May 23-30, 2009

Albania, a country being reborn. After centuries of being controlled by outside forces, dictators, and foreign powers, they are finally beginning to control their own destiny. Known as Shqiperia, “the land of the eagles” by its people, it is a mountainous beautiful Mediterranean country.

They began forming a democracy in 1992 and formalized it in 1995 . With that the abuses of the last several rulers/leaders the country was largely in shambles. Food supplies were extremely short, most had no money, no job, and a very dismal outlook for the future. 10’s of thousands had left the country, thousands more killed. What was once a proud and strong people, was now fragmented, broken, with no public services available for health, sanitation, or law and order. Yet a spark survived, and from that spark a democracy was born. Not a perfect system by any means, but it was a start. The various parties of the country were still vying for position, for control, for popularity, yet it seems to have begun to realize they need to find ways to work together.

And so they are making progress. Incredible progress in recent years. Over 2000 churches were destroyed or taken over during the communist era, now some are being rebuilt or opened as churches again. The Health system of the country was easily 100 years behind that of neighboring European countries, one of the new government’s early initiatives has been to try to improve the health service for its citizens. Along with paving roads, building infrastructure, building adequate, safe, efficient housing for the thousands of Albanians that have been returning home. Incredible progress has been made in recent years. Whole sections of cities, especially Tirana, the capitol, have been totally renovated, complete with numerous high rise hotels, businesses, and apartment buildings. The health system is largely a public system. Health services are offered free to all citizens, currently, almost all technically advanced diagnosis and treatments, are currently only available in Tirana at Mother Theresa Hospital. Basic services, and basic surgery are the only services available at the other 16 Regional Hospitals.

And so the need for a Gift of Life program in Albania. For every 1000 births per year there are 7-9 children that are born with congenital heart defects that will most likely require surgical repair if the child is to live a fairly normal life. Mother Theresa Hospital has been able to develop its pediatric program to the point where they can do some pediatric heart surgery. Currently, they have one cardio-thoracic surgeon and 3 cardiologists that see children. It is the only place and these are the only doctors in a country of 3.5 million where people can bring their children for help. Obviously, there are thousands of people, many, if they have survived, are now in their adulthood, doing the best they can. Thousands more children are also hanging on to a hope that maybe, somehow, soon, they will be able to receive the Gift of Life. Everyone we spoke with agreed that this is the current situation. Noone knows for sure how many are suffering and waiting or dying from CHD (Congenital Heart Disease). Noone knows because the country is still too fragmented to have that kind of information centralized. Even the cardiac team at Mother Theresa does not currently have a running list of patients they have not been able to help. Yet they are doing the best that they can. There is an Italian team that has been coming for 6 years, 3-4 times per year to perform surgeries there. Albanian, Dr. Boboci continues to operate on as many children as he can, those surgeries that he believes he can handle, in between the Italian teams visits. All in all, they are able to perform 80 – 100 surgeries each year. Unfortunately, that is not enough. There should be about 200 children born each year in Albania that need corrective heart surgery, plus there is the backlog of children born from all the years that surgery was not available anywhere in Albania. Currently, no children under 2 years of age or 21 kg are receiving surgery. For some of these, it means they are destined to die, since their parents do not have the means or the know how to send them elsewhere for help.

Needless to say, there is much we can do. And so we have taken the first steps to giving the Gift of Life to many children of Albania that need it. Our Gift of Life program has worked in many countries, yet not Albania, yet. Fortunately, Peter Kikot is married to a wonderful girl of Albanian descent. Erinda (Begeja) Kikot who also has a heart to help children worldwide, and now in Albania also. And so Peter, Erinda, and myself (Andrew Topp), travel to Albania to see what we can do. Rotary began in Tirana in 1996 and has recently branched out to 2 other cities of the country with a 4^th club, in Elbason, having its charter meeting on June 15. The beauty of Rotary International is the almost automatic cooperation we received from the Tirana Rotary club, in particular, from its current president, Adrian Shehu. Adrian is thrilled to be making this one of their first international cooperative projects, and so he was eager to set up appointments for us with anyone and everyone that he could.

Remember, Albania is still in a very delicate political state. In order for any program to succeed, it will need the blessing of political powers, administrators, and chiefs of staff.

And so, on Monday, we begin our week with a meeting with Deputy of Parliament - Alira from the Albanian Children’s Foundation; a government supported charity (chaired by the Prime Minister’s wife). Meeting in Adrian’s office, she is very interested in what we are proposing and believes that we can work in partnership with each other. In order to make it clear how we will work together she asks if we can draw up a Memorandum of Understanding which will outline what each of us expects the other to do. Once we both agree on the details, we will both sign and then begin our work!

