The Story


Open Heart is the story of eight Rwandan children who leave their families behind and embark on a life-or-death journey to receive high-risk open-heart surgery in Africa’s only free-of-charge, state-of-the-art cardiac hospital, the Salam Center run by Emergency, an Italian NGO. Their heart valves, damaged and weakened by rheumatic heart disease, which develops from untreated childhood strep throat, leave them lethargic and weak. Some of the children have only months to live.

During their cross-continental journey, Open Heart reveals the intertwined endeavors of Dr. Emmanuel Rusingiza, Rwanda’s lone, overworked public cardiologist, and Dr. Gino Strada, the Salam Center’s head surgeon. As one of Emergency’s founders, he must fight not just for the children’s lives but for the tenuous financial future of the hospital.

While heart disease is often associated with the excesses of Western nations, severe cardiac diseases requiring surgery are extremely prevalent in resource-poor Sub-Saharan Africa.

Because medical treatment is often unavailable, minor maladies like strep throat are often left untreated, and lead to a host of complications, including rheumatic fever, which – especially in young children and teenagers – can permanently damage the heart valves. Children with the weakened valves show symptoms of fatigue, fever, bloody coughing and trouble sleeping. They quickly become weaker as their valve tissue deteriorates, and open-heart surgery – while invasive, dangerous, and prohibitively expensive – quickly becomes the only option to repair or replace the damaged valves and save the children’s lives.

There are an estimated 18 million people afflicted with rheumatic heart disease and in need of urgent surgery, almost two thirds of them children, and the disease kills 300,000 people per year. Despite those facts, the Salam Center remains the only facility in Africa capable of such high-standard cardiac surgery, free of charge.

At once a marvel of modern medical engineering and the triumph of an idea, Salam is key in Emergency’s plan to treat and reduce heart diseases in an area three times the size of Europe and home to 300 million people. Building a world-class, technologically advanced cardiac diagnostics and surgery facility in the middle of a desert in Northern Sudan is an impressive feat on its own. Making its services free (including lifelong regimens of prescription drugs and follow-up visits) to anyone who steps through its doors is just shy of revolutionary.

The idea that “the Right to be Cured” should be accessible and free of charge to every member of the “human community,” is part of Emergency’s operating ethos. To accomplish that, the Center serves as a hub for the program for pediatrics and cardiac surgery that Emergency is implementing throughout its own medical facilities and local hospitals across Africa.

Dr. Gino Strada

The pioneer of this medical marvel is Dr. Gino Strada, an Italian war surgeon with a resume that reads like the complete history of modern international conflict zones. One of the founding members of Emergency, Gino’s life’s work is to bring the highest standard of excellence in surgical care to the world. He is a fierce supporter of universal healthcare without precondition.

“One thing is to have the same rights on paper. A completely different story is when you look into the content of what you call rights. My right to health care as a European cannot include a CT scan and sophisticated diagnosis, but the right to be cured for an African stops at the level of a couple vaccinations and a few antibiotics.”Dr. Gino Strada, 2012

Dr. Emmanuel Rusingiza

Rwanda’s only public cardiologist, Dr. Emmanuel Rusingiza works tirelessly and with a marked lack of resources, but thrives in a country that is ambitious in its plan to provide true healthcare as a human right to all of its citizens. Despite the country’s remarkable strides in many areas of health care, often by the time patients arrive in the public hospital where Dr. Emmanuel works, they have been living with untreated rheumatic fever or other heart disease for years. Emmanuel knows that the Salam Center is a vital link for Rwanda, a country of 11 million people but no high-standard cardiac surgery facilities.

“If we see a patient dying because it’s too late to do surgery, or it’s not possible…it’s very hard on me…when you know that there is something which should be done but which has not been done because you don’t have the means.”Dr. Emmanuel Rusingiza, 2012


When Angelique was three years old, doctors diagnosed her first with a chronic cough, then lung cancer, and finally rheumatic fever. She spent two years in and out of hospitals in Kigali, never able to spend more than three weeks at home before falling ill, requiring another lengthy hospital stay. Her father sank deeper into debt, borrowing huge sums of money, unable to pay for food, travel or her constant treatment. Upon arrival at the Salam Center, Angelique’s condition was met with grave concern. At the medical meeting before her surgery, surgeons were “not optimistic” about the feasibility of repairing her valves.

“If they would fix my heart, I would thank God.”Angelique Tuyishimere, Age 6, 2011


Marie, now 17, has been sick for almost a decade. When she first started seeing blood in her cough, her father left his farm and sold his livestock to take her to several far-flung hospitals in Rwanda, staying by her bedside every day for years of treatment, including donor-funded surgery in India. She failed to recover even from that surgery, but as this year’s crops were spoiling and the family going increasingly hungry, Marie was accepted for treatment at the Salam Center as a critical case. She arrived at the Salam Center with a hole in her aortic valve, as a Class II heart disease patient, and needing urgent mechanical valve replacement.

“She has suffered a lot from this sickness. I keep missing her but I put my heart at ease telling myself that even though we are far apart, she is getting healed. .”Minani Claver, Marie’s Father, 2012