An account of how a large Catholic medical center has lost its way. Go to pmmdaily.blogspot.com to see recent updates.

Tuesday, March 14, 2006

Catholic Diocese Abandons Haitian Hearts



Catholic Diocese of Peoria Abandons Haitian Hearts

During the Spring of 2003, there were no more meetings with Bishop Jenky regarding Haitian Hearts. OSF had placed Haitian Hearts on suspension after calling the American Consulate in Haiti demanding that no more visas be issued to children needing to travel to Peoria for heart surgery.

I was very disappointed with my meeting with Bishop Jenky in the chancery when he refused a petition for a tribunal court against OSF and repeatedly told me that “this isn’t going to work out” (the survival of Haitian Hearts at OSF). He just seemed very intimidated by OSF and the local business community and I did not think that he would support Haitian children that needed heart surgery based on what he said.

Haitian Hearts wrote up a new agreement for OSF detailing how Haitian Hearts would be run. However Sue Wozniak, CFO at OSF-SFMC, who had been placed on the “new” Diocesan Haitian Hearts committee told us she never read it after my sister-in-law presented it to her. Why would she not even read it? We had read OSF’s set of rules for Haitian Hearts which included details that OSF would even control the visas of the Haitian children. This meant that OSF could send them back to Haiti whether they were ready to go or not after surgery. Haitian Hearts thought that this could endanger the children. Also, OSF’s document stated that the Catholic Diocese of Peoria would pay for costs to children in the hospital that were not covered under the contract. The Diocese said they would not pay these costs. So the OSF document was extremely deficient and not realistic. There were going to be so many rules established by OSF, I thought it would endanger the kids and the program. That is why we had to write our own proposal that Wozniak said she did not read.

In May, 2003, Monsignor Rohlfs called me and stated that the Sisters had made a financial offer to set aside monies in Children’s Hospital of Illinois to help cover surgery. I told him I was grateful for this. He added that I needed to accept the money before any other detail of the program could be discussed. I told him that this would of course be impossible to do because of OSF’s shenanigans in the past and what there proposals were this time (like controlling the kids’ visas, etc.) Rohlfs stated that we had to have a meeting which I agreed to, but insisted that Haitian Hearts know the rest of the details of OSF’s proposal before we accepted anything.

On July 16, 2003 we finally had our meeting. Joe Piccione greeted me at the door of the Bishop Sheen center with a smile and a hand shake which made me worry that the end of Haitian Hearts was near. The meeting was run by Monsignor Rohlfs and Patricia Gibson. Others in attendance were my brother and sister-in-law, Dr. Gerald McShane (wearing his golf shoes), Sister Diane McGrew from Corporate, Sister Judith Ann Duvall, President of OSF, and a friend of mine who had lost her husband to a heart attack after a bungled ambulance experience.

Monsignor Rohlfs stated the meeting by saying that I needed to accept the financial offer from the Sisters. I told him again that I needed to know the other “details” of the contract constructed by OSF and the Diocese. He would not tell me any of the details, but Dr. McShane gave us a hint that they were "significant". One of Haitian Hearts concerns was that if a Haitian child’s bill ran over the what was allotted by the Sisters, Haitian Hearts would be blamed (in the media like they had in January) and OSF would demand that it be paid. Rohlfs had said that the Diocese was not going to contribute anything for the Haitian children. Joe Piccione and McShane said that the debt would not be carried over each year but, amazingly, Sister Diane stated that Haitian Hearts would be responsible for any debts, that the debts wouldn’t be forgiven at the end of each year, and that there would be no “caps”. This was what I was worried about, along with the safety of the Haitian kids. Thus, I could see that the OSF people and the Diocese had not really prepared for this meeting and Sister Diane was driving a hard bargain. She was definitely not a happy lady and poor Sister Judith Ann did not say anything again. As President of OSF Corporate, I would have thought that the secular leaders would have let her say something.

Monsignor Rohlfs was adamant that no details be discussed until I accepted the plan as it was. We obviously could not accept this. If I accepted the offer and the rest of the contract was bogus, I was cornered and the Diocese and OSF could say that I refused all help for my Haitian kids. The trap was being set. My brother asked for another meeting so OSF and the Diocese could better understand what Sister Diane was saying. Rohlfs said we had just 7 minutes left to make our decision. I showed a framed picture of a little Haitian girl named Pamela needing heart surgery and Rohlfs chided me and called Pamela “my advertisement”. Joe Piccione, OSF Corporate Ethicist called me arrogant and told me that I was “not going to back the Sisters into a corner.”

