Pacemaker charity hurt by its own growth

<a href=www.heraldtribune.com>By MITCH STACY Associated Press Writer

In the back room of a storefront office, steel shelves are crammed floor to ceiling with pacemakers and other medical equipment that soon will be helping sick hearts keep beating around the world. The aptly named charity Heartbeat International works with Rotary Clubs worldwide to match donated pacemakers with poor people who need them and surgeons who can implant them. Those who get the lifesaving devices couldn't even begin to pay for them otherwise. But like many charities in these uncertain economic times, Heartbeat International finds itself struggling to make ends meet. Quietly responsible for providing about 6,000 pacemakers since its beginnings in 1984, the charity has grown too big for its own good. Now maintaining 46 "pacemaker banks" in 28 countries, Heartbeat International is having trouble covering administration costs for all the devices that need to be shipped and implanted. "The financial situation is such that we're in serious jeopardy of reaching our 20th birthday in October 2004," said executive director Wil Mick. Administration costs are relatively modest because pacemakers and the services of hospitals and surgeons are donated, Mick said. Heartbeat International pays about $250 for each set of lead wires that connect the pacemaker to the heart, and the cost of getting the devices where they need to be. But the demand for them is so great now that the charity has been forced to reinvigorate fund-raising efforts, trying to raise $2 million over the next two years. It reorganized its board this spring with a sharper focus on raising money and is rallying its international Rotary partners to be more aggressive about seeking donations in their communities. Officials are concerned but not panicky. "This is the greatest challenge we face after 18 years," said Ramon P. Camugun, a Rotarian in the Philippines and a new board member who oversees Heartbeat International's operations in Asia, Africa, Europe. "In the past, there was much concern with improving the knowledge of doctors in the program, but there was not much time given to raising funds for the program. We knew we had to get reorganized." The mission was begun by an idealistic Guatemalan cardiologist, Dr. Ferderico Alfaro, who was haunted by the death of a 17-year-old patient who needed a pacemaker and couldn't afford one. Vowing to never let it happen again, he teamed with his Rotary Club in Guatemala to establish the first pacemaker bank. He started with more than 50 donated pacemakers, many of them harvested from patients who had died. When Dr. Henry McIntosh, chairman of the Department of Medicine at Baylor, visited his former student in Guatemala in 1983, he saw the potential for extending the effort into developing countries worldwide. "I was impressed with his sincerity," said McIntosh, now retired and living in Lakeland, where Heartbeat International was founded. Because of potential problems with used pacemakers, Heartbeat International persuaded manufacturers to begin donating new devices whose "use-by" dates were nearing. Pacemakers carry 10-year batteries, so the U.S. Food and Drug Administration requires they be sold by a certain date or destroyed. Medtronics and St. Jude Medical, the two largest manufacturers, now donate 300 to 400 pacemakers and related equipment every year worth as much as $2 million. The half-dollar-sized devices are implanted just under the skin on the chest, with two leads snaking into chambers of the heart. Having a pacemaker implanted usually costs between $22,000 to $46,000. After going to the hospital with chest pains, 19-year-old Rama Kumari of Baldi, India, got a pacemaker from Heartbeat International in 1999. The family was so poor they could barely afford to eat. Today she's living a normal life. Giovanni Schwalm of Quilpuc, Chile, was born in 1996 with heart problems that put her in intensive care at 3 months old. The charity provided a pacemaker around Christmas that year, and she was home recovering on New Year's Day. She's now a healthy, active little girl. Doctors said 4-year-old Alexandra Repeto of Puerto Cavello, Venezuala, wouldn't live two weeks with a pacemaker after she was diagnosed with heart problems in 1999. On the 10th day, someone contacted the charity, which immediately provided one and arranged to have it implanted. Alexandra recovered. The availability of the donated devices and demand for them led Heartbeat International to establish 11 new pacemaker banks in the past five years, expanding during that time into Russia, Brazil, Suriname, Turkey and Venezuela. Those involved with Heartbeat International say its benefits go far beyond saving lives. And they're hoping the new moneymaking efforts will keep the charity's heart pumping well past the two-decade mark next year. "We call our pacemakers peacemakers," McIntosh said. "We think we are establishing international goodwill and lasting peace through this program. "It shows that doctors, representatives of the (pacemaker) industry and leaders of an organization like Rotary are able to pull together and do something worthwhile for the world."

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