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Achieving more together: A public private partnership to support children with heart diseases in Bolivia

Training on the appropriate use of the new medical devices

Many children in Bolivia are affected by heart diseases. In 2013, German Development Cooperation, the medical technology company Dräger and local partners joined forces to change this.

Children in Bolivia are heavily affected by heart diseases, but the country’s treatment facilities lack equipment and qualified staff to alleviate their suffering. In 2013, German Development Cooperation, the medical technology company Dräger and local partners joined forces to change this.

Bolivia: a country above the clouds

Illimani Mountain in the Bolivian Andes

With around 28% of Bolivia being located on an average altitude of 3 850 meters, Bolivia is not only the country with the highest navigable lake on earth, but there are also twice as many children born with congenital heart defects than in countries located on a lower level. Combined with acquired heart conditions caused by common poverty-related diseases, such as Chagas disease and rheumatic fever, Bolivian children face a high burden of heart diseases in total.

This burden, however, remained unresolved for a long time as resources for adequate diagnostics and treatment were lacking and patient costs were not covered by the public health insurance. Dr. Alexandra Freudenthal, cardiologist at the pediatric hospital in La Paz and director of the Fundación Cardioinfantil, remembered the desperate situation: ’If only the hospitals had been equipped with qualified staff and adequate medical devices, we would have been able to help most of our patients.’

Development partnerships with the private sector

Partners of the PPP
Partners of the PPP

Not willing to sit tight and to wait for things to change, the pediatric hospital in La Paz and the Fundación Cardioinfantil took action and contacted Claudia Dräger, board member of the German non-profit Dräger Foundation – with significant success. In 2012, Claudia Dräger took on the journey to La Paz, gained an on-site impression of the situation and announced to support the pediatric hospital with donating medical machines. Dräger’s commitment did not go unnoticed. . Discussions with Dr. Alexandra Freudenthal and the GIZ Country Director Dr. Michael Dreyer, resulted in a public private partnership through the programme of German Development Cooperation.

The German Federal Ministry for Economic Cooperation and Development (BMZ) initiated more than a decade ago in order to foster the involvement of the private sector at the intersection of business opportunities and development cooperation – partnerships must have an added value on both dimensions. Since then, the implementing partners DEGGIZ and sequa have already realized more than 1,500 development partnerships in over 70 countries.

Better treatment through technology and training

Training on the appropriate use of the new medical devices
Training on the appropriate use of the new medical devices

In Bolivia, the partnership on child health was initiated in mid-2013, with a joint agreement of Dräger, the pediatric hospital of Ludwig-Maximilians-University (LMU) in Munich and GIZ for German Development Cooperation to invest more than EUR 1.1 million in the next three years. The partnership aims at strengthening the health system regarding prevention, diagnostics and treatment of children with heart diseases and at developing a local market for corresponding medical devices and services. The pediatric hospital in La Paz has received high quality medical machines from the Dräger Foundation and LMU, such as medical ventilators and two heart-lung machines. In addition, around 50 staff members have been trained regarding the appropriate use and maintenance of these machines.

Leveraging the partnership for sustainability

To spread the new expertise, training on a broader level has been funded and implemented with a focus on the highland regions of Bolivia: In La Paz and Oruro, 165 nurses and 78 pediatricians completed their training and further courses are scheduled for Oruro and Chuquisaca. Moreover, 30 staff members of the pediatric hospital in La Paz were given the opportunity to complete their specialization in Argentina. More than 180 parents were educated on the prevention and treatment of heart diseases. International participation and awareness was further raised in the course of an international congress on heart diseases that took place in La Paz in 2014.

In order to ensure sustainable financing, training and treatment, public decision-makers have been involved in the partnership right from the start. Building on a successful initial phase, an agreement with the Ministry of Health was reached, intending government support for a nationwide health programme to tackle the burden of heart diseases. The Ministry of Health committed to generate additional staffing positions and facilitate training opportunities. Furthermore, drug-related costs will be covered by the public health insurance, as it is planned for treatment costs.

Eeva Karsta, Director Government Relations at Drägerwerk AG & Co. KGaA points out the leverage that the partnership has gained: ‘I am really excited by the idea that partnering with German Development Cooperation has allowed our commitment in Bolivia to have such a capacity-building and sustainable effect on the local health sector.’

Looking forward to a promising future

In the pediatric hospital in La Paz, last preparations are running to perform 15 pilot surgeries that are scheduled for 2016. Representing an important milestone, the pilot surgeries will show that the pediatric hospital in La Paz gained the essential capacities and structure to be able to offer complex treatment to children with heart diseases in Bolivia. Implementing trainings in different regions and countries has further led to a remarkable momentum. Former participants are still showing strong commitment to promote the project – through incorporating own ideas, offering training sessions to their staff members and establishing standard treatment procedures.

Based on the development of the public private partnership, it seems possible that the achievements will constitute a solid foundation for a national programme on congenital and acquired heart diseases and that the good practices will be replicated in further hospitals in Bolivia. Not least owing to the tireless work of Fundacíon Cardioinfantil, the project is already a remarkable success. As Dr. Josef Henao, director of the pediatric hospital in La Paz, confirms: ‘The project is giving children with heart diseases a chance to live, a chance they wouldn’t have without it.’

by Verena Kohlbrenner, GIZ

January 2016

© Fundación Cardioinfantil / AHK Bolivia
© Fundación Cardioinfantil / AHK Bolivia
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