Rohlfs ended the meeting in one hour. No other meetings were scheduled and my friend whose husband had died got into a wreck on the way home she was so upset with the outcome of the meeting.

The Diocese had aligned themselves with OSF and the big money in Peoria. Catholic social justice was not discussed by anyone except Haitian Hearts.

I left for Haiti the next day to begin working again. The director of communications for the Diocese called me in the Miami airport. She is a friend of mine and sadly informed me that the Diocese was pulling away from Haitian Hearts. Elaine Hopkins of the Journal Star interviewed Dr. William Albers, a pediatric cardiologist at OSF. Even though Dr. Albers was not there, and not on the Haitian Hearts committee, he blamed me on the front page of the Journal Star for failing to “negotiate” with the Diocese and OSF. Monsignor Rohlfs and OSF wouldn't negotiate at all with their mandate to accept OSF's offer, or nothing will be discussed. (OSF usually picks someone peripherally involved in an issue who is well known by the community, to talk to the media when necessary. I had actually expected they were going to pick Dr. Albers to slam me and told my family months before...but it hurt because he was another mentor of mine that I really looked up to as a physician.)

I was really sad during my first couple of days in Haiti that so many people had turned on the program and that Haitian kids were going to suffer greatly for decisions made in fancy offices in Peoria.

With the background as presented, the Catholic Diocese of Peoria came out with the press release as follows:

July 18, 2003,

Catholic Diocese of Peoria’s Statement on Haitian Hearts

Peoria—It is with enormous regret that Bishop Daniel R. Jenky, CSC, is announcing today that the Diocese of Peoria was unable to successfully facilitate an agreement between OSF St. Francis Medical Center and the Haitian Hearts program. The Diocese originally became involved in the process at the request of the Sisters of the The Third Order of St. Francis. From the beginning, all parties involved were fully aware that there were many obstacles that needed to be overcome for this undertaking to succeed. Despite good will on everyone’s part and many hours of hard work, the parties were unable to come to an agreement. The Bishop would like to publicly recognize the zeal and goodness of the many supporters of Haitian Hearts. He would also like to commend the ongoing generosity of the Sister of The Third Order of Saint Francis for their willingness to make a significant financial contribution had this program been successful.

The Diocese will be making no further comment at this time.

-----------------------

My 87 year old mother wrote Monsignor Rohlfs the following letter after the Diocese's pathetic effort regarding helping Haitian children:

Msgr. Rohlfs:

I am quite sure you read Dr. Albers' misinformation in the Journal Star that said that "Dr. Carroll would not negotiate." You know that the reason John could not negotiate was that you would not allow him to do so. You emphatically told everyone at the meeting that John must accept or reiect the sisters' offer of$200,000 before discussing the list of stipulations that accompanied their proposal. You also know that no clear thinking adult would even consider accepting or rejecting without first discussing and negotiating all of the terms that would have to be met first. How could you issue such a senseless ultimatum that is in direct opposition to good business procedures? Why would you not allow negotiations before commitment? Give me one good reason!

I have talked to Dr. Albers and have learned that he was given the false information that John didn't try to negotiate -- Msgr. Rohlfs, you know that even John's written attempt to negotiate (counteroffer) was never responded to. You also know that he asked you verbally at least three or four times and my son Tom also asked for discussion/negotiation before committing to accepting or rejecting the Sisters' proposal. You emphatically refused. In your letter to John announcing the date and time of the fateful meeting, you stated that many things needed to be discussed -- John, of course, totally agreed. Why then did you not encourage discussion and negotiation rather then forbid it?

Surely you know John's reasoning for insisting on discussion and negotiation before accepting the proposal: he would be held responsible if Haitian Hearts could not cover its St. Francis' bill. Had this been you, Monsignor, would you (or the diocese) have agreed to accept the Sisters' offer and take the risk of going bankrupt? Of course you would not! Of course John could not!
Regarding Dr. Albers' unwarranted statements to the newspaper concerning negotiations and meetings that he was not a part of: apparently one or more persons have given him inaccurate information -- how unfair! and I believe in some cases dishonest.

Regarding the only two Diocese/St. Francis Haitian Hearts meetings that were held: meeting No.1: you appointed the useless and never-called-upon-to-report committee chairmen and you announced that the Diocese did not intend to "end up with egg on its face." Meeting No.2: you issued the edict that John should blindly accept or reject .... Sounds like a pre-planned charade to me!

