Photo: Medical staff in the operating room at the KHMH

by Kristen Ku

BELIZE CITY, Mon. Oct. 30, 2023

A relieved mother is grateful for the life-saving surgery her 5-year-old son, Aroldo Clarke, Jr., underwent at the Karl Heusner Memorial Hospital (KHMH) in Belize City.

Aroldo’s medical journey has been marked by challenges, since he was diagnosed with Tetralogy of Fallot, a congenital heart defect that severely disrupts the normal blood flow, leading to minimal oxygen levels in the bloodstream.

Tetralogy of Fallot is a condition that arises during the developmental stages when a baby’s heart doesn’t form in synchrony with its body inside the womb. Such heart defects are not uncommon. Globally, congenital heart defects affect 1 in every 115 to 150 individuals. About 10% of these individuals are diagnosed with Tetralogy of Fallot.

Despite the pressing need for specialized cardiac care in Belize, many families are faced with the reality of not being able to afford life-saving surgeries due to their prohibitive costs. Recognizing the gap, the Rotary Club of Belize established an initiative named “Gift of Life Belize.” This non-profit, now in its 40th year, organizes pediatric cardiac screening clinics every six months. More than just screenings, the organization ensures that children in need receive surgical interventions.

Aroldo’s struggle with heart complications began at the tender age of 5 months. Under the compassionate umbrella of the Gift of Life initiative, he underwent his first open-heart surgery in the Cayman Islands, a process that required Aroldo to be in recovery for an extended period of about 2-3 months until he recovered. Here he spent most of it being hooked up to an ECMO machine which pumps and oxygenates a patient’s blood outside the body, allowing the heart and lungs to rest.

Unfortunately, following the surgery, some complications required a second operation.

“Part of the redoing of the operation, they had to use an extra conduit, which meant they had to harvest graft from a jugular vein of a cow. One of the things that can happen with this conduit or homograph is they can shrink over time, or they can dilate or become aneurysmal. So, his became very cyanotic, small, obstructing the pulmonary blood flow,” shared Dr. Elsa Suh, the pediatric cardiologist guiding his treatment.

Now that Aroldo is five years old, the doctor’s focus is on a follow-up procedure called catheterization (the process of putting a tube in the heart to allow fluids to pass or to make a passage wider).

“His pressure in his right ventricle was very elevated, so we were trying to alleviate that by opening up with a balloon, but it looks like it’s more of a stretchable conduit. Ballooning alone is not going to solve his problem. He may need to have a stent placed to keep it in open position,” she added.

Children with Tetralogy of Fallot often exhibit symptoms that are both startling and distressing. Their skin can exhibit a blue tone, which can become especially visible during episodes of crying or feeding. Patricia Clark, Aroldo’s mother, was the first to notice these early signs. “It was difficult for him to breathe, and I saw that around his mouth it was blue; his fingers, it was blue, and they called him … babies with this condition … I’ve heard they called him the blue babies, because when they cry, they turn blue, like blueish color,” she said.

Beyond the immediate cardiac concerns, Aroldo struggles with developmental delays. “We do a lot of therapy with him … because, since the procedure got complicated and the ECMO machine does the thinning of the blood, some of the blood went on the bone of the skull, and that caused him a developmental delay, so he’s not going to school, but I try to get all the therapies that he needs. But he plays like any normal kid; it’s just that the milestones that he’s supposed to reach he’s not there yet,” Clarke told reporters.

The road ahead is a long one for children like Aroldo. Regular medical check-ups and interventions are crucial. But with organizations like Gift of Life Belize, which pledges to care for these children until they’re 18, there’s a beacon of hope for Belize’s young hearts.