Interview with Dr. Vinay Nadkarni.
By Raif Karerat
WASHINGTON, DC: The American Heart Association, a nearly 100-year-old nonprofit whose mission is “Building healthier lives, free of cardiovascular diseases and stroke,” recently launched the “Saving Children’s Lives” campaign in India. Its goal is to stop easily preventable deaths with pediatric emergency care.
The American Bazaar spoke to Dr. Vinay Nadkarni, one of the lead volunteers of the project and an internationally recognized physician and scientist. The Indian American is the director of the Center for Simulation, Advanced Education and Innovation at the Children’s Hospital of Philadelphia and Associate director of the Center for Resuscitation Science at the University of Pennsylvania’s Perelman School of Medicine. Author of more than 250 peer-reviewed manuscripts and 30 book chapters, Dr. Nadkarni is a member of the AHA’s Science Advisory and Coordinating Council. Here are the edited excerpts:
The campaign is called Saving Children’s Lives in India, which makes the mission statement fairly straight forward. But what are their circumstances, and what are the means to the end? Could you tell us a little about the project?
The project is really just beginning. There are more than 6.3 million children around the world who die before they reach their fifth birthday. And because 1 out of 5 children who die are in India it’s an age problem, and the preventable diseases that cause the deaths are things like pneumonia and diarrhea — things that are treatable, particularly when recognized at an early stage. The Saving Children’s Lives program is being designed to integrate with the existing programs in India, to assist with global recognition, and the assessment and stabilization of these children so that they can be either treated in the home, a clinic, or a district bubble hospital and then transferred when appropriate to caregivers who have the ways and means to help them survive. There are huge campaigns for mothers and newly born infants helping babies breathe — these campaigns have been incredibly successful in recognizing and treating the problems in the first few minutes to hours of life for a newborn child. But beyond that there are a lot of challenges for children in India and this Saving Children’s Lives program is meant to augment the services that are available now.
This model that you’re using — has it been implemented anywhere else?
We initially developed this approach under the name of PEARS — Pediatric Emergency Assessment Recognition and Stabilization — training course, and that was targeted mostly towards nursing providers on the wards or adult providers who might rarely take care of kids to give them the basics. But then this was adapted for the Saving Children’s Lives programs in Botswana and Tanzania. There we worked with in-country providers to contextualize the American course and make it relevant in Botswana. We started small with a pilot in one hospital and one district, saturating that district and training the trainers so that it’s a self-sustaining program. It’s designed by and for providers in the locale in which they’re working. Their intention is to the same thing in India which is to take one state, starting with a pilot, meeting with the healthcare providers and the healthcare providers in Gujarat, India, and to try and identify those components of the existing program that can be adapted and contextualized for the needs of the children of India.
You mentioned Gujarat — so you intend to start there before spreading operations to other parts of India?
With Mr. (Narendra) Modi’s election, attention has been focused on his state, Gujarat, and our meetings with the American Association of Physicians of Indian Origin (AAPI) and with the Indian Association of Pediatrics we have been identify that there is a community health program that was initiated by AAPI called the SEVAK program that already has community health workers in every district of Gujarat. What we’re doing is meeting with them at the AAPI conference and doing a workshop to demonstrate how this American Heart Association program has been adapted for Botswana and changing children’s lives there and discussing how this training could be adapted to make an impact in their districts in Gujarat. The specifics of the program are still being worked out– we’re still soliciting donations to try and help the American Heart Association as well as support the development of a pilot program. We’re also intending to train about 180 local healthcare workers over the next year or so. Again, one of the key, important things we’ll be doing is monitoring the outcomes of the children, how well the providers like the course — how useful it is to them, how confident it make them– and then also once implemented, how much of an impact this is having on preventable deaths in children under 5 years old.
If individuals are interested in donating, they can do that through your website or an Indiegogo page, correct?
That’s correct. Those are the easiest ways to donate.
Regarding the Indiegogo page, I’m curious since it is crowdfunding donations, do you think the advent of websites such as Indiegogo and Kickstarter are making it easier for philanthropic endeavors such as yours to reach out to the public, or are they making the waters any murkier?
Well, it’s interesting. It’s one of the American Heart Association’s first endeavors with crowd sourcing funds. The American Heart Association is the nation’s largest nonprofit and has always benefitted from individual donors who give $25 a year, etcetera, and they’ve always benefitted from being a very grassroots organization for donations. This sort of crowdsourcing approach seems like it would fit very nicely for such an endeavor. We’ll have to see how successful it is; we’re fortunate to have some donors who are matching funds for the individuals who donate on the site, so we’re excited that this could be a really great mechanism. Saving children’s lives is something that anybody can do, so it’s nice to have a venue where everyone can feel like they’re contributing and participating in saving those children’s lives.
It certainly seems like you’ve got a solid platform for more visibility.
Yes, and even if people can’t donate, if they find out more about it, there are so many ways in which people can help — such as volunteering.
Switching gears back over to the initiative itself, I suppose you’ve already covered what the goals are and what you’re hoping to accomplish, but in your own words, what do you think the overarching impact has been since the program’s inception?
It’s very early to measure impact, although it’s very important to measure impact. There’s several levels that it should have impact. Through volunteers and the development of a program that takes resources and expertise and helps the providers in country to develop a self-sustaining program, they’re given hope. So one of the impacts is really hope, that children’s lives really can be saved and that needless lives won’t be lost. It won’t happen. The first impact would be transitioning from hopeless to hopeful. The second impact is on the process of care, of getting communications and systems and to start addressing some of the very challenging problems we have with local resources and just a little bit of knowledge. By elevating providers in-country to train other providers, the impact is a self-sustaining improvement in children’s lives. The third impact which we hope to measure — and this usually takes two to three years to scientifically measure as a statistical impact — would be the number of children’s lives saved. Currently, India has very high rates. Gujarat has about 44 deaths per 100,000 under 5 years old, which is not the highest in the county, but there are certain districts in Gujarat that are exceeding 50 under 5 year old deaths per 100,000 children so it’s an important measurement in preventable deaths and lives saved — the proof of concept, if you will.
Is there anything you’d like to highlight?
I think it’s important to state that everyone can help. Even if it’s in a small way everyone can contribute. There have been many attempts made and many initiatives, but with the American Heart Association’s support, with its links — to the rural health mission of India, the government, the World Health Organization, USAID — there’s so many ways in which this program will be different and it’s highly likely that it will be successful.