Sue Wozniak stated at the meeting that she did not read John's written attempt to negotiate (his counteroffer)--why was this? Had any others on the committee read it?

Over the past two years, John has made numerous attempts to resolve these and other serious concerns regarding OSF St. Francis Medical Center. Nothing has been resolved. As you know, John did not want to sue the sisters, so he and Tom thought a tribunal was the logical, sensible solution. When they discussed this with you early on, you did not appear to object to a tribunal. In fact, you know that you and Patricia helped John write the letter informing Sr. Judith Ann that he was considering it. Why would you then suddenly, three or four months later, get so upset about the tnbunal that you threatened John by saying that you would go to the media if he went ahead with it?

Who/what changed your mind? Did either of you ever tell the bishop that you had known about the tribunal for three or four months and had even helped write the letter? I am sure you know that when John talked to the bishop, the bishop was quite upset regarding the idea of a tnbunal and said that he had just heard about it during the previous 24 hours. Since this is true, why hadn't you or Patricia told him long before and, at the very least explained to John why you so adamantly switched views on the tribunal approach?

John was told by a very well known Peoria attorney that the diocese would never help him-we didn't, for a minute, believe it. Also, he was told by another attorney that the diocese would destroy his reputation. Now, what are we to believe?

Surely your conscience, as well as Dr. Albers', tells you that you have an obligation to do whatever it takes to right this temble injustice to someone who tries to live as he believes. I sincerely implore you to do so.

Mary Carroll


cc: Bishop Jenky
Sister Judith Ann
Patricia Gibson
Dr. William Albers
Dr. McShane
Sr. Canisia
Diana Couri
Joe Piccione
Monsignor Campbell
Monsignor Watson



---------------------------

Addendum: March 17, 2006--

Even though the Diocese walled away from Haitian Hearts in 2003, as many people predicted they would, my wife and I continued with Haitian Hearts spending 5 months per year in Haiti. We have now brought 122 Haitians to the United States. In the past 4 days, two little girls have had life saving cardiac interventions in Ohio and Missouri. Below are two articles from 2005---



Chicago Tribune

Haitians get priceless gift
Illinois doctor helps open the door for heart surgeries

By Deborah Horan Tribune staff reporter
December 6, 2004

When the pain came, as it often did, attacking Katia Cesar's heart with a breathtaking, debilitating cramp, the young Haitian woman would squeeze a pillow to her side, wait for the spasm to subside and count herself among the lucky ones.
Rheumatic fever had damaged her heart years ago, causing the skin on her throat to rise and fall with each heartbeat and leaving her unable to climb the hilly streets of Port-au-Prince, the Haitian capital.

But a chance meeting in Haiti between her uncle and a Peoria doctor led Cesar to a Joliet heart surgeon who could put an end to the painful episodes and ultimately save her life. It's a journey she attributes to a higher power.
"It was God's hand," Cesar, 21, said of the day she saw Dr. John Carroll, a Peoria internist, at a clinic in Port-au-Prince. "The Haitian doctors had told me that I had no hope to live. I was so discouraged, every day I cried."

On Friday, Cesar successfully underwent a three-hour operation in Provena St. Joseph Medical Center in Joliet, where doctors replaced her aortic heart valve with a man-made prosthetic valve.

She became the 111'th patient to receive care in U.S. hospitals since 1995 under the auspices of Haitian Hearts, a charity founded by Carroll that is devoted to helping patients fmd treatment for heart disease and other serious maladies. The treatment is unavailable to people in the crowded and violent shantytowns of Haiti, the poorest country in the Western Hemisphere.

"She's a very serious case," Carroll said, days before Cesar's operation. "She would likely die without surgery."

Cesar's uncle, a waiter, met Carroll while at work at the hotel where the doctor stayed during his visits to Haiti. The two struck up an acquaintance. Then one day, the waiter told the doctor about his niece's "sickness of the heart." The conversation catapulted Cesar from the crowded and anonymous ranks of Haiti's gravely ill onto a select list Carroll uses to track heart patients he knows are in dire need of care.

He shopped around for a hospital that would perform the surgery free of charge and found St. Joseph. He persuaded the U.S. consulate to grant Cesar a three-month visa to America.

"I was nervous when they told me I was going to America" Cesar said in a recent interview at the Franciscan Sisters of the Sacred Heart convent in Frankfort, where she stayed while she awaited surgery. "I was so happy."

