The Hindu Business Line : Touching needy little hearts

The parents get flabbergasted when you say your child might have a heart problem. Unless you can give them a proper diagnosis straightaway, it's terrible and cruel to tell them that a problem might be there.

DR P.S. SREEMATHI: A large-hearted effort - Bijoy Ghosh

Having watched from a government hospital how difficult it is to provide quality healthcare — in this case, paediatric heart surgery — to all those who need it, Cardiac Surgeon P.S. Sreemathi is now engaged in an effort to help "needy little hearts". Actually this is the logo of the `Less Affluent Kids Cardiac Fund' headed by her at the KJ Research Foundation in Chennai. Its aim is to do at least 200 heart operations a year on poor children.

Sreemathi, who retired from the Government Institute of Child Health (ICH) in Chennai in 2002, says that she has watched for years how corporate/private hospitals are beyond the reach of parents from the lower classes. "Government hospitals are overcrowded and the demand is so huge that however hard we try, we're not able to cope. So I thought I should do my bit to support the government in a small way."

With the KJ Hospital offering to help the effort in 2003, she decided to raise money through a combination of corporate help and government funds. "There are several government funds giving between Rs 25,000 and 30,000, and one can raise Rs 90,000 for a deserving case, but the problem is lack of coordination and the money never comes in time; one comes without the other and the time limit is violated. By the time you get money from the PM's fund, you might have already returned money from the CM's fund."

Prevalence of cardiac disease

On the prevalence of cardiac disease in children, Sreemathi says that authentic data is not available in India but making projections from western data, six children in 1,000 have congenital heart disease, and five per 1,000 have rheumatic heart disease (RHD). Even though all of them may not require surgery, she estimates that around 1.1 lakh children are born each year with congenital heart disease in lower-middle class homes. Add to this the RHD, and the number is huge. "Forget statistics, I have seen blue babies just dying like flies in the general paediatric ward at the ICH; if we had the means we could have saved them."

She says it is generally thought that cardiac disease is not common, or its treatment is too expensive and only for the wealthy. "But we cannot tell a poor mother that if her child is lucky enough to get diarrhoea he'll survive, but if he gets heart disease, tough luck."

Sreemathi was inspired to start this venture with the hope that even if she couldn't raise much money from corporates or individuals — till now she has met only with modest success — "I said, `if worse comes to worst we already have government funds available; we need around Rs 1.1 lakh for each operation and have to make efforts to co-ordinate these funds'."

After a recent camp where 460 poor children — some from far-flung places like Kanyakumari and Vellore — from Corporation schools were screened, 38 were diagnosed with heart problems and successful surgery has already been done on four. "After reading about the camp, some children have come forward to help us; one of them got donations of Rs 1,000 each from two different donors; another sold newspapers from home and gave us the money," she says.

She wants to do more camps, but has found from trips to schools and orphanages that "the parents get flabbergasted when you say your child might have a heart problem. Unless you can give them a proper diagnosis straightaway, it's terrible and cruel to tell them that a problem might be there. So we want to get an echo machine, do the test on the spot and tell the parents. For example, it could be a murmur in the heart, which is innocent. We can tell the parents this because later if another doctor sees this and thinks it is a serious problem, they should know the child will grow out of it."

If it's an organic problem, more tests could be done and if necessary the child could be admitted. With plans to do 200 operations a year, and each operation costing Rs 1.1 lakh in a general ward, the Fund needs to raise a total of Rs 2.3 crore a year; "this includes unforeseen expenditure in the form of complications, emergencies, etc."

The most common heart problems in children requiring attention are holes in the heart, blue babies, defective valves, and pus collection outside the heart. "If not attended to, all these children die. So we are talking about saving little lives," she says.

While the KJ Hospital gives rooms and care at a discount, the professionals are also decreasing their fees by 40 per cent and "60 per cent for complications because the cost goes up, and the child may be stuck to the ICU for a longer time," says Sreemathi.

On her team is Dr C. Saravanan, "one of the few doctors who opted to come back and stay in India and be happy about it," she says. While he was looking for a job in India while working at the Leeds General Infirmary, UK, he was keen "that most of my work should be on charity. Dr K. Jagadeesan (Founder of KJ Hospital) saw my CV and told Sreemathi and as we were on the same wavelength, I joined the team," he says.

Raising funds

Sreemathi is grappling with the nitty-gritty of raising funds for this cause. At first she wrote to wealthy individuals as also corporates, but got no response. Some of the international charities, such as Ford Foundation did respond and by trial and error she "realised that there is a particular method of approaching people or organisations for such fundraising." Initially she focused on cardiac surgery, but soon realised that donors preferred complete healthcare projects including prevention and rehabilitation. "So with this new armament I'm trying to get back to all of them!"

She even attended a seminar on donation collection! "They advised us to first understand the donor completely and the reason he may have for giving money. We were told: `Don't depend entirely on his altruism or philanthropy completely. He might expect something in return. While some donors don't want their names mentioned, others want publicity and we have to be able to tell the latter how to get it'."

The cardiac surgeon says that many celebrities such as Oprah Winfrey give money for charity, but the "difficulty is getting past secretaries to reach them! If we can reach them I can convince them about our cause as we have two strengths — the genuineness of the team of doctors and the genuineness of the patients we operate upon." This genuineness, she adds, is being monitored through professional audit.

Saravanan adds that they had also approached banks with funds for the social sector. One of the General Managers of the State Bank of India responded; "we gave him a list for equipment worth Rs 53 lakh, and he said, `don't cut it, we'll try our best to give all of it'."

(Dr Sreemathi can be contacted at kjh@vsnl.net)

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