Next Adrian has arranged a meeting, for Monday afternoon with Dr. Sasha Shashenka, the head intensive care Dr. at Mother Theresa Hospital PICU unit. She was extremely helpful and very interested in working with us. She was especially interested to find out if we can find an Echocardiogram Machine for their use. They currently have to share time on the one machine that they have in the hospital, that does not work very well. They really need one dedicated to the Pediatric department.

Next we head downstairs to the cardiology dept to see their one echo. Machine in action. It is used for both adults and children, doesn’t always give a complete picture and will not make any recordings—the one piece of information that our cardiologists really need to make a good decision when evaluating potential cases. For this reason we are trying to obtain a working echo-cardiogram machine as soon as possible.

Monday afternoon we have a meeting scheduled with Minister of Health Mrs. Zonia Godo. We have an impressive meeting, talk at length about the scope of the problem as well as the various approaches to solve some of the problems. Mrs. Godo also makes the suggestion that we may want to look into the possibility of working with some of the regional hospitals and working out a system of cooperation with them and Tirana Hospital. We were already thinking along the same lines!

Mrs. Goda calls her good friend, the General Director of Mother Theresa Hospital, Mrs. Gjeorgjina Kuli-Lito who is also a pediatrician to set up a meeting for us with her on Tuesday. General Director Gjeorgjina Kuli-Lito was very interested in getting all the details worked out to help us and so she quickly set up a meeting for us with Dr. Ariel Como – Deputy Director of Mother Theresa (in charge of the Cardiologists). She also sets up a meeting for us with Dr. Baboci.

Tuesday morning we have a meeting first with Dr. Arben Baboci- Cardiac Surgeon who does some surgery in between when the Italian team comes to help out. He agrees that there are many children who they are not able to help, but it really is the cardiologists who would have a handle on those cases. Many of them are either more complicated than what they can handle there or the babies are too young and small.

Ariel actually stopped in to meet us briefly and scheduled a meeting for Thursday with himself and the 3 cardiologists that worked also with pediatrics there. He was most concerned with going over the details of how we would proceed. He was also very interested in coming up with a way to keep track of patients that come to them for help and for one reason or another did not get it. Currently, if they cannot help them, they just send them home with whatever records might have been produced, there is no record of how many patients have been seen or who they are. Our meeting concludes with thank-you’s (filomenderit) and goodbyes (mirumpopshoo).

We spend a few moments over coffee outside in the warm Albanian weather with Dr. Ariel Como, getting to know him better and the makeup of the hospital better. He tells us we have made all the right connections and have gotten all the right support and so our progress should be good. By this point its almost dinner time for us, but in Albania, that’s not till 8 or 9 pm, so we stop at Erinda’s house, pick up her dad, and go out for some “coffee” and light snack until it is Albanian dinner time, while Erinda and Zana do some shopping.

Wednesday, we have a meeting scheduled with Albana, the President of the newly formed Rotary club of Elbason. She is going to introduce us to the head of the Pediatric department of the Regional hospital in Elbason. It is about a 1.5 hour drive through winding mountain roads. A beautiful drive, as long as you don’t get car sick! We all survive and stop several times to take photos. Elbason is a larger picturesque town in the middle of a large flat valley, with a river running through and mid-sized mountain peaks all around. In spite of the huge steel mill spread out through much of the town, (it is only partly operational), the town still retains much of its mid-evil charm, including the remains of several castle walls which now frame the downtown shopping and business area.

We go with Albana to meet Dr. Arben Paralloi, director of Hospital at Elbason, who is extremely nice and seems thrilled to meet us. He explains that their hospital is the only hospital in the region and serves about 400,000 people.

Still they only have the basics, they do some emergency care, some general surgery, some outpatient procedures and care. For everything else, most people either go to Mother Theresa in Tirana, out of country if they can afford it, or if they cannot– accept their fate.

A very interesting finding comes to light in our meeting, they have a good working ultrasound cardiology machine that will make DVD recordings! Only trouble is, they do not have a cardiologist trained to use it on pediatrics and they many need a different transducer to make it work effectively. Our next step then to help them and in turn to help more children, is to get them whatever parts they may need to be able to do echo-cardiograms on kids, and then bring one of the cardiologists here for training. That way early detection and diagnosis could be performed right in this regional hospital and they could be sent straight to us; saving time, money, red-tape and quite possibly, a good number of children’s lives.

After meeting with the cardiologists and checking out their equipment, we stop to have a cup of coffee with everyone, while we are socializing, the father of a good friend of Erinda and Peter’s, who lives in the US., but is from this town, stops by to pay a visit! I’m not sure if it’s another sign that it’s a small world, or this is just a small country! It is a joyous occasion nonetheless, and it feels good to feel like we have family everywhere we go!