Two other Haitian patients who arrived with Cesar on Nov. 13 will also undergo surgery arranged by Haitian Hearts, including Suze Lapierre, 26, scheduled for heart surgery at St. Joseph. Caleb Derestil, 16, who suffers from a rare cancer, will be treated at St. John's Mercy Medical Center in St. Louis.

In a little less than a decade, Haitian Hearts has raised $1.2 million from individuals and companies to bring patients, mostly children, to U.S. hospitals for surgeries unavailable in Haiti, including heart bypasses, Carroll said. Cesar and Lapierre are the first adults sponsored by the group.

Most of the funds raised went to the Children's Hospital of Illinois at OSF St. Francis Medical Center in Peoria where Carroll worked in the emergency room until 2001. The children's hospital took in some 60 children before it ended its support for Haitian Hearts in July 2002, about six months after Carroll and St. Francis parted ways following a dispute regarding hospital policy.

Since then, Haitian Hearts, led by Carroll with assistance from other Downstate volunteers, donors and board members, has had some success finding other hospitals to admit needy Haitian patients.

Carroll, 41, has been passionate about bringing Haitians to the U.S. for treatment since he first traveled to clinics in the Haitian countryside with a church group in 1981 and fell in love with the people.

He took an interest in tropical disease and noticed a high number of patients had severe heart problems. But hospitals were poorly equipped and underfunded, and patients were often at the mercy of the political violence that has plagued Haiti, particularly since President Jean-Bertrand Aristide was forced to flee the country in February. Carroll's solution was to find help for as many of the patients as he could outside the country.

"It's just so important that children's hospitals around the U.S. and Canada open their doors to a child or two a year," he said. "We probably have 20 kids on our list that need to come here for surgery."

Poverty and ignorance compound the problem. Both Cesar and Lapierre live in houses without plumbing or running water; neither one knew they had contracted the strep throat that turned into rheumatic fever and damaged their hearts.
As a child, Cesar remembers always being sick with fever. At 14, things got worse: Her legs swelled, she couldn't walk without feeling winded, and she couldn't study or play sports. When her mother took her to a community hospital, a doctor gave her medicine for anemia.
"They never revealed I had a heart problem," she said. "They didn't know what was wrong with me."

Three years later, another doctor discovered her bad heart and told her she probably would not live much longer. She sat without hope in her mother's tiny house in a crowded slum until the day her uncle told Carroll about his niece.

By then, Carroll had become locally famous. Haitians had heard about the American doctor who worked at a rural hospital five hours south of the capital. When he advertised his arrival on the hospital's radio station, patients would flock there and to the Lucella Bontemps clinic in Port-au-Prince to receive help for ailments common to the developing world: typhoid, malaria, tuberculosis and malnutrition.
"We'd get besieged with calls," he said.

All the while, he kept an eye out for severe heart patients, adding each new case to a handwritten scroll on which he logs a patient's medical condition and history of illness. Cesar was No. 43 on the list.

Lapierre was No. 30. She had been referred to Carroll a few months earlier by a Cuban doctor working in Haiti who discovered her damaged heart and knew the American doctor might be able to help.

"My heart was beating faster," Lapierre said. "I didn't know what was wrong."

When the U.S. visas for Cesar and Lapierre came through, their journey began. Carroll's sister-in-law Theresa Atchley met the women at O'Hare International Airport with coats and other clothing. The young women then went to the convent, where Lapierre spent two nights before doctors discovered possible signs of tuberculosis and pneumonia. Rather than expose elderly nuns to contagious disease, Carroll brought her to his home in Peoria for a few days. She is now staying in Minooka until the surgery.

Cesar remained at the convent, in a room usually reserved for friends or prospective nuns.

"I was suffering so much," Cesar said of her medical condition. "When I met Dr. Carroll, I felt I had hope again."
Copyright © 2004, Chicago Tribune
---------------------------------------

A wise use of medical resources?
Caring for sick Haitian children personalizes poverty of developing nations
Sunday,April 24, 2005
BY MARIA KING CARROLL

We are standing on the second floor of the UNICAR hospital in Guatemala City at 7 a. m, listening to about 15 doctors discuss the children on the floor who have recently had heart surgery. A tall, trim man wearing a light blue suit and sporting a full head of neatly combed white hair leads the group from one child's bed to another, asking questions and making comments.

