When Rubelis was just 1 month old, doctors discovered that her little heart had big problems. Oxygenated blood was entering the wrong chamber; a narrow valve opening was slowing the flow of blood; and the right-side chambers were enlarged. The challenges following such a diagnosis were heightened because of where Rubelis lives. In her home country of the Dominican Republic, open-heart surgery is an extremely rare procedure.

Rubelis and Dr. Casilang Rubelis with Clarisse Casilang, MD, a CHOP David N. Pincus Global Health Fellow Luckily, though, Rubelis was being cared for by Children’s Hospital of Philadelphia (CHOP) — thanks to a primary care program jointly operated by the CHOP Global Health Center and a local healthcare provider in the Dominican town of Consuelo. It was at the infant’s first visit to the clinic that Chloe Turner, MD, a CHOP David N. Pincus Global Health Fellow, detected a heart murmur. At a visit a few months later, Turner also determined that Rubelis was malnourished and enrolled her in the clinic’s nutrition program.

“Excellent primary pediatric care is important everywhere — whether a child is being seen in Cobbs Creek, Pennsylvania, or in Consuelo, Dominican Republic,” says Andrew Steenhoff, MD, Medical Director of the Global Health Center. “Once Chloe suspected a heart problem in Rubelis, further testing was needed — a situation where we rely on our partners. In global health, effective partnerships are vital to optimize care of children, despite the many challenges.”

Because CHOP Global Health works with the DR’s largest pediatric hospital, Rubelis was able to promptly receive the echocardiogram that revealed the specifics of her heart defects. Next, the CHOP clinicians managed her condition with medication while working diligently to locate a team that could perform the needed surgery.

Healthy all around

After more than a year and a half, the CHOP team connected with a visiting surgery group, who then successfully repaired Rubelis’ heart defects. Now 3 years old, Rubelis is healthy and has the energy to keep up with other kids. And because the CHOP team provided her with nutritional supplements and taught her mother about healthy eating, the shy but affectionate girl has achieved a normal weight for her height.

“CHOP’s global health programs in the DR and other locations partner with key in-country institutions to achieve health equity for all children by fostering excellence in every area — clinical care, advocacy, education and research,” says Steenhoff. “Rubelis’ story powerfully illustrates the profound impact that such programs can have on the life of a child.”