The third aldo castaneda lecture: the neglect of neonatal/infant cardiac disease in Africa--continental genocide?

The advances made in pediatric cardiology and cardiac surgery now make it possible for survival into adulthood of the majority of children born with congenitally malformed hearts. On the African continent, unfortunately, this is only a dream as roughly 280,000 neonates born every year on the continent are left untreated, demonstrating the natural history of the congenitally malformed heart by default. Pediatric cardiac surgery is available in very few countries on this continent. This article takes a look at the problem of neonates and infants born with cardiac defects on the continent and attempts an extrapolation of the magnitude of the problem. Using the experience gained at the Walter Sisulu Pediatric Cardiac Center since its inception in 2003, issues of financing indigent patients, training local personnel, and building capacity through infrastructure development and regional cooperation are discussed. The success of the Walter Sisulu model demonstrates the benefits of treatment for the neonates and infants with congenitally malformed heart, on the continent. It is emphasized that African governments and all stakeholders must participate to ensure a good outcome for the African child with congenital cardiac defect.