Despite the uncertain political relations existing between the U.S. and Nicaragua, our involvement in health-assistance has been a success story. Our first contact with the Nicaraguan health officials occurred only two years ago during our initial visit to the La Mascota Pediatric Hospital, a 280-bed institution, the only pediatric facility in Nicaragua. Their problem was the dilapidated state of medical equipment. There was not even a working x-ray machine. We were able to fill this gap with the help of Dr. Dan Wheeler and TranState Company of Charlotte by repairing some and replacing other pieces of x-ray and other equipment. We have also delivered echocardiographs, pediatric respirators, cribs and other items.

The situation in cardiac diagnostics was dire. Nicaragua, a country of six million, did not have a single functioning heart catheterization laboratory available for the general population. The equipment in the National Center of Cardiology was broken and unused for the past five years. Evaluating the situation carefully and after several sessions with Nicaraguan government officials, as well as our own consultants, we proceeded with rebuilding the broken down laboratory. The new and updated facility opened in the summer of 2008 by the Minister of Health, Dr. Guillermo Gonzalez, and now performs about 30-40 heart catheterizations a week.

Having solved the problem of heart catheterization, we concentrated on the issue of pediatric intensive care facilities. The situation of severely ill children was critical. In absence of incubators, babies were warmed with ordinary light bulbs. There was a crucial shortage of respirators and warmers. Monitoring equipment was obsolete and broken, and free-standing, rusty oxygen tanks were everywhere.

Again, using refurbished equipment donated by Carolinas Medical Center, supplemented with newly purchased machinery obtained by a grant from The Heineman Foundation for Research, Charitable, Educational and Scientific Purposes, Inc., we succeeded in installing a piped-in oxygen system, complete with air conditioning and up-to-date bed-side technology, comparable to our own facility in Charlotte. On the day the Unit was opened by the Vice Minister of Health and by Dr. James McDeavitt, Senior Vice President of Research and Education at Carolinas Medical Center, the Unit was full with babies that were admitted the previous night.

Originally the Nicaraguans requested that we take the full task of establishing a pediatric cardiac surgical program. With our own pediatric surgeons tied down by spending their free time assisting their colleagues in Romania, and having no on-site adequately trained Nicaraguan surgeons, we decided to yield to Surgeons International, a cooperative group of five major northern institutions in the United States. They have agreed to send five pediatric cardiac surgical teams each year to Nicaragua, while concurrently we will train Nicaraguan surgeons to do pediatric cardiac surgery. Even though we will not be directly involved in this surgical program, nevertheless the pediatric surgeries will be performed on children diagnosed in the laboratory we have equipped using the heart lung machine we provided, and cared for postoperatively in the Intensive Care Unit we have established.