One doctor's mission to screen each child in the Caribbean for heart disease
St. Vincent & the Grenadines
5 Minute Read
Many doctors can trace their calling back to a particular moment, often in childhood, when they realized they were fascinated with the human body, how to fix it, how to heal it, and how to solve some of life’s most important problems with their own two hands.
Dr. William Moskowitz was in sixth grade when he watched a short film, Hemo the Magnificent, that made him consider for the first time how important a heart was, not just to humans but to the entire animal kingdom. He wasn’t sure what kind of doctor he’d be—at 12, he didn’t even know pediatric cardiology existed. But as he grew older and his education and career grew with him, he found he loved the specificity of diagnosing and correcting heart issues in children, helping them lead healthy lives and watching them grow up to be adults.
Dr. Bill Moskowitz screening some very interested pupils
But there’s a certain type of doctor whose own heart is too full to keep his or her talents limited to just their own community, or even their own country. When World Pediatric Project approached Dr. Moskowitz to come along on a diagnostic trip to Guyana, he got his first taste of what would become his true passion—helping communities with a lack of medical resources. This humanitarian approach to medicine would fill gaps in his life that he didn’t know were there.
All he knew as he started out for Guyana was that WPP had been making real strides in Central America and the Eastern Caribbean by diagnosing congenital heart disorders and treating disease early. It was exciting to think of himself as being part of that impact. But nothing prepared the doctor for just how much he and the rest of the team were needed.
Guyana isn’t an easy place to live. As the poorest continental country in the hemisphere (it’s situated next to Venezuela, but identifies culturally as a Caribbean country), the setting boasted exactly none of the necessities he was used to children having, and the dangers of disease and congenital heart defects were pronounced. Excessive humidity left his echocardiogram machine unusable, so Dr. Moskowitz and the WPP team improvised with an obstetric ultrasound wand.
With extreme poverty around every corner, the country clearly had more urgent priorities—sanitation, infrastructure, education, you name it. It became clear just how necessary outside help would be for these children, whose hearts had a much greater chance of beating for a lifetime if defects were caught and operated on early.
It would be the first of 35 trips Dr. Moskowitz would make in the 12 years between then and now. He’s traveled to seven different countries, circling back again and again to follow up with the children he’s operated on or those who’ve been screened and entered into WPP’s database for further observation.
“Geography should not limit a kid’s access,” says Dr. Moskowitz, firmly. And the kind of health care he promotes extends to a long-lasting relationship with the children, their families, and their communities. “We don’t come in and then leave. We’re committed to these kids and we follow up.”
A child in the remote village of Sandy Bay, St. Vincent
The first visit, though, can often be the most important. Early detection plays such a vital role for a heart that can be made healthy again. Once congenital heart problems grow along with the child, they’re harder to correct. Some children’s issues are minor, correctable by a procedure that can be done on-site in a cath lab. Some require more complicated surgery, and Dr. Moskowitz’s team will schedule that child for a trip back to the U.S. for surgery. And some are simply too advanced to be operated on without a risk to the child’s life.
Those cases are the most frustrating, but a large percentage could be avoided, had the issue been caught by a regular screening earlier in the child’s life. The team is seeing that change, with 90% of all heart patients now making it into adulthood. “Four years ago, that number was inverse,” he says.
Setting up massive screening efforts in multiple hub countries in the Eastern Caribbean and Central America have helped change the trajectory of heart disease in that part of the world. Helping the local medical teams incorporate a culture of early diagnostics and detection turns generation after generation into healthier, more productive adults.
Dr. B. Datta, St. Vincent's pediatrician, working with Dr. Moskowitz
“It’s of course gratifying to deal with adults, but the kids are the ones that you really have fun with,” Dr. Moskowitz says. “And after you’ve done the repair to their heart, their whole life is in front of them.” It’s simply a matter of numbers, he says. The more of those kids the WPP team can see, the more issues they can find early, correct early, and monitor throughout the crucial next few years of their lives.
In estimation, this one particular individual has treated at least 2,500 patients in the Eastern Caribbean and Central America. And he’s nowhere near finished with his work. This fall, Dr. Moskowitz will travel to St. Lucia to establish another diagnostic sweep.
And as it comes, he’ll make sure every child who needs surgical intervention will be referred and prioritized as soon as scheduling and WPP funding makes this possible. With every trip, every child, and every family, Dr. Moskowitz will add to the joy in his own heart that comes from creating healthier futures.