Ensure care for congenital heart diseases

Besides the communicable diseases like diarrhoea, pneumonia, mumps etc., congenital heart diseases are still a leading contributing factor that increase the death toll of children. In Bangladesh, approximately 25,000 to 30,000 children born with congenital heart diseases and 90 percent of these children die before their 5th birthday. But the treatment facilities for the large number of children are still very poor and relatively under-focused.
In Bangladesh, there are a very few centres where people can treat their children with congenital heart defects. In National Institute of Cardiovascular Diseases (NICVD), Bangabandhu Seikh Mujib Medical University (BSMMU), Dhaka Shishu Hospital, Combined Military Hospital (CMH) and some private set-up, there are limited opportunities to treat these ill-fated children with both conservative and surgical approaches. Scanty number of beds and other medical facilities including the treatment outcome in these institutions are not enough to handle with the huge number of children suffering from various congenital heart diseases.
There is still lake of consciousness; taboos existing both in affluent and general society hinder the approach towards these children. Paediatric congenital heart diseases all the way need urgent medical and in most cases expensive surgical interventions.
Besides, there are few centres in Bangladesh to diagnose the diseases accurately as early as possible. Very often, these patients are being diagnosed by paediatricians clinically or by adult cardiologist through echo findings. The gold standard to diagnose the congenital paediatric cardiac defects is Color Doppler Echocardiogram. There are very few number of paediatric cardiologists sound with the technical expertise. After Echo diagnosis, angiogram may be needed to assist the surgeon for cardiac surgery. Ironically, there is shortage of paediatric cardiac surgeons also in Bangladesh to treat the huge bulk of patients with utmost care.
So from the above pale and pain picture, it is understood that we need logistic supports, trained and skilled manpower to provide medical and interventional approaches for children with congenital heart disease. At the same time people should be aware with these problems. We must identify at least the treatable cause of congenital heart defects.
Pregnant women should be given proper antenatal care especially with diabetes, rubella and other viral diseases responsible for birth defects to combat diseases at early stage. Suspected mothers to give childbirth with genetic heart defect like downs syndrome should be screened as well. MMR vaccine can protect child from congenital rubella syndrome and thus reduce the burden.
I hope with the holistic effort and commitment we can relieve the distress of children with congenital heart defect.
The writer is the Secretary General of Paediatric Cardiac Society of Bangladesh.