Introduction:
The aim of this three-day children’s heart screening mission at Mbeya Zonal Referral Hospital was to screen children between the ages of 0 and 14 from seven regions of the Southern Highlands zone, which has a population of over 10,000,000 people.

This mission is part of a three-year nationwide children’s heart screening program aiming to reach children from all areas of the country, especially those who have not yet received this crucial service. It also aims to measure the prevalence of congenital heart diseases, enhance early diagnosis, and provide affordable heart treatment to these children.

Thank you to all partners and sponsors for your support in making the mission possible. Corporate sponsors of this mission include Mbeya Zonal Referral Hospital, Container Concepts Limited, Pacific Diagnostics, Tembosoft Limited, Ark Associates, and Maternal Care Foundation.

Mission Overview:
Our goal was to provide free heart screening to children from seven regions of the Southern Highlands zone. The specific objectives were to create awareness, build capacity, measure the magnitude of congenital heart defects, and provide treatment options to the screened children.

Preparation:
The mission preparations included raising funds for the mission and then application processes (permission to conduct the mission at the Mbeya Zonal Referral Hospital, VISA for our overseas Doctor, and practicing license). Logistics arrangements included booking flight tickets and arranging meals and accommodation for the team. Also, we had to outsource an echo machine for the mission and fortunately, we obtained one from Pacific Diagnostics Limited. We planned to transfer this machine from Dar es Salaam to Mbeya using a rented private car because the machine was not mobile (weighing 75 kgs) and we were supposed to cancel some of our local flight tickets to accompany the machine to Mbeya, a road journey that could take up to two days. Luckily, we were given an echo machine by the Mbeya Zonal Referral Hospital.

Execution:
Our overseas doctor arrived in Dar es Salaam on time from Bangalore, India, on the morning of 9th March 2024. We had a short board meeting in our Dar es Salaam office, had lunch, and then transferred to Julius Nyerere International Airport heading to Mbeya during the evening. We arrived safely in Mbeya through Songwe Airport and were taken by a hospital driver to accommodation that was located very close to the hospital’s gate.

We started our screening on 10th March (half-day) and had a brief introductory meeting with the medical director of the hospital. This day we screened only 17 children because it was Sunday.

The next day we had a meeting with the Executive Director of the hospital and shared a collaborative plan for establishing a sustainable heart treatment program at the Hospital. This day we screened a larger number of children and had to screen until evening hours. Then we had a chance to visit most of the hospital areas and witnessed the infrastructure that the hospital has invested in for the heart treatment program.

On the 3rd day, we continued with screening from the morning, and it went together with a brief presentation from the surgical team regarding the strategic plan for establishing heart surgery services at the Hospital.

Participation and Engagement:
We successfully screened more than 100 children. Roughly, in every group of 10 children we screened, approximately 4 children seemed to have received their first cardiac echo at the appropriate time after birth. About 6 children experienced delays in receiving their first cardiac echo, potentially indicating delayed diagnosis or medical evaluation. We still need to do more echoes to validate this estimation. Our team included 2 members of The One New Heart Tanzania, 1 Interventional Pediatric Cardiologist from India, 1 Pediatrician, 1 Pediatric Cardiologist, 1 Cardiovascular Surgeon, Doctor of Internal Medicine, a Biomedical Engineer, 2 Nurses, a Public Relations Officer, and a Registrar.

Screening Results:
A total number of 104 children were screened. We’ve committed to sponsoring treatment for 5 children needing urgent surgery. Others with critical conditions will receive palliative care, and more will undergo diagnosis after 1-3 years.

Impact and Success Stories:
Some of the patients who came to our mission were for follow-up care, who were previously operated on a few years ago in Dar es Salaam but sadly, they were not able to attend clinic due to the long distance and costs of staying in Dar es Salaam.

Acknowledgments:
We acknowledge the contributions of sponsors, partners, volunteers, and the hospital staff in making the mission a success.

Way Forward:
During this screening mission, we noted a large number of congenital heart cases originating from the Rukwa region. However, more data are required to accurately measure the magnitude of congenital heart defects in these areas.

We have created a network with the children, parents, and doctors, and we have a collaborative continuous screening, awareness creation, and training program around the local wards and villages to be able to detect the symptoms of congenital heart diseases and report them immediately.

Conclusion:
Our next mission will aim to conduct a free screening program and train the hospital technicians and doctors on doing detailed echoes and translating them.

We are grateful to everyone, and we hope to join hands together in these early heart diagnostic services which result in early treatment intervention and hence reduce the mortality and morbidity rate due to congenital heart defects in Tanzania.