"This is like going on rounds with God," whispers my husband, Dr. John Carroll, the founder of Haitian Hearts, a program that brings Haitian children to the United States for heart surgery. In fact, Dr. Aldo Castaneda, our elegant leader, is one of the gods of pediatric cardiac surgery. We have ventured to Guatemala to see if his program might accept a Haitian child for surgery.

Fifty years ago, as a med student in Guatemala, Dr. Castaneda hooked up dogs to a prototype heart-lung machine to understand how it might be used to help people. It's difficult to operate on a beating heart. The heart-lung, or bypass, machine allows surgeons to stop the heart without killing the patient. Bypasses made open¬heart surgery possible.

After completing his residency and working at the University of Minnesota, Dr. Castaneda spent the bulk of his career at Boston Children's, where he headed the Department of Cardiovascular Surgery from 1972 to 1994. Our host in Guatemala, his young associate, Dr. Juan Leon-Wyss, tells us that most prominent among Dr. Castaneda's many surgical innovations is showing the world that it is not only possible but preferable to operate on newborns with congenital heart defects, rather than waiting until the children are older, as was the practice.

Despite these world-class accomplishments, Dr. Castaneda has saved what I believe is one of his most impressive achievements for his "retirement." He returned to Guatemala, a poor central American country of 14 million where there was no children's heart surgery, and started the Fundacion Aldo Castaneda. Through this foundation, he built the hospital, UNICAR, supplied it with state-of¬the art medical equipment and recruited staff.

In 1997, doctors performed the first pediatric heart surgery in Guatemala. Last year 373 surgeries were completed at UNICAR. The program is managing cases just as complex as those in medical centers in the United States. On rounds, we see three children with hypoplastic left heart syndrome, a condition where essentially the left half of the heart is missing. This severe defect requires three surgeries to correct.

We are so impressed with the level of medical care at UNICAR that Haitian Hearts donates money to pay for the surgery of a Guatemalan child whose family cannot afford it. Guatemala and Costa Rica are the only central American countries where pediatric heart surgery is performed.

After rounds, we gather in the conference room to review some echocardiograms of Haitian children. We show the group echoes of children with complex and simple defects. Watching these echoes sets Dr. Castaneda to musing.

"If you look at this from a public health point of view, given limited resources, we'd like to operate on children who we can cure, who can go on and have a good quality of life and a normal life span. But to view it less coldly, I know when the child is in front of you, it's different; you want to help that child."

Dr. Castaneda says they would like to operate on a Haitian child, but they are not able to do it for free. The team is interested in an 18-month-old girl who has ventricular septal defect, or a hole between the lower chambers of the heart. As heart defects go, VSDs are usually relatively easy to repair. For this surgery and the necessary medical care, the cost would be $6,000.

"You should know," says Dr. Casteneda, "that our success rates don't match the big programs in the U.S., like at Boston Children's, but we achieve rates as good as those at second-tier U.S. programs."

We all agree that this little girl would be a good candidate for surgery at UNICAR. Our next step is to arrange for the child and her mother to travel to Guatemala City, which will necessitate flying to Havana, Cuba, as there are no direct flights between Haiti and Guatemala.

Given the widespread health problems in developing countries, is the extensive cost and effort of providing Haitian children with heart surgery a good use of resources? After all, bringing individual children from Haiti to the United States or Guatemala does not alleviate Haiti's crippling poverty. What it more immediately does is help some children and their families.

In a broader sense, though, I think having these children in our communities helps "raise the voice of the poor," which economist Jeffrey Sachs states in his book "The End of Poverty" is one of the nine steps to exactly that goal.
Because of the power the United States wields, we need to be especially aware of the conditions of people in poor countries. We were in Haiti last November. Haitians were paying close attention to the U.S. presidential elections. Arguably, the U.S. president affects the lives of average Haitians more than the lives of average Americans.

The children we bring for surgery personalize the problems in developing countries. We hope people will want to help them and the millions they represent in places like Haiti. Children in developing countries, like all of us, deserve first-class medical care.

Individual stories can move people to action. For despite the moral calculus those in deprived countries are forced to use to determine who gets medical care, Dr. Casteneda says that sometimes even when the surgical risks for a child are high and the outcome uncertain, they have taken a leap.

"When we've seen the child, we've broken down and operated."

Maria King Carroll lives in Peoria and spends part of the year working in Haiti. Her husband, Dr. John Carroll, founded the Haitian Hearts program in Peoria in 1995 and continues to run it.

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