In 2002, a diagnostic cardiology department was created in collaboration with two Italian Associations: Bambini Cardiopatici nel Mondo, Cuore Fratello and the Tertiary Sisters of St. Francis. Dr. Jean Claude Ambassa was the first Cameroonian Cardiologist. In 2009, the full-fledged Cardiac Centre was inaugurated by the Minister of Public Health – His Excellency André MAMA FOUDA, and declared the Hospital a National Referral Hospital.

By decree No. 2015/493 0f 04 Nov. 2015, the Head of State, His Excellency, President Paul Biya declared the Cardiac Centre a Public Utility.
The cardiac centre offers services in general cardiology, performs open heart surgeries, catheterization and pace maker implantations. The modern nature of the centre offer quality services to our clients at affordable cost comparatively.
The Centre has a bed capacity of 79 with 91 total number of staff. 15 staff members were trained in Milan, Italy and 6 of the staff have undergone crash training in Modena and South Africa.

Shisong Cardiac Center Project

After several visits, the NGO “Frontliners“, together with another Italian NGO (Cuore Fratello), and the TSSF started the project in 2002, with the objective of establishing a center which could be completely autonomous. We spent 8 years for the initial phase that included the building construction, staff training and instrumental equipment of the CC, it ended with the inauguration of the center on the 19th of November, 2009.
During this phase several training and diagnostic missions were carried out, 120 urgent cases of children with CHD were transferred to Italy for cardiac surgery. The total economic investment by the 3 partners consisted of about 6 million euros.

The CC is today a modern complex of 3,100 covered square meters (Figure 1) with 7 blocks including:

Block-A: out patients department (reception, public-relations office, pharmacy, consultation-rooms, secretariat, administration, social- case office);
Block-B: pre/post-surgical unit;
Block-C: clinical unit;
Block-D: extended wards and X-Ray unit;
Block-E: critical area with cath lab, 2 operating theaters, and 2 intensive-care units with a total of 12 fully-equipped beds;
Block-F: left basement with technical department, procurement office and drugstore;
– Block-G: right basement with a conference-hall, meeting-rooms, blood-bank, guest-house, changing rooms, laundry and research- committee office.

Results

The CC is the only center performing cardiac surgery in Cameroon. In only a few years it has become a national reference center for cardiology and cardiac surgery activity for both pediatric and adult patients. The CC provides a total of 74 beds: 12 in ICU, 22 Post-Op, 20 for female hospitalization and 20 for male hospitalization. The healthcare team includes 56 nurses, 2 pharmacists and 4 physicians (2 cardiologists, 1 cardiac surgeon, and 1 anesthesiologists). In collaboration with the medical staff, there is also an administrative staff responsible for the non-medical management.

After an initial training phase, the cardiological activity at the CC is now improving every year, reporting ~6,500 cardiological consultations each year with an average of 3,000 echo and EKG procedures per year.
The invasive activity includes cardiac surgery for CHD and acquired heart disease (AHD), diagnostic and interventional catheterization, and PMK implantation (Table 2); 719 patients underwent cardiac surgery between November 2009 and December 2017, including operations for 302 CHD (42%) and 417 AHD (58%) (Table 3), with a mean of 80 patients operated per year. The most frequent operations performed are shown in Table 4. The total activity of the CC is shown in Table 5. In the last 3 years, the surgical mortality at 30 days has been of 4.7% for CHD and 4.2% for AHD patients.

The local team is completely autonomous for the AHD surgery, while for CHD patients the team still needs the support from surgical mission teams from foreign countries. In 2017, 43 patients with CHD have been operated during 5 surgical missions (3 from Italy, 1 from Belgium, and 1 from Mozambique), 30 of them (70%) have been operated by the local surgeon helped by more experienced surgeons and 13 by surgeons coming from abroad.

Congenital heart diseases (CHD) are present in nearly 1% of live births; according to WHO, there are 1.
Productivity enhancement since 2009.

The number of cardiac surgery procedures depends on the funds that various charity associations, NGOs, and Foundations make available to cover the costs of the interventions.
Most of the patients assessed and operated at the CC come from Cameroon, especially from the near provinces of Littoral, Center and North-West. In the last 2 years, patients from other countries such as Democratic Republic of Congo and Equatorial Guinea have also been operated, demonstrating that the CC is a reference center not only for the local population but also for the neighboring population.

Out of the hospital environment, it is important to highlight that the consumable goods completely purchased abroad at the beginning of the CC, are now purchased on the local market when it comes to 40% of the goods.

From a scientific point of view, the CC medical staff in collaboration with the foreign staff has produced 20 publications on Index-Medicus since 2009.
Read more about different well-known organizational models to develop a cooperation project in pediatric cardiac surgery in a developing country at Frontiersin.org.