Back through the mountains to Tirana, a little bit of down time, getting ready for Erinda’s step-mom’s 50^th birthday party that is scheduled for Wednesday night! They put it off purposely so they could hold it while we were there. We have a great time, get a real taste of Albanian hospitality, food, music, dancing, vino, raki, and fun!

Thursday- We get back to our hotel around 2 AM, only trouble is, we have to be up at 5:30 AM to drive to Durres for a ½ hr. live news conference on UFO, and educational/news channel that is broadcast in many parts of the country. We look a little bleary eyed on the screen, but all in all the piece turns out very well! It plays not only then, but also at 4:30 pm, and then again on Saturday. We give an overall explanation of the Gift of Life program and how we hope to help Albania. The host of the show wraps it up with an invitation for any families with children needing surgery to contact one of the country’s Rotary clubs for more information. By the end of the day we are already hearing good comments from people that have seen the coverage! Great advertising not only for GOL but also for Rotary International.

We would all love nothing more than going home and sleeping for a while, but we have a 10:30 meeting scheduled with Dr. Ariel and the 3 cardiologists. Adrian has a driver pick us up and we meet him and the others at the hospital. After introductions, we get down to the key business that we have been hoping to accomplish since we arrived, to determine for sure that not only are they willing and eager to work with us, but that they have some cases of children waiting to be helped. They admit they don’t keep records on kids that have come to them that they could not help, but they do know of 5 at the moment that were not helped by an Italian team of surgeons that was just there two weeks ago. They propose to get records together and to us as soon as possible. We have since received emails from them with their contact info and are awaiting the charts of these children that need our help.

Next we make plans to go up to the top of Dayti Mountain by cable car to get a good look at the layout of Tirana, and have lunch. On the way we talk about the benefit of at least stopping in at the US Embassy to visit the consular office to introduce ourselves. One of the key components to helping people get a US visa to come to the US for treatment, is having a good relationship with the Embassy. If they get to know us there and we have a good record of making sure people return to their home country, they are much more likely to issue visas when requested. We are tired and would rather go home to rest for the late afternoon, but this is important.

On the cable car, we are seated with 3 other people, we assume are Albanian, turns out one lives in the US in NY and knows a friend that Peter and Erinda know very well, and the other two are good friends with one of Erinda’s uncles! What a small world!

After a delicious lunch and many photographs; of the city, the people, the WWII bunkers still visible in many of the hills, we hire a taxi to take us to the Embassy.

They will only allow Peter and I in, so we drop off Ashok and Erinda waits outside while we make our introductions and leave some brochures. They look forward to working with us and are glad to know that we already have a clear understanding of what is required for them to issue medical visas.

Next, we need to go to the Tirana Rotary meeting! Remember, Peter and Erinda and I are still operating on 3 hours sleep! We are really starting to show some wear and tear!

The Rotary meeting goes great, a wonderful group of folks who are very interested in making Gift of Life one of their first International projects. Peter, Erinda as translator, and I give a good program overview, we exchange cards, take some photos and then its off to dinner, finally! (although we would rather we were going home to sleep!) Adrian tells us that there is another Doctor in his Rotary club that wants to meet with us and he really thinks we should meet with him after dinner tonight. (OH NOOOO! We are soooo tired…) This Dr. is a good friend of Dr. Baboci, he is a general pediatric surgeon and besides wanting to help us work out the details of helping children with congential heart defects, he is also interested to know if we can help some of the children he sees with other difficult conditions. We tell him of our other foundation, International Humanitarian Aid Foundation that will consider other cases. We promise to keep in touch and finally—its time to go home and crash!!

Friday morning we are hoping to take some free time to travel south to see a little more of the country, Adrian has other plans! There is a possibility that we will have a meeting with Mrs. Berisha, the wife of the Prime Minister of Albania, unfortunately her schedule doesn’t work out for us to meet, but Peter, Adrian and I, do have a meeting at 1 with Dr. Zaneta Shatri of USAID. She is also a pediatrician by training but is now in charge of health development within Albania. She is very interested in what we are doing and how Rotary works in a country like Albania. She also has similar ideas on how to work with the Regional hospitals, taking some of the burden off of the Tirana Hospital. It’s a very informative meeting for both of us!

We leave there with a great sense of accomplishment for the week. We hope and pray that many or all we met with will follow up with their part and that we can get all the support that we need to make this ongoing, life saving project a reality. We agree with Adrian and this year’s Rotary theme, that together, we can “Make Dreams Real”! Yours in Rotary International Gift of Life service, Peter and Andy