By the time Afshan and her father returned to Pakistan, the word had spread, and parents of other children with congenital heart defects flooded the United States Embassy and the Adventist hospital in Karachi with requests for similar assistance. What to do? Logistics and financial realities for sending all the potential patients and their parents to America seemed prohibitive. Nonetheless, the creative minds at the Embassy and the hospital came up with a plan. Arthur W. Weaver, MD (Class of 1953), Chief Surgeon at the Karachi Seventh-Day Adventist Hospital, decided to contact the heart team at Loma Linda University and inquire whether they would be willing to come to Karachi. In a letter to Dr. Wareham, Weaver was asked, “If the government could pay your way, would you come?” Wareham discussed the idea with his colleague, C. Joan Coggin, MD, a cardiologist. The two agreed that if transportation for a six-person medical team and a ton of equipment necessary for open-heart surgery could be arranged, they would spend their vacations helping the people of Asia. Correspondence literally flew between California and Pakistan. In addition to the bulky load of supplies, Loma Linda University’s only heart-lung machine would have to go to Karachi. The Department of State’s Agency for International Development (USAID), with additional help from Vice-President Johnson, landed the heart team in Karachi on May 2, 1963. The Loma Linda University Overseas Heart Surgery Team had been born. According to Dr. Joan Coggin, people all over America began supporting the project. “Several pharmaceutical houses were very generous in donating medical supplies for our surgeries in Asia. Eli Lilly and Company supplied Protamine; Organon, Inc. provided Heparin; Abbott Laboratories contributed Sodium Bicarbonate; Merck, Sharp and Dohme gave us Mannitol; Don Baxter, Inc., supplied all of the IV sets; and Davis and Geck furnished our sutures. The kindness and helpfulness of everyone was amazing.” Immediately, Doctors Wareham and Coggin began screening patients, some of whom had traveled as much as 1,500 miles. The other four members of the team, Wilfred M. Huse, MD, a surgeon, F. Lynn Artress, MD (Class of 1942), an anesthesiologist, and Mr. Lester H. Gibson, the heart-lung machine technician, began setting up the operating room. Gibson set up the operative room and Lavaun W. Sutton, RN, a nurse specialist, started training the local nurses in techniques of cardiac post-operative care. By May 8, everything was ready and the surgery schedule had been completed. The Loma Linda University team transformed the 120-bed mission hospital into a temporary university medical center. At 8 a.m. Jamil Shaid became the first Karachi heart-surgery patient. Jamil’s father had carried a newspaper clipping of Afshan’s surgery in his wallet since October, 1962; he had been to the United States Embassy for help. Then he watched the press for news reports. As soon as the Americans arrived, he rushed his son to the Karachi Adventist Hospital for an examination. The boy’s surgery was a closed-heart procedure. The next day, however, the team performed the first open-heart surgery in Pakistan on nine-year-old Anwar Zaida. A semi-invalid with a very short life expectancy, he was the first in Pakistan to use the heart-lung machine. Both boys were from the small Pakistani middle class. As in Afshan’s case, expensive heart surgery in America or Europe would have been impossible. During the first two days, the team performed four surgeries—as many as they would have performed in a week at home. In 22 operating days, they performed 44 heart surgeries. Working 16 to 20 hours a day, they also had seen 300 patients in clinic. Pakistani President Mohammad Ayub Kahn flew one of the patients from East Pakistan by military transport. Dr. Coggin remembers the spirit of cooperation the team witnessed from the hospital’s personnel. “We came in and turned their hospital upside down. We made 18-hour days the rule for many, and they thanked us for it over and over again. We were very, very impressed by the hard work they did with a cheerful, thankful spirit.” The effort would not have succeeded without the help of the hospital staff and many other interested parties. The All Pakistan Women’s Association and the Jamshed Lions Club united to donate the 6 to 12 pints of blood needed for each surgery. Even government agencies offered Karachi jail prisoners 15 days of grace for donating a pint of blood. Something the heart team had not seen in the United States surprised them. When they entered a patient’s room to examine one of their patients, they found the entire family looking on. Somebody from each patient’s family stayed all night with their loved ones, even if it meant sleeping on a floor mat beside the bed. Lester Gibson, the heart-lung machine technician, noticed the patient’s response to a routine pre-surgery prayer: “Our Moslem patients were particularly impressed by the doctors’ prayer before each surgery. One instructor from a local medical school asked what the prayer was and could hardly believe that it was not a memorized paragraph but a conversation.” According to Dr. Wareham, the hardest part of the trip was closing down the surgeries. “There were so many more patients—little children—waiting for help and asking us to do just one more operation.” Finally, because of other commitments on their scheduled tour, they had to set an arbitrary date and stop. Local newspapers urged the purchase of a heart-lung machine for Pakistan, and the team inspired local surgeons to establish their own program.

Heritage Snapshot Part 88