The Department of State’s Agency for International Development (USAID), with additional help from Vice-President Lyndon Johnson, landed the Heart Team in Karachi, Pakistan, on May 2, 1963. The Loma Linda University Overseas Heart Surgery Team had been born.
According to Dr. Joan Coggin, people all over America began supporting the project: “Several pharmaceutical houses were very generous in donating medical supplies for our surgeries in Asia. Eli Lilly and Company supplied protamine; Organon, Inc. provided heparin; Abbott Laboratories contributed sodium bicarbonate; Merck, Sharp and Dohme gave us Mannitol; Don Baxter, Inc., supplied all of the IV sets; and Davis and Geck furnished our sutures. The kindness and helpfulness of everyone was amazing.”
Immediately, Drs. Wareham and Coggin began screening patients, some of whom had traveled as much as 1,500 miles. The other four members of the Team were: Wilfred M. Huse, MD, a surgeon, F. Lynn Artress, MD (Class of 1942), an anesthesiologist. Mr. Lester H. Gibson, the heart-lung-machine technician, began setting up the operating room. Lavaun W. Sutton, RN, a nurse specialist, started training the local nurses in techniques of cardiac post-operative care. By May 8, everything was ready and the surgery schedule had been completed. The Loma Linda University team transformed the 120-bed mission hospital into a temporary university medical center.
(According to my dad, who witnessed my birth at the Loma Linda Sanitarium and Hospital in 1941, Dr. Artress saved my life when I didn’t breathe and was turning blue.)
At 8 a.m. Jamil Shaid became the first Karachi heart-surgery patient. Jamil’s father had carried a newspaper clipping of Afshan Zafar’s surgery in his wallet since October, 1962, had been one to go to the United States Embassy for help. Then he watched the press for news reports. As soon as the Americans arrived, he rushed his son to the Karachi Adventist Hospital for an examination. The boy’s surgery was a closed-heart procedure.
The next day, however, the team performed the first open-heart surgery in Pakistan on nine-year-old Anwar Zaida. A semi-invalid with a very short life-expectancy, he was the first in Pakistan to use the heart-lung machine. Both boys were from the small Pakistani middle class. As in Afshan’s case, expensive heart surgery in America or Europe would have been impossible.
During the first two days, the team performed four surgeries—as many as they would have performed in a week at home. In 22 operating days, they performed 44 heart surgeries. Working 16 to 20 hours a day, they also had seen 300 patients in clinic. Pakistani President Mohammad Ayub Kahn flew one of the patients from East Pakistan by military transport.
Dr. Coggin remembers the spirit of cooperation the team witnessed from the hospital’s personnel. “We came in and turned their hospital upside down. We made 18-hour days the rule for many, and they thanked us for it over and over again. We were very, very impressed by the hard work they did with a cheerful, thankful spirit.”
The effort would not have succeeded without the help of the hospital staff and many other interested parties. The All Pakistan Women’s Association and the Jamshed Lions Club united to donate the six to twelve pints of blood needed for each surgery. Even government agencies offered Karachi jail prisoners 15 days of grace for donating a pint of blood.
Something the heart team had not seen in the United States surprised them. When they entered a patient’s room to examine one of their patients, they found the entire family looking on. Somebody from each patient’s family stayed all night with their loved ones, even if it meant sleeping on a floor mat beside the bed.
Lester Gibson, the heart-lung machine technician, noticed the patient’s response to a routine pre-surgery prayer: “Our Moslem patients were particularly impressed by the doctors’ prayer before each surgery. One instructor from a local medical school asked what the prayer was and could hardly believe that it was not a memorized paragraph but a conversation.”
According to Dr. Wareham, the hardest part of the trip was closing down the surgeries. “There were so many more patients—little children—waiting for help and asking us to do just one more operation.” Finally, because of other commitments on their scheduled tour, they had to set an arbitrary date and stop. Local newspapers urged the purchase of a heart-lung machine for Pakistan, and the team inspired local surgeons to establish their own program.
Not only did the team inaugurate heart surgery in Pakistan, but they also taught surgical techniques to scores of Pakistani physicians who had visited the hospital. The response in the professional community was amazing. “Our team’s work seemed to break through existing barriers of religion, nationality, and race,” Dr. Artress recalled. “We were accepted with little professional jealousy because no one else in Pakistan was doing similar work.”
The team remained a few days following the last surgery on June 2 to provide intensive care until all patients had recovered. This gave them time to report their efforts to the nation from the United States Information Center. On that occasion, all Pakistani heart surgery patients were made members of Mended Hearts, Inc., an organization of former heart surgery patients.
As the team prepared to leave Pakistan, prominent citizens of Karachi lauded them for their accomplishments. The president of the Pakistan Medical Association expressed profound admiration for the “miraculous success” of their efforts. Even President Mohammed Ayub Kahn held a personal audience where he could express his appreciation.
Before returning to California, the team performed more surgeries in India and Thailand. Altogether they saw 400 Asian patients and performed 55 surgeries—on their vacation.