Humanitarian cardiac care in Arequipa, Peru: experiences of a multidisciplinary Canadian cardiovascular team

Over the past several decades, considerable advancements have occurred in the field of cardiovascular medicine, resulting in overall improved morbidity and mortality. Whereas most of these advancements are widely available for patients in developed nations, access to such highly specialized cardiovascular care for those in underdeveloped or politically and economically hampered countries has been slow.1–3 Improving access and enhancing the quality of cardiovascular services in developing countries was highlighted as a goal by international cardiac societies more than a decade ago.4 However, despite these policy papers, improved educational opportunities and increased financial support for international health care, a substantial discrepancy in the level of cardiac care between developing and developed nations remains.5 Concurrently, it appears that the burden of cardiovascular disease in developing countries is forecast to further increase over the next several decades, as lifestyle-related cardiac risk factors continue to become more prevalent.6 Cardiovascular mortality has now surpassed infectious complications as the leading cause of death in many Latin American countries.7 Humanitarian missions consisting of highly specialized cardiovascular teams travelling from developed countries can provide valuable local assistance with patient care.1,5,8,9 Interventional and corrective surgical procedures can be performed and potentially save the lives of patients with no alternatives. For humanitarian mission groups to provide safe and high-quality cardiovascular care to these patients, it is critical to recognize local needs and inherent challenges and to triage appropriately while recognizing the local and visiting team’s limitations. We report the 2-year experience of a Canadian multi-disciplinary cardiac surgery team volunteer mission to Arequipa, Peru. We describe the specific challenges we faced, how we addressed them and our attempt to develop sustainable cardiovascular care within this region.