Salam Centre for Cardiac Surgery
Cardiac surgery for patients from around the world.
In 2017, EMERGENCY’s Salam Centre for Cardiac Surgery celebrated its tenth anniversary. It remains the only completely free cardiac hospital in an area home to over 300 million people. The centre opened in 2007 and is situated on the outskirts of the Sudanese capital, Khartoum. It remains one of very few facilities across the African continent offering highly specialised and free treatment to patients suffering from acquired and congenital cardiovascular diseases. Severely limited access to free, specialist treatment in Sudan and the wider region leads many to postpone visits to healthcare facilities. As a result, their conditions continue to deteriorate, putting their lives at serious risk.
Patients operated on at the Salam Centre suffer primarily from valvular conditions caused by rheumatic fever. These complications have a very high incidence rate among young people: 56% of our patients are under the age of 26. Across Africa, there are an estimated 18 million people suffering from rheumatic fever, an inflammatory disease of the heart valves caused by untreated group A streptococcal infections (GAS). While in wealthier regions rheumatic fever has been effectively eradicated and affects only 1 in every 100,000 people, the incidence rate in Sudan is 1 in every 1,000 people. This marked contrast is linked to poverty, limited hygiene infrastructure, and a lack of healthcare facilities. During 2017, complications arising from valvular conditions accounted for 80% of patients presenting at our Salam Centre.
The co-situated guesthouse provides board and lodgings – completely free of charge – for the relatives of patients travelling from beyond Khartoum for treatment. The Salam Centre also houses a multi-faith Meditation Hall for use by patients and their relatives. Upon discharge, patients continue to receive regular and close monitoring by staff at the centre; especially those who have undergone valvular surgery and who must follow anticoagulant therapy. While hospitalised, and subsequently during follow-up at the INR Clinic, patients receive information on nutrition and on the importance of following their tailored therapy programmes in order to avoid cardiac and neurological complications.
As of 31 December 2017, EMERGENCY professionals at the Salam Centre have supervised 70,474 outpatient visits and 63,482 cardiological consultations. A total of 8,412 patients have been admitted for further care and our surgeons have performed 7,407 operations. The centre currently has 63 bed spaces and employs 410 local staff members.
Collaboration and Training
EMERGENCY collaborates closely with the Sudanese Ministry of Health. After ten years of activity, in 2017 the Salam Centre was recognised as a specialist centre in anaesthetics, cardiology, and cardiac surgery. Furthermore, the centre has been accredited as a certified training centre and hosts trainee doctors and nurses during their specialisations. The Sudanese Medical Specialisation Board has authorised the Salam Centre to educate cardiologists; intensive care nurses; anaesthesiologists; cardiac surgeons; and specialist theatre nurses.
Additionally, Sudanese generalist doctors can spend a year of their National Service at the Salam Centre, with the potential to obtain certification in cardiology. The hospital is, therefore, an integral part of the national and regional healthcare system, contributing to local capacity-building and developing future autonomy. In recent years, the country’s national healthcare system has suffered after seeing many of its doctors and nurses emigrate to the Gulf. As such, the training of young Sudanese specialists has become a fundamental part of our work in the country.
The Sudanese government provides a financial contribution that covers part of the running costs of the hospital: approximately 15% in 2017.
EMERGENCY’s Salam Centre for Cardiac Surgery is a hospital for the entire region. Thanks to screening projects and follow-up visits by our cardiologists, our surgeons in Khartoum have operated on patients from 30 countries. This has been possible thanks to the ground-breaking ANME programme.
The African Network of Medical Excellence (ANME) is an innovative model of humanitarian healthcare designed by EMERGENCY, with multinational support from the Health Ministries of the Central African Republic, Chad, Democratic Republic of Congo, Djibouti, Egypt, Eritrea, Ethiopia, Rwanda, Sierra Leone, Somalia, South Sudan, Sudan, and Uganda. The aim of ANME is to develop an integrated network of medical centres of excellence on the African continent. The Salam Centre was the first of these centres, and sits at the heart of ANME. Thanks to the ‘Regional Programme for Cardiac Surgery’ – and in collaboration with numerous local authorities – EMERGENCY’s international team of cardiologists identify patients from a vast area who require transfer to Khartoum for urgent cardiac surgery, and guarantee the necessary follow-up care for patients who have already been operated on.
One of the goals of the project is to foster stronger relationships between the countries involved, through reciprocal healthcare collaboration in a region marked by decades of conflict. Our hospital in Khartoum is named to reflect this aim: Salam is the Arabic word for Peace. Patients from 30 countries have undergone surgery at the Salam Centre, including: Afghanistan, Burkina Faso, Burundi, Cameroon, the Central African Republic, Chad, the Democratic Republic of Congo, Djibouti, Eritrea, Ethiopia, Jordan, Kenya, Liberia, the Philippines, Rwanda, Senegal, Sierra Leone, Somalia, South Sudan, Sudan, Tanzania, Uganda, Yemen, Zambia, and Zimbabwe. Italian citizens temporarily residing in Sudan have also undergone treatment at the centre.
The Salam Centre for Cardiac Surgery and ANME programme collectively embody EMERGENCY’s humanitarian ethos; a vision of human rights-based healthcare centring on the principles of Equality, Quality, and Social Responsibility (EQS). Outlined in our Manifesto for a Human Rights-Based Medicine (2008), these principles require:
Equality: every human being has the right to be treated, without discrimination of any kind. In order for care to be accessible, it must be completely free.
Quality: healthcare systems need to be of high-quality and based on the needs of everyone. Only healthcare of a high-quality is effective. Healthcare provision must not be shaped or determined by industry-based lobbies or corporations.
Social Responsibility: governments must consider the health and wellbeing of their citizens a priority, and provide public healthcare services accordingly.
The EQS model promotes the ‘right to be treated’ as a ‘fundamental and inalienable right belonging to each member of the human family’, in accordance with the stipulations of the 1948 Universal Declaration of Human Rights. This is why, every day, EMERGENCY practices medicine based on the above principles. The Salam Centre provides – completely free of charge and available to all – medical and surgical care according to the most advanced international standards and making use of the latest innovations; while concurrently working to promote the autonomy of the Sudanese national healthcare system.
Architecture and Awards
The Salam Centre for Cardiac Surgery has won numerous architectural prizes, including the Aga Khan Award for Architecture in 2013: awarded to ‘innovative buildings that combine architectural excellence with a positive impact on the quality of life of surrounding communities.’ The facility is highly innovative and is designed to minimise its environmental impact. The building is designed to minimise energy consumption, using effective ventilation to mitigate the heat and an extensive system of solar panels to generate energy for cooling.
Activities: Paediatric cardiac surgery, cardiac surgery for adults, cardiology, interventional cardiology.
Facilities: Accident and emergency, clinic, 3 operating theatres, sterilisation, intensive care, wards, physiotherapy, radiology, laboratory and blood bank, pharmacy, classroom, play room, technical and support services, guest accommodation.
Bed spaces: 63
Local staff members: 477
Clinical visits: 75,312
Specialist cardiology visits: 69,996
Surgical interventions: 8,093
Diagnostic and interventional haemodynamic procedures: 1,382
Non-Sudanese patients: 1,446
(Data correct as of 31 December, 2018)