The Little Hearts Project -- 25th May 2023-- 500 Surgeries Milestone

 

Vijay, a seven-year-old boy from Cuddalore, went in for his cardiac surgery on May 25, 2023. His surgery was a little more complicated than regular cardiac surgery. He underwent the surgery and is now doing well. So what is special about this patient, May 25th, and this surgery?

 

It is a big milestone for the Little Hearts Project, a project that is run by the Rotary Club of Madras South with support from Rotary International, the Rotary Club of Pasadena, and funding support from the Chief Minister’s Insurance Scheme of the State Government of Tamilnadu, very kind sponsors (including a significant contributions from Ford), and Soorya Hospital,  who have been performing the surgeries with the support of Doctors and their support system.

 

While reaching the milestone of 500 surgeries calls for celebration, I was thinking through this journey and how we were able to get to this number. Saving lives and giving them back their regular lifestyle is not easy, and there are  now 500 of them. It has taken time, but the project has reached this Milestone number.

 

I was thinking of the roller coaster journey that we have had, the challenges both internal and external, how we got to this magic number, and how we hope and plan to continue the journey.

 

1. The initiation came from Rtn Saravanan who did lot of research and fact gathering and has been a key driver for the success of this project. Not a day passes without his contribution in one way or another to this project. He does a stellar job. The project was conceptualized among a small group of Rotarians in December 2016, and then work started on the schematics. This took nearly four to five months. Time spent on several meetings, going around hospitals, understanding the prevalence of child heart disease (CHD)), its impact on the lives of the children affected by it, the number of kids affected, etc. We then had to scout for a surgeon and a hospital who would support this good cause. Normal price ranges in well-known hospitals are close to three times the amount that we spend on each type of surgery. Not only that, the surgeries had to be successful, We also realized that these types of surgeries are not performed at hospitals that are government-owned. A framework had to be established. To move forward with our proposal, we had the full support of the Rotary South Board.
2. A governance process was established that laid down all stakeholders  responsibilities and their roles. A process map was drawn to ensure that every stakeholder understood his responsibility and role. Every surgery was to be performed only after the submission of documents in a Google Group that was created, with all documents available for review by all Group members. The group included our key sponsors as well. The document included pre-approval by the insurance company administering the CM Insurance Scheme, a patient data sheet, and a picture. Approvers were set up by Rotary South. It included a primary and a secondary approver (to take care if the Primary is traveling, etc.). Surgery will be performed only after approval. A Reimbursement  process has been set up. It included an independent verification backed up by a Chartered Accountant certificate to confirm surgeries performed and Insurance settlements received by the hospital. Based on the presentation of all details, payment was released to the hospital.
3. Quotes were received from hospitals. We nearly tied up with a leading hospital. But the hospital was not happy to host the parents of the kids in their wards—They thought it was an unwanted stigma for a leading hospital. Back to the Drawing board
4. Finally, everything fell into place, and Soorya Hospital was selected.
5. The first patient was Chandru, a nine-year-old from Vridhachalam. The procedure was performed on August 2, 2017.
6. The first 75 surgeries were self-funded by the Rotary Club. When I say self-funded, I mean the club raised funds to pay for the amounts minus the support that came in from the Chief Minister's insurance scheme. The fund-raising was a grand success. Gaur Gopal Das was the speaker for the fund-raising event, and it created the corpus for us to sponsor the first 75 kids. Club Rotarians , friends of Rotarians  chipped in with their contribution as well.
7. When the project started, a few of us were very anxious about the surgery and would closely follow up on the patient's condition and recovery. We visited the hospital, interacted with the child and their parents, gave them goodie bags, etc. But as the surgeries progressed, the confidence level increased, and it became clear that this was a very worthy project, and we had to get a funding model that would give the project continued assurance and availability.
8. Rotary International gives you the wonderful opportunity to seek global partners who will match the local club for the contributions they make, and along with it, the local district and International Rotary as well as Global Rotary will put in their contributions. With all this, there is Rotary International governance of the project, with their stringent norms for the project to be approved. A community assessment of the need was done—this was a prerequisite to putting in the Global Grant (GG) Application. Funding was raised through local CSR partners. The Rotary Club of Pasadena ( International Partner) arranged its portion and dedicated support to the Project. After due diligence, the project was approved. The monies were credited to a separate bank account for this purpose, and the funds could be used only for this purpose. A total of 200 surgeries were performed, and it was a smooth one. We ventured into the next GG, and again, it was approved, and when we thought all was well,
9. Covid stuck, and what a mess it created! Little Heart Surgeries had to be stopped as they were no longer a priority. The dedicated ICU for Pediatric surgeries was converted to a Covid treatment bed. Lockdowns ensured no travel—Patients were forced to wait. As things slowly came back to normal, the team resumed its work, but we lost the pace. Patients were hesitant to travel to Chennai for the surgery. The team had to work harder to put things back in place. GG2 commenced in late 2019 and was completed by 2023.
10. We worked hard to break the deadlock after the removal of all lockdown curbs. Camps were conducted. We visited Villipuram (wwhere the CHD cases were higher) and met most of the patients and their parents. While it was clear that the surgeries were very successful, it was taking lots of effort just to get back to normal. Covid had played its part. In one month, on October 22, the hospital had lined up several patients. But every one who had come in fell ill due to fever. All surgeries were cancelled. We just had no control. But things started changing after November 22.
11. We had one more challenge in between that was kind of internal to the project. The master surgeon, who did most of the surgeries, decided to form his own hospital and quit the Soorya team. The team was also a little stuck on what to do next—Follow the doctor to his new hospital or continue at the existing hospital. As we deliberated the pros and cons of this, it became clear that we needed an established set-up that could do the whole project end-to-end. And what I meant by that was: identifying the patient at locations all over Tamil Nadu; planning; insurance approvals; paper work; follow-up; logistics support to the family; post-operation checkups; and having a non-medical team that took good care of all these. And Soorya had that. But we lost precious time because of this change, and thankfully, the project was back on track.
12. In the meantime, we had started the work for putting in the next GG3. This was a roller coaster. The change in CSR rules meant that we could not allow the CSR funds of local sponsors to remain unspent over the Financial year. So our CSR sponsors insisted whatever was given be spent by the last month of the Financial year. It was becoming clear that we could not do a GG with this condition. The solution was to have two sets of MOUs. One locally with CSR sponsors to support the spending of the monies contributed by them for this cause. Second, since Pasadena had already arranged funding, to utilize that money, we had to still do a GG. So more work in terms of documentation, follow-up, etc. We also had the Rotary guard change, who changed priorities, and that delayed taking the project forward.
13. The Little Heart Project had gone through "Four Rotary terms,"  which meant that different Presidents and teams had supported this project, and everyone wanted to support this noble cause. It was life-impacting, and one cannot afford to miss it. But all need not see it the same way. This is the beauty of human life. Ego needs to be met with humility to succeed. It was a learning experience. Whenever challenged, all that came in front of my eyes were the little children that we met on several occasions, their playful ignorance, and the faces of their parents, who were thankful to the Rotarians and the other good Samaritans of the world. If not for the project, the kids would not have survived. Anyways  All is well and will be well.
14. Thanks to everyone  for the support

Celebrations are in the air soon. As we move on,  I am always  thankful to the Almighty for the opportunity to serve, and serve in the best way possible.