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Dr. Franz Freudenthal
Founder of PFM (Bolivia)
First I wanted to thank for the opportunity to be here, to the organizing committee, to the people who are here, and I wanted to start this talk asking Dr. Alexandra Gil, who is my wife, to do a little introduction of what is the problem we have so I may later show the way of what we have done. Alexandra, please.
Dr. Alexandra Gil
Thank you very much, Franz, and many thanks also to everyone for being here and for giving us the opportunity to present a little of our work in Bolivia.
The subject relates, the one we are going to present, is about innovative solutions for congenital heart diseases. It is not very common to listen to these types of topics in these horizontal forums. We are very proud to be here.
Congenital heart diseases, that is, diseases with which a baby can be born with, represent 1%; In other words, 1 in every 100 children is born with a heart disease.
What does it mean, in Bolivia, to come into the world with a heart problem?
What we have is that in high-altitude cities these problems occur twice as often as at sea level. We estimate that based on the annual births in Bolivia, which represents around 253,000 births, we have 5,000 new cases each year, and a patient pool, a patient cohort, of 50,000 children that are currently adrift.
Around us, that is, in neighboring countries, there are care programs for children with congenital heart disease, such as the SUS in Brazil and Peru, the Auge program in Chile and the Sumar program in Argentina. In all these countries, the child born with congenital heart disease has the fundamental right to be diagnosed and treated in the first hours of life. It is not the case in Bolivia, nor in Paraguay.
You can give many numbers around this problem; suffice it to say that 50% of patients die before reaching the first year of life, swelling the enormous figures of infant mortality that we have in our country and that occupy the sad second place in Latin America. Twenty-five percent more, will die before reaching the age of 5, swelling the mortality figure again before 5 years of age.
Along with this, that is, with early mortality, which can be calculated based on a life expectancy of 68 years in Bolivia, gives us a huge number of 500,000 lost years for our patients; and those years lost due to disability can also be calculated.
The solutions for these children, which can occur to any of us, go through different aspects. We have to take into account, however, that we are not only talking about mortalities and illness; we are talking about families, we are talking to truncated families, who are going to be left without a member; we are talking about hospital hours, we are talking about hours waiting for a file.
What happens to the other children in the meantime? Who brings them to school? Who will work?
How do we lend a hand to our patients? Well, we arrived in Bolivia after our specialty 15 years ago, and we went through different ideas.
One of the ideas was to carry out diagnostic campaigns in those cities in Bolivia where there were no pediatric cardiologists. Of the ten main cities, in Bolivia only three have pediatric cardiologists; then we packed our devices and went to look for our patients by lengthening our waiting lists with that.
We made alliances based on public-private projects with German cooperations, with Japanese cooperations, making it possible for at least one hospital in Bolivia to treat children based on cardiac surgery.
We founded the “Fundación Cardioinfantil” looking for resources for our campaigns and for our surgeries, and achieving that a number of patients who came to us could be treated. We did missions in different places, in different cities, also performing heart surgeries.
However, how many people can one reach as a private person? Not many. Remember the initial figure: 5,000 new patients every year. We only reached 50.
We decided then to look for new alternatives already in the area of technological innovation. Children can be treated, when they are diagnosed in time, in 85% of cases. Halfway through open-heart surgery, very expensive, with a lot of time in intensive therapy, with a lot of danger; or they can be treated through cardio pediatric interventionism: By half. I'm going to give Franz the floor now to tell you how we did that.
Dr. Franz Freudenthal
Well, you are all aware why I had to do all of this. Alexandra does not allow me to go to bed if the problems are not resolved. And I wanted to speak a little about what science means. Science is not something abstract or unreachable in the skies. Science is small, safe, solid, consequent, and protocolized steps. There cannot be chaos or disorder in science; we have to do things step by step and that is what the children expect from us.
Education: You can see that I’m not alone, Alexandra is showing the children what and where the problem is; and the children arrive with their family members and we have to understand them.
The Aymara people have a tradition of what the heart means and what feelings mean. The most important thing is to understand the patients.
We must understand that these patients come with a solution in their hands. As you see, these are the most incredible artists that exist. They can make millimeter wide stitches with incredible precision. I have not found those capabilities in any place in the world like I have found them there, but they are present in many places, they just need to be cultivated.
What we do is that we take a very thin catheter and we travel until we reach the problem; there we place a device and solve the problem. The only thing we do is utilize the natural pathways that the patient has in order to fix it. Before, we had to open the chest, disrupt many organs to reach this place. You can see this patient already has a device in place and is completely normal: He can get up and start his life as any person who is completely normal.
You can see, we cannot see inside the body (these are real images). In this case we are closing using a CIA. These tissues made by the Aymaras are the ones we use to stop these heart defects.
These are the images that we see. At this moment the device is inside the body, inside the heart, and it is solving this problem that this patient had all his life. As Alexandra said, that patient had many limitations, he lived ill, and if this problem was not solved he was going t be a burden. These patients, when the problem is solved, are the pillars of their family.
I’m giving you a tour inside the body. These are tissues that are already inside the human heart and are working; they will be there for their whole life, they will live together.
I wanted to explain a little that these stitches that have been made: They have a technology that no machine can match. They do not have welding points that means they do not have corrosion. There is no other device in the world better than this, thanks to those skills.
I am showing here another image ... There you can see in magnetic resonance. These intelligent materials are compatible with all the diagnostic methods available today and in the future; that is, the other devices that exist make a lot of artifacts and these are really beautiful because they are compatible with ultrasound, with magnetic resonance, with x-rays and with all the means of image.
Here you can see our Aymara partners stitching these fabrics.
So I wanted to show you in this photo how there is a symbiosis between the culture that we carry inside, the problems we carry inside, and the solutions we have inside.
The solutions for us are not going to come from a satellite, they are going to come from us; we have to solve the problems, and it is through our solutions that we will be able to reach the peace we are seeking.
Again, here we see the artisans, who work hand in hand with the engineers, hand in hand with the doctors, hand in hand with the patients. Anyone could tell us that these people are outside of Bolivia. No! They are in Bolivia, and all this technology has managed to have all the international endorsements; that is, it has been recognized both in Bolivia and in all the Latin American countries, but we have also managed to sell all these devices in Europe, and we do not discriminate there either; that is, it is not because they have money, it is because they do not need technology. Here we have to reach everyone, absolutely.
Well, in this I meant to say that the strength that gives Alexandra and me, to move forward, comes from each of the patients, from each of the parents, from each of the mothers who come to us, and they have the courage and strength to live.
We believe that if we have health, if we have integral families, where we have not lost anyone, it will be possible to have peace.
I wanted (although it is a bit of a short talk) to have more time later for the questions, and show them through example, that it is possible to have peace, that it is possible to have all the people we love nearby, live; and I wanted to thank you again for your time.
Thank you very much.
Thank you very much, Dr. Franz Freudenthal, Dr. Alexandra.
We will continue by inviting Dr. Nick Buettner, Director of the corporate community program, “Blue Zones Project.” In his current role as the director of the program, “Blue Zones Project”, he is responsible for giving lessons on longevity of Blue Zones to 42 communities in all of United States. The “Blue Zones” project is a wellness initiative that positively impacts the health of more than five million people all over the country.
Thank you sir, it’s a great honor. Let’s give him a round of applause, please.