Kids in Yunnan given free heart disease screening

Deqin County is situated in the northwest of the Diqing Tibetan Autonomous Prefecture. More than 7000 square kilometers in area, it had a population of 67,000 by the end of 2018. The high altitude in this region, which is around 3400 meters, puts children living here at a higher risk of congenital heart disease.

However, the symptoms are not obvious. Hence, a lot of parents don't realize their children have the problem. Early treatment effectively avoids bigger problems later in life, so regular screenings are carried out each year.

In July this year, voluntary medical professionals from a variety of medical institutions across the country visit local primary schools in Deqin to help check if any children need treatment. Let's find out more.

Medical professionals visited an elementary school in Deqin County, Yunnan Province, in a bid to provide free congenital heart disease screening for infants and children. [Photo: from China Plus]

On a rainy day in July, a group of medical professionals from Beijing and Wuhan visit an elementary school in Deqin County to give free screening for infants and children.

Doctor Zhu Shuangli was doing an ultrasound scan for a local girl to check if she had congenital heart disease. [Photo: from China Plus]

Zhu Shuangli, a doctor from Beijing Royal Integrative Medicine Hospital, explains how the test is done.

"Three physicians here give a tentative diagnosis by pressing an echometer against their chests to detect heart noise. Then kids with heart noise will be sent to me to do an color ultrasound scan to confirm the illness. Ultrasound examination is one of the most effective methods of diagnosing heart disease."

Karma tested positive for congenital heart disease received surgery half a year ago. She was with her math teacher Tenzin in the classroom. [Photo: from China Plus]

A second-grade girl, Karma, aged nine, is escorted by her teacher to do an ultrasound test. She was screened last year and found to have some problem. Then she had surgery around half a year ago.

Now it's about to see how well she's recovered. All the medics gather around to see the result of the ultrasound.

Doctor Zhu says the 3D images indicate a chest tube was placed around Karma's heart during the surgery. It shows that she has recovered quite well. Doctor Zhu asks the girl where she recieved surgery.

Karma answers that she got it in Nanjing in Jiangsu Province, on the east coast of China.

Doctor Li uses a stethoscope to check whether a student has a heart murmur during the screening. [Photo: from China Plus]

Li Rui, a doctor from Wuhan Tongji Hospital who is responsible for identifying heart noise during the screening, says she is very happy to hear the news.

"The screening is very meaningful and helpful. If they hadn't been diagnosed with heart noise when they were little, they would probably fail the health checks they have to take when they apply for future jobs. Early treatment effectively stops anything more serious or complicated from developing."

Karma goes back to her classroom for her maths class. When the class finishes, Karma's teacher Tenzin, who has been teaching Karma since grade one, remembers her being diagnosed with heart disease.

"Last year when she was in grade one, a screening was carried out. She was found to have some heart problem. About half a year later, in the first term of her second year, she was taken out of the class. Later, I heard from the organizer of the screening that she would get surgery soon. In the following month, she didn't come to school and asked for sick leave. Now she is quite well but has to avoid intensive sports."

Students were waiting in a line to get the screening. [Photo: from China Plus]

The common heart problem in this area is funnel chest, also known as sunken chest or Pectus excavatum. It's a developmental defect which causes a depression in the sternum and ribs, accompanied by various disorders of the respiratory and cardiovascular systems.

Doctor Li says during the past few days of screening, she's found Tibetan children have a higher risk of getting funnel chest.

"I found over a dozen students with funnel chest from three local primary schools in the past few days. Two of them I highly recommended to have surgery as soon as possible."

According to Doctor Li, sunken chest is mainly caused by Calcium Deficiency. The shape of the human sternum is funnel-shaped. If a child lacks Calcium, the ribcage can develop abnormally, with the breastbone growing inwardly.

This results in a noticeable and sometimes severe indentation of the chest wall, which means the heart does not have enough space to grow or beat. In this case, minimally invasive surgery is required to fix it.

Metal plates will be placed at each side of breastbone to reshape the sternum. They can be removed after two years, once the bones have fixed themselves. Doctor Li says the best age for the surgery is under 12.

Zhu Zhui has been the headmaster in Deqin Demonstration Elementary School for eight years. [Photo: from China Plus]

Headmaster Lu Zhui agrees with Doctor Li. He explains why these children tend to have calcium deficiency issue.

"Every child has eggs and milk each day. But many of them love snacks without much nutrient, especially spicy ones made with flour. We give them nutritious food every day before lunch, including milk, bread and fruit. As we don't have a microwave in school, the students often take it home. So we have no idea if they eat it. I guess we need to make sure students eat nutritious food to prevent similar diseases."

The screening for congenital heart disease lasted for four days and nearly 1500 students in the Diqing Tibetan Autonomous Prefecture received it, with a total of 28 students found to have positive signs of the disease. They will be re-examined this month to see if surgeries are needed.

(Written by Chen Ziqi; narrated by Yang Yong)