Ten years after the initiation of congenital heart surgery in Guatemala: observations after a one year fellowship in the pediatric cardiac unit in a low income country.

High-tech medicine in a low income country remains a controversial issue. In September 1997, a congenital heart surgery program was initiated in Guatemala by Aldo Castañeda, emeritus Harvard Professor of Surgery and surgeon-in-chief at the Children's Hospital Boston. He trained 3 young pediatric cardiac surgeons and in addition assembled a team of pediatric cardiologists, intensivists, anesthesiologists, nurses and the necessary technical staff to develop a pediatric cardiac program in Guatemala. Faced with limited governmental financial support, he set up the Aldo Castañeda Foundation to ensure sustainability of the program. Now, 10 years after the initiation of this program, the pediatric cardiovascular unit (UNICARP) offers diagnosis as well as medical and surgical therapy to children born with a congenital heart malformation in Guatemala and neighboring countries. In addition, UNICARP offers training opportunities for young surgeons from abroad. The experience of one such trainee from Switzerland is highlighted in this report.