A CONTROVERSIAL OASIS OF HEALTH CARE

"The center is largely funded by private donations, with additional support from the Sudanese government, which has committed two and a half million dollars a year. The organization estimates that, with its current infrastructure, a single valve replacement costs two thousand dollars, half of that being the cost of the valve itself; in the United States, the surgery could cost upward of thirty thousand dollars. Still, Sudan’s total per-capita expenditure on health in 2011 was less than two hundred dollars. On a continent where nearly fifty per cent of deaths in children under five are attributable to malnutrition and thirty per cent are preventable with vaccines, the argument for directing efforts toward improved primary care, rather than expensive specialized surgery, is compelling. One of the facility’s critics is Fred Cobey, an anesthesiologist at Tufts Medical Center, who worked at the Salam Centre for three months in 2010. 'Millions and millions of dollars have been poured into this place,' he told me. 'Even after working there, I still feel the money could be better spent elsewhere, like on basic health services. You saw how poor the surrounding area is; people have nothing.' The official position of the World Heart Federation is that surgery for rheumatic heart disease is 'a drain on the limited health resources of poor countries.'"