To Soddo Zuria and beyond: the quest to end rheumatic heart disease continues

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Last year, we completed screening all 11,000 students ages 8-18 years old in Soddo town. This in itself is quite an accomplishment. Our team is very proficient at screening for early signs of rheumatic heart disease. The team is comfortable with the process caring for those students in Soddo, but now we are increasing our distance from Soddo. The area right outside of the city is called Soddo Zuria, it is essentially the ring of communities around Soddo.

Getting started has been a challenge. We had to get additional letters of support from the zonal ministry of health and the school board. Getting permission from each of the schools has been hard work for my team, but I am so thankful to have such capable and dedicated staff.

The school year just started a month ago and we have had four outreach events, one per week for the entire day. When the team comes back, they are tired and have been screening up to 270 students in one day using bedside echocardiography! That is over 1000 per month.

 This week they went to the school about 20 minutes away from our hospital.  A 14 year old girl was brought by her family to the screening event. She had previously attended school at this site, but had not been able to attend because she was so sick. Our screeners examined her heart and determined that she had a sick heart from rheumatic heart disease. They knew that they couldn't wait for her to get her confirmatory echo done by our physicians in a week or two, so they brought her back in our hospital's ambulance for evaluation. She was indeed very sick, so sick in fact that she was admitted to our ICU. She had an acute exacerbation of her rheumatic heart disease cause by a recent strep infection. She was in heart failure and died overnight. 

On a good day I feel joyful about the success of our screening program. It is doing its job to detect asymptomatic or early rheumatic heart disease, initial secondary prophylaxis to prevent the progression of the disease and educate the community. On a day like today, I remember that is is sacred ground. We walk forward in this endeavor on the memories of many, many children, mothers and young adults that have seen succomb to this deadly and yet preventable disease. 

Lord have mercy. Help us to hold this space with the privilege and the respect it deserves. Pave the way to not only reach more in Soddo, but to multiply our efforts.

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