Child cardiac problems rising amid inadequate treatment facilities 

Arfin, 7, Sakib, 4, and Nabila, 2, were playing in the Women and Children’s Ward-2 at the National Institute of Cardiovascular Diseases in the capital. They have no idea that they have cardiovascular problems and will undergo surgery soon.

The ward is full of little children like Arfin, Sakib and Nabila.

The number of children suffering from heart disease is on the rise in Bangladesh. At present, nearly 4,00,000 children are suffering from various types of heart problems. Most of them have been diagnosed with Congenital Heart Disease (CHD).

According to the Child Heart Trust Bangladesh, an organisation of cardiologists specialising in treating children with heart diseases, 1,500 children on average are diagnosed with heart problems in Dhaka every month.

At least 25 in every 1,000 children are born with CHD, which means at least 2.5% of the newborn babies suffer from CHD, the organisation said.  

Even though the number of children with heart disease is increasing, treatment facilities remain inadequate. At least 500 doctors specialised in heart problems in children are needed but the existing number is only 31.

Only six institutes in Bangladesh provide treatment for various heart ailments in children: National Institute of Cardiovascular Diseases, Bangabandhu Sheikh Mujib Medical University, Heart Foundation Hospital and Research Institute, Cardiology Department for Children at Dhaka Shishu Hospital, Combined Military Hospital (CMH) Dhaka, and Ibrahim Cardiac Hospital and Research Institute.

However, these institutes lack adequate intensive care unit support or separate cardiac catheterization lab for children. 

The Department of Child Cardiology as an integral part of the National Institute of Cardiovascular Diseases was established in 2001. The following year, 4,674 children received treatment. The number of child patients admitted to the hospital with cardiac problems rose three times to 16,000 by 2018.  

At NICVD, 50-60 children receive treatment as outdoor patients on an average every day. Doctors there said Bangladesh lags behind in child cardiac surgery as only the National Institute of Cardiovascular Diseases and Dhaka Shishu Hospital offer this type of surgery. 

Because of this, most of the children having critical cardiac conditions go abroad for treatment.  

NICVD doctors said they need to create new posts for doctors, broaden the medical curriculum, and ensure cardiac treatment for children outside Dhaka in order to improve the situation. 

The situation is the same at Dhaka Shishu Hospital, where the number of patients has also been increasing. Kingkar Ghosh, an epidemiologist at the hospital, told The Business Standard that the hospital introduced cardiac surgery facilities in 2012. 

“Since July 2012 to June last year, 441 children underwent cardiac surgery.”  

Brig Gen Dr Nurun Nahar Fatema Begum, a child cardiac specialist, told The Business Standard that every medical college should open child cardiology department and employ staff required for treatment of patients. 

“If CHD is included in the IMCA (Intramural Coronary Artery) programme of the government, health workers will be able to identify heart diseases in children by looking at the symptoms. Then they will be able to recommend specialist doctors and the disease can be identified at an early stage,” she added. 

Dr Abul Kalam Azad, director general of the Directorate General of Health Services, said measures had been taken to improve child cardiac treatment. “Many facilities have already been extended in order to cover diagnosis of cardiac diseases among children.” 

Professor Dr ABM Abdus Salam, head of the Department of Child Cardiology at the National Institute of Cardiovascular Diseases, told The Business Standard the reason for heart disease in children is genetic. 

Doctors said heart problems in children cannot be prevented completely since they are genetic. However, preventing ‘gene mutation’ can reduce the intensity of the disease.

Therefore, MMR vaccine before conception, protection from any infection by viral attacks, adequate rest, balanced food, regular ultrasound check-up, and echocardiography of fetus after conceiving is necessary for checking heart condition of women. 

Any kind of birth defect, pregnant women suffering from infection, mothers infected with rubella virus, radioactivity, diabetes and environmental pollution can cause CHD in children.