This post was authored by William Zoghbi, MD, MACC, immediate past president of the ACC.

Given global concerns regarding work force shortages, particularly in cardiology, a study recently published in JACC: Heart Failure conducted in rural Rwanda, suggests that training nurses and generalist physicians at the district level is one strategy to help improve health systems in areas with limited specialists, avoiding delays in care and needless suffering and improving health.

A previous study, the Heart of Soweto study, showed that heart failure was the most common new diagnosis of heart disease in South Africa, the majority of which was non-ischemic in etiology. Findings were similar in the current study. Heart failure services were set up in two rural district hospitals in Rwanda where nurses, supervised by physicians, were trained to use simplified diagnostic and treatment algorithms, such as echocardiography, with diagnoses confirmed by a cardiologist. Results showed that the causes of heart failure there are almost exclusively nonischemic even though patients often present with advanced symptoms. This study is important as it show that simple solutions and team work can improve patients’ diagnoses and overall cardiovascular care.

In today’s day and age, while technology and discovery continues to advance, current knowledge on cardiovascular health and prevention is actually plentiful to have a meaningful effect on overall health and outcome. However, we do have an issue with health care delivery in the U.S. and abroad and we need to strike a balance between exciting innovations and care delivery. (Read a related JAMA viewpoint article written by David Holmes, MD, MACC and me on the topic.) Although finding cures and improving the technology around us is important, isn’t it just as crucial to provide training and support to those in need?

To this end, there are several volunteer opportunities for members of the ACC to assist in combating disease and suffering in developing countries as doctors with specialized skills are in great demand to offer clinical and teaching services. One such organization, Health Volunteers Overseas (HVO), offers opportunities for highly qualified health care professionals to teach and train on short-term volunteer assignments in developing countries. Please contact international[at]acc.org and cardiologyeditor[at]acc.org if you plan to volunteer for any of the programs.

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