<i>60 Minutes II :</i> Heart To Heart

Ten Years Later, Hospital Project A Huge Successs

A group of California doctors, calling themselves Heart to Heart, first went to St. Petersburg in 1992, using their vacation time to give Russian children with heart problems a chance to live normal lives.

At the time, Russian doctors didn't have the skills or the equipment to perform the simple heart surgeries considered routine in the United States. The difference these Heart to Heart doctors have made is staggering, reports Correspondent Lesley Stahl.

In her first visit to Children's Hospital No. 1 in St. Petersburg a decade ago, the 60 Minutes correspondent saw children so weak they squatted instead of stood. Some couldn't walk at all. They were born with congenital heart defects, and if they'd been operated on as infants, as they are in America, they'd be leading normal lives.

Dr. Christian Hardy, chief cardiologist of the Heart to Heart team, thought the majority of the children he saw would die because Russia had very few cardiac centers.

"We saw patients laid out on beds with IVs that weren't sterilely inserted," Hardy said. "We saw lack of supplies, reused supplies over and over and over. And we saw children who, with very simple problems, were inoperable and dying."

Dr. Mark Zilberman, the Russian head of cardiology at the children's hospital, says sophisticated medicine was reserved for Communists and high-level military men. The medicine most Russians encountered was 40 years behind American standards.

Russians reused syringes, even the disposable plastic ones brought over by the Americans. There was a shortage of antibiotics and a shortage of nurses and hospital staff. Family members stayed with their children, cooking and cleaning up for them

The shortage of blood was so severe that when a patient needed an emergency transfusion. a Russian doctor rolled up her sleeve and donated blood on the spot.

These things were driving doctors out of Russia. Dr. Zilberman estimated that his salary was the equivalent of $7 a month in American terms, less than a bus driver is paid.

On the first visit there, Stahl met the family of 2 1/2-year-old Andrei Retchetz, who had been told repeatedly by Soviet doctors he wouldn't make it to his third birthday. The family took a 20-hour bus ride to get to Heart to Heart.

Surgeons operated on Andrei but without proper diagnostic tools, they had no idea how badly damaged the boy's heart was. He survived surgery, but after he was transferred to the intensive-care unit, his heart started to fail.

The Americans and Russians teamed up to do emergency surgery on Andrei in the intensive-care unit, but his kidneys began to fail, and the hospital didn't have the diuretics that could have saved his life. The next day, Andrei Retchetz died.

Heart to Heart has had such a powerful effect on cardiology in St. Petersburg that, had Andrei Retchetz come to doctors there today, they would be able to save his life.

Russian doctos now perform 300 surgeries a year, with a success rate equal to that of hospitals in the United States.

"We needed to teach them the basic building blocks so that they could gradually become self-sufficient and do things on their own," Hardy says. "And that's really what they've been able to achieve."

Dr. Vadim Lubomudrov was their star pupil. He was chief surgeon and head of the children's cardiac unit 10 years ago, a title he holds today.

"I try not to remember," Lubomudrov says of the old days, "because for me it's like a nightmare. All these years, we've been improving everything. And now we live in these conditions."

The Russian health system as a whole has not made these strides. In most places, illness and mortality rates are rising; doctors have to scrounge for essential medicines. Even other parts of the St. Petersburg hospital are struggling.

Bur Lubomodrov's unit is still supported by donations from the U.S. One Virginia benefactor raised more than $2 million to pay for renovations and essential supplies. A grant from the Conrad Hilton Foundation and Toshiba paid for a new $2 million cardiac catheterization lab for diagnosing complex cases and determining if a child's defect is operable.

Sasha Mulchanov was one of the children operated on 10 years ago. Without surgery, his life expectancy was only another three or four years. Today, at 17, he is a healthy university student and can barely remember the days when his heart was so weak his lips turned blue and he had trouble walking even the few blocks to school.

"I feel like a normal, healthy kid," Sasha says. "There are practically no restrictions."

His father calls the surgery "a second birthday - a miracle."

Since 1992, the Heart to Heart team - Americans and Russians - has operated on about 2,500 children. The one downside is that Russian doctors in the program continue to leave for the West. Dr. Zilberman left in 1995 and is a cardiology fellow in Cincinnati.

"It got much better with American supplies and American help, " he says of the Russian cardiology unit. "And then it got worse again. And it was a time of great frustration, when we had no surgeries for weeks, because we couldn't get medicines we needed, or we couldn't get equipment."

The average doctor still makes less than a bus driver and Lubomudrov, the chief surgeon, makes only about $500 a month.

While the Russian health system continues its decline, this program stands out, making Dr. Hardy's dream come true.

"This trip has been particularly wonderful for me to see other children and see how it's been able to come to fruition," he tells 60 Minutes II.

Meanwhile, Dr. Hardy has founded a new program called the "Children's Hospital Alliance International." They've already started working with the only children's hospital in China's second poorest province. Hardy sys things there are even more primitive there than they were when he first got to St. Petersburg in 1992.

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