CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 3, April 2012
AFRICA
167
to this continent, targeting country-specific conditions, and
investigating the role of toxins and traditional practices in the
pathogenesis of cardiovascular conditions. Apart from providing
the means to enable the clinical services to achieve excellence,
research provides important tools to define the size of local
problems, and helps the evolution of appropriate solutions by
local researchers.
27
However, creation and sustainability of such
comprehensive services is hampered by several problems, the
most important being the lack of human resources for healthcare
and research.
The major challenges for surgery for cardiovascular diseases
in African children include (1) building local capacity and
expertise in the diagnosis and management of congenital heart
diseases; (2) training local surgeons in the management of
conditions that are geographically restricted to Africa, using
indigenous techniques that can be applied locally at lower costs;
(3) improving the efficiency of equipment and systems for
adequate maintenance of equipment; (4) creating infrastructure
for the management of and research into cardiovascular diseases
in children; (5) creating systems for financial support of the
communities served by these infrastructures; (6) addressing the
issue of poor local governance and low commitment from policy
makers.
The success of the institutional collaborations currently in
place, and their acceptance and recognition by the community
will hopefully encourage local governments to increase their
support, making an effort to become partners with these
initiatives while giving enough independence to the projects.
Indeed, we think that although individuals or private institutions
can start these networks, political support and willingness
are crucial to ensure their sustainability in the medium and
long term. Finally, the institutions that are running successful
programmes must be reinforced as regional referral centres.
Conclusion
The surgical treatment of cardiovascular diseases in children
remains a major challenge in most African countries. Although
requiring major investments, surgical programmes must be
stimulated, allowing comprehensive management of patients and
offering a unique opportunity for research into the particular
aspects of geographically restricted diseases, namely the
development and testing of approaches to management tailored
to the specific conditions of the continent.
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