which has set up similar partnerships in African countries like Nigeria, Gabon, Tanzania and many others.
The Apollo doctors came to Buea at the behest of the Regional Delegate for Public Health, Dr Victor Mbome.
“Some time ago, two doctors from the Apollo Group of Hospitals were just visiting some friends in Buea and they got interested in what we were doing here,” says Dr Mbome. “We had a discussion and I told them we were open to partnerships, especially as we know that India is doing very well in terms of medical technology and health care delivery. So I thought that they could come here and we could learn from their experiences.”
In Cameroon, specialists in areas such as cancer, kidney problems and heart disease are a rare breed. Meanwhile, the country has huge challenges in “the increasing number of non communicable diseases in [its] epidemiological profile…now we are beginning to see more cases of cardiovascular diseases, hypertension, diabetes, cancer,” says Dr. Mbome.
The absence of specialists in these fields means that patients with life-threatening conditions are often diagnosed at very late stages in the disease, when there’s almost nothing doctors can do to help the situation. For instance, in Kimora’s case, the hole in his heart has already led to paralysis on the right side of his body.
“The hole in his heart can still be fixed,” says Dr Warrier, “but the paralysis can’t be fixed.” According to Dr Warrier, holes in the heart are among the commonest heart problems in children. “But generally what we find in most children is that they are not detected very early and that is what we are aiming at. We are trying to get to these children as early as possible, so that they can have a better life.”
Health officials in Buea are optimistic about a long term partnership with the Apollo Group of Hospitals, which would lead to doctors in Cameroon being trained in rare specialties in India. The idea is, if doctors get the training, they can identify heart complications, cancers and other life-threatening conditions in time for medical intervention to make a difference.
“The main purpose of our collaboration is … the training of the doctors, the nurses and the paramedic staff,” says Dr Vineet Arora, who is in charge of corporate development for the Apollo Group. In the meantime, the Apollo Group is also offering treatment in India for those patients who cannot be treated in Cameroon because of a lack of technology and the absence of specialists.
“It takes time to develop the treatment modalities locally” says Dr Arora. “So while these things are being developed, the patients that cannot be treated locally, they can come to Apollo Hospitals in India for their treatment.” Dr Arora says in India, they will have the same quality of treatment available in western countries but at a fraction of the cost.
However, this lesser cost still translates to colossal sums of money for the average Cameroonian. This is the dilemma Kimora’s family is faced with. Surgery can save his life but the procedure and travel to India will cost about five million francs.
A partnership between the medical core in the Southwest and the Apollo Group of Hospitals will certainly help to train doctors and provide more treatment options for patients in Cameroon, which would help fix some problems in the country’s health systems. Yet one big obstacle would still stand between many of these patients and good health, and that is paying for treatment.
Meanwhile, Kimora’s grandmother has one wish;
“I just want my grandson to be fine.”
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