Sep 20
World Heart Day: For many children, getting treatment is still a privilege
World Heart Day: For Many Children, Access to Care Is Still a Privilege Childhood Heart Disease: When Place of Birth Determines Access to Care A child anywhere in the world can develop heart disease. What makes a difference—often a decisive one—is the ability to detect it early and receive the necessary treatment. September 29 marks World Heart Day, promoted by the World Heart Federation to raise awareness about cardiovascular diseases and their impact. For POBIC, this occasion also represents an opportunity to address a less visible inequality: the one that separates children who can quickly access a diagnosis and treatment from those for whom seeking care remains a difficult, costly, or even impossible journey. In fact, not all children born with a heart condition have the same opportunities ahead of them. Congenital heart defects are abnormalities in the structure or function of the heart present from birth. Some can be managed, while others require prompt diagnosis, specialized care, or surgery. In countries with well-established healthcare systems, a child with a heart condition can undergo the necessary tests as early as during pregnancy or in the first days of life. From that point on, the child is monitored by pediatric cardiologists and guided toward the most appropriate treatment plan. In many parts of the world, however, this care network is either unavailable or accessible only to a portion of the population. Distance from hospitals, a shortage of specialized physicians, the cost of tests, and the lack of facilities capable of performing complex procedures can delay diagnosis. As a result, the condition is often detected only when symptoms are already evident and the child’s condition has become more difficult to treat. It is in this gap between need and access to care that a treatable condition can become life-threatening. Not all heart conditions are present from birth. In addition to congenital problems, there are heart conditions that can develop during childhood. Among these is rheumatic heart disease, caused by damage to the heart valves resulting from one or more episodes of rheumatic fever. According to the World Health Organization, this is the most common acquired heart disease among people under the age of 25. It primarily affects children and adolescents living in low- and middle-income countries or in communities where access to health care is limited. The disease can result from a streptococcal infection which, if recognized and treated promptly, can prevent very serious consequences. However, not all families have the means to reach a healthcare facility, cover the costs of treatment, or consult staff capable of making a correct diagnosis. Here, too, the problem is not merely the presence of the disease. It is the lack of a system capable of recognizing it and intervening before the damage to the heart becomes permanent. Treating a child means building an entire care pathway. When it comes to heart surgery, attention understandably focuses on the operating room. But making a child’s treatment possible involves a much broader process. Before surgery, there are consultations, tests, precise diagnoses, and collaboration among professionals. When treatment must take place outside the child’s home country, it is necessary to organize the trip, prepare the necessary documents, identify an available facility, and ensure that the child and their companion are properly accommodated. After the operation, recovery and follow-up care begin, continuing until the child returns home and their medical journey continues. Behind every life saved, therefore, lies a network of doctors, hospitals, volunteers, families, organizations, and donors—a diverse group of people who each take on a share of the responsibility needed to guide that child from diagnosis to treatment. It is a complex task, often unseen but indispensable. Open Heart: The Heart of POBIC’s Commitment Through the Open Heart project, POBIC helps children with serious heart conditions who cannot receive the necessary treatment in their own country. The goal is not merely to provide access to surgery. It means supporting the child throughout the entire process, collaborating with healthcare facilities, managing the organizational aspects, and supporting the family at a time when the fear of the illness is compounded by the challenge of facing a long journey away from home. The stories of Jeremiah and Perl, who came from Uganda and underwent surgery in Italy, vividly illustrate the value of this network. Their journey is not an isolated incident but part of a commitment that POBIC has been carrying out for years to offer a chance at treatment to children who might otherwise go without it. Every surgery gives a child a future. But it also speaks to something greater: it demonstrates what can happen when medical expertise, international cooperation, and solidarity work together toward a common goal. Early Diagnosis Can Change a Life Ensuring access to care also means strengthening the ability to detect conditions before they become more serious. This is why pediatric cardiology visits, access to diagnostic tools, training for local healthcare staff, and ongoing collaboration with hospitals and specialists are essential. Early diagnosis of a heart condition allows for the evaluation of the most appropriate course of action and, when possible, intervention before the child’s condition worsens. Health cooperation cannot, therefore, be limited to responding to emergencies: it must contribute to building expertise, relationships, and continuity. This perspective is also crucial for the work POBIC has launched in Ghana on rheumatic heart disease, with the goal of increasing awareness of its prevalence among children and laying the groundwork for interventions based on reliable data. World Heart Day: Turning Awareness into Tangible Opportunity World Heart Day reminds us every year how important it is to protect cardiovascular health. But not everyone starts from the same starting point, and not everyone has access to the same resources. For some children, the problem isn’t knowing that treatment exists—it’s being able to access it. Bridging this gap requires expertise, organization, and resources. It requires hospitals willing to care for young patients and skilled doctors
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