China Cal publishes its first annual report
This newsletter contains many items from our 2015 Annual Report. To view the entire report, please click here（pdf format.）
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Letter from the CEO
January 7, 2016
Founded in 2006, the China California Heart Watch（China Cal）celebrated its tenth birthday in Yunnan Province, China this year. Between 2006 and 2009, our focus was tackling the growing epidemic of high blood pressure in the rural areas of Yunnan through clinical screening programs and research. Our work in this area led to significant and sustainable improvements in the health of adults. In 2008, we discovered another important public health problem in Yunnan：a high prevalence of undiagnosed and untreated congenital heart disease in children.
By 2014, China Cal had begun focusing exclusively on efforts to improve the diagnosis and treatment of newborns and children living with congenital heart disease. Along the way, we developed innovative methods to improve early detection and treatment of pediatric heart disease, including:
Enlisting volunteers to screen school children for heart murmurs, an important clinical indicator of underlying congenital heart defects;
Securing financial assistance for impoverished children with complex heart disease who are not covered by insurance or Chinese charities;
Training local healthcare providers in modern, evidence-based techniques for examining the hearts of newborns.
China Cal employs a unique, boots-on- the-ground approach to solving this complex and challenging health issues. First and foremost, we maintain official registration in Yunnan with the Departments of Health, Public Affairs, Foreign Affairs and Public Security. Our CEO, CFO and most of our staff work in Yunnan Province for most the year. As an organization, we also have major contractual ties with Kunming Medical University and Dali Medical University, as well as partnerships with a number of notable Chinese charitable foundations. In addition, most of our volunteer staff are Chinese citizens. This approach allows us to monitor and control our use of resources and to leverage strong professional and personal ties within the Yunnan community.
2015 was our most successful year yet in terms of our impact on pediatric health in Yunnan. Our Newborn Training Program was approved by a committee of public health specialists from the University of California at Irvine, Peking University, and Kunming Medical University. This year, the program trained over 600 rural doctors and 400 nurses how to properly conduct newborn cardiac exams. In addition, our ongoing Grants for Kids Program provided diagnostic assistance for over 20 children with highly complex congenital heart defects.
2016 will see the completion of the Newborn Training Program and expansion of our Grants for Kids Program. Our Dali City Free Clinic, which just opened this year on the main highway between Dali Xia Guan and Dali Old Town, will see hundreds of kids for diagnosis, follow-up and referral. The clinic comprises 40 square meters and
is equipped for clinical and ultrasound examinations of pediatric patients.
We will continue to need your help in order to realize our training and patient care missions in Yunnan, and we encourage your continued participation and support.
Robert Detrano, MD, PhD
The mission of China Cal is to provide evidence-based cardiovascular training and care in rural Yunnan Province. In addition, we perform expert public health and epidemiological research related to our clinical care and teaching.
In the past five years, we screened over 90,000 school children for congenital heart disease and discovered over 600 children with heart defects. Of these, about 300 were amenable to interventional or surgical correction. Unfortunately, approximately 50 children had uncurable disease because diagnoses were not made earlier when treatment could have been life saving.
This latter group of underserved children prompted us to turn our focus toward province-wide pediatric congenital heart disease prevention, detection and treatment. In pursuit of this goal, our Newborn Training Program was instituted in 2014 in order improve and hasten diagnosis.
China Cal is determined to ensure that every newborn in Yunnan Province receives a proper heart examination at birth. We are also working to make sure that as many kids with heart defects as possible have access to the care that they need to live long and healthy lives.
How We Work
China Cal partners with Chinese hospitals, universities and charitable foundations and with American companies and foundations. Both of our programs, Grants for Kids and The Newborn Training Program, are dependent on these partnerships.
In China, China Cal is particularly appreciative of our collaboration with the Kunming Medical University First Affiliate Hospital, which is our official Chinese partner for all of our activities and programs in Yunnan Province. Our other Chinese partners include the China Overseas Student Development Foundation, the Ai You Foundation, the MEET foundation and the SOHU Foundation. These Chinese charities help support surgeries for the children with congenital heart disease that we discover and treat and form the financial backbone of our Grants for Kids Program. Because of our collaborations, a $3,000 pediatric heart surgery can cost far less, allowing us to stretch contributions from our Chinese partners further than otherwise possible. In addition, our Chinese partners often match individual donations several times over.
In Hong Kong, China Cal partners with the Hong Kong Children’s Heart Foundation, which provides about $25,000 of support for the Grants for Kids program each year.
In the United States, China Cal partners with the Ping and Amy Chao Foundation of Los Altos, California, and with the Masimo Corporation of Irvine, California — both of which help make our Newborn Training Program possible and successful. China Cal never accepts funding from foundations or corporations without the understanding that an ongoing collaboration is the only way to achieve a common goal to help the rural poor of Yunnan Province.
Our Programs：Grants for Kids
Our Grants for Kids Program was started in 2008 and is funded entirely by donations and grants. Children with heart defects are referred either to the China Cal Clinic in Dali or to our partner organization, the Kunming Medical University First Affiliate Hospital. These children undergo diagnostic assessment, their families submit completed applications and produce documentation of need to China Cal. After thoroughly reviewing each application, China Cal contacts its partner foundations and an appropriate surgical referral hospital to arrange treatment and negotiate payment for surgical and hospital services. In general, China Cal pays only about 20% of surgical costs directly. Its foundation partners pay about 60%, and the child’s family and insurance carrier cover the remainder.
In 2015, China Cal was responsible for the surgical, interventional, and medical treatment of 32 children with congenital heart disease. Fifteen of these children had heart defects that were considered so complex that most foundations refused support. Working with our partners and generous donors, China Cal found help and hope for these children.
We have recently turned our attention to children with complex heart defects, as they make up about 40% of all cases of pediatric heart disease and are not covered by local rural insurance or by many charitable foundations. In 2015, China Cal made the conscious decision to create our own donation fund to support surgeries for these children. We are also combining our fund with that of one of our partner organizations, the MEET Foundation, formerly called the West China Foundation. MEET and China Cal representa- tives met with representatives of the China Foundation for Poverty Alleviation in December（FUPIN）. FUPIN pledged ¥1,000,000 in aid to MEET for the treat- ment of Yunnan children with complex heart disease. In addition, we are thankful for the continued support from the Ping and Amy Chao Foundation and the Hong Kong Children’s Heart Foundation who are have renewed their grants to China Cal this year and who provide additional support for these important initiatives.
Newborn Training Program
Undiagnosed congenital cardiac shunt lesions with pulmonary hypertension and critical duct dependent congenital heart disease kill three to four children per 1,000 born in rural China. These heart defects are completely curable if discovered early in life; however, most go undetected for too long, rending a cure impossible. We are conducting a program to train doctors responsible for the care of neonates and small infants in rural Yunnan. Specifically, we are teaching the doctors modern, evidence-based cardiac examination techniques of neonates.
In 2015, we trained all relevant staff in 52 of 125 counties in Yunnan. During 2016, we plan to train all of the remaining county hospital doctors who are responsible for the care of newborns and infants less than one year of age.
Without appropriate evaluation, it will be difficult to convince other Chinese provinces or other developing nations to adopt similar programs. China Cal is fortunate to have found a young scholar, Ms. Fang Qi Guo, a PhD student at the University of California at Irvine Program in Public Health, who is excited about making this evaluation her doctoral research project. Ms. Guo has already participated in one of our training missions in Yunnan. Her ultimate goal is to use this project as a launching pad to help others in impoverished